Menopause and Testosterone

Testosterone is thought of as “the male hormone”, but testosterone also plays an important role in women. Testosterone in women is produced in the ovaries and the adrenal glands. The ovaries produce testosterone even after menopause. Women who have their ovaries removed are at significant risk for decreased testosterone levels and the subsequent symptoms associated with it.

Testosterone has many functions. In women the hormone is responsible for many male characteristics, such as hair growth, muscles, sex drive and a deeper voice. In females, it is essential for the proper functioning of the ovaries, the libido and is necessary for bone strength as well as the development of lean muscle mass and strength. Testosterone also contributes to an overall sense of well-being and energy level. It is best known for its crucial role is a woman’s sex drive or libido. Testosterone in women is responsible for the sensitivity of a woman’s nipples and clitoris and associated with sexual pleasure. Testosterone not only enhances the sexual mood of women, but the overall sexual experience as well.

Menopause and Testosterone

Similar to other hormones, the onset of perimenopause and menopause causes the decline in production of testosterone (by at least 50%) in women. A hysterectomy, with or without removal of the ovaries, will also cause a more significant decline in testosterone levels. High stress levels can also contribute to symptoms earlier in the perimenopause when a woman is in her late thirties or early forties. Symptoms include less energy, brittle hair, loss of bone and muscle strength and a diminished sexual drive. Some prescription drugs can also result in lower levels of testosterone for women.

Abnormally high testosterone levels in women can lead to a variety of symptoms. Women with high testosterone levels may develop male pattern hair growth, especially on their faces and chests. More rarely, and over time, some women may experience virilization, which is increased muscle mass, redistribution of body fat, enlargement of the clitoris, deepening of the voice, male pattern baldness, acne, and/or increased perspiration. It is important to note that some women develop hirsutism without having a high testosterone level.

Hormone testosterone does impact sex drive — as well as remedy other sexual problems — in certain women with sexual dysfunction but the long-term safety of testosterone therapy for women has not been studied. For this and other reasons, some doctors hesitate to recommend it. Testosterone therapy usually is prescribed only for women who have sufficient estrogen levels.

Testosterone therapy may be prescribed if:

  • There is reduced sexual drive, depression and fatigue after surgically induced menopause, and estrogen therapy hasn’t relieved the symptoms
  • You are postmenopausal, taking estrogen therapy and have a decreased sex drive with no other identifiable causes

The Food and Drug Administration does not approve testosterone preparations for use in women. If testosterone is prescribed, it’s for off-label use. Although testosterone contributes to healthy sexual function in women, many other factors contribute to postmenopausal sexual dysfunction. These include decreased estrogen levels, vaginal dryness, medication side effects, chronic health conditions, loss of a spouse or partner, lack of emotional intimacy, conflict, stress or alterations in emotions and mood.