For many years, menopause discussions have mainly centered on estrogen and progesterone. However, testosterone is increasingly recognized as an important hormone affecting women’s health during this stage of life.
Testosterone, naturally produced by the ovaries and adrenal glands, rises during puberty and peaks in a woman’s early twenties. From the mid-thirties onward, levels slowly decline, with a sharper drop during perimenopause and menopause. This decline can influence energy, mood, and sexual desire.
“Testosterone is often associated with men and muscle building, but women need it too, just in smaller amounts,” explains Dr. Ceri Cashell, a women’s health GP and co-founder of the Healthy Hormones platform. “For many women, especially after menopause, restoring testosterone can bring significant benefits.”
Currently, testosterone therapy is approved only for treating hypoactive sexual desire disorder (HSDD) in post-menopausal women, a condition marked by persistently low libido. However, emerging research suggests testosterone may also help improve cognitive function, bone density, mood, pain, and migraines linked to menopause.
“For some, testosterone therapy can be transformative. Others may notice improvements in energy, motivation, joint pain, mental clarity, and mood,” says Dr. Cashell.
Like other hormone therapies, testosterone is usually applied as a skin cream, which allows the hormone to enter the bloodstream gradually. However, careful monitoring is essential to avoid side effects such as acne, increased facial hair, or hair loss, particularly if doses are too high.
Although testosterone has been prescribed for decades in countries like Australia, it remains largely off-label for women and is not yet officially subsidized through programs like the Pharmaceutical Benefits Scheme (PBS). This means many women must pay out of pocket, often at a cost exceeding $100 per tube, making long-term use expensive.
Dr. Cashell highlights the disparity: “Men have nine testosterone products covered by the PBS, but women have none. This exclusion is unacceptable.”
Advocates, including Dr. Cashell, are campaigning for testosterone therapy to be added to the PBS to improve access and equity. A petition supporting this cause has already gathered over 10,000 signatures.
Recent progress saw three menopausal hormone therapies added to the PBS earlier this year — the first government subsidy for such treatments in over twenty years — fueling hope that testosterone therapy will soon follow.
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