The Menopause Medic Resources

Testosterone Replacement Therapy in Perimenopause & Menopause

Introduction

Testosterone is often thought of as a “male hormone,” but it plays an important role in women’s health too. Levels naturally decline with age, and during perimenopause and menopause this can impact libido, energy, cognition, muscle and bone health, and overall vitality.

While most women will benefit from oestrogen- and progesterone-based menopausal hormone therapy (MHT, commonly called HRT), some continue to experience low sexual desire and other symptoms. In these cases, testosterone may be considered as an additional treatment under specialist care.

What Do Guidelines Say?

In the UK, NICE guidelines recommend testosterone supplementation only for women with Hypoactive Sexual Desire Disorder (HSDD) where HRT alone has not been effective [1].

However, clinical evidence and practice suggest some women may also experience improvements in areas such as energy, mood, cognition, sleep, hair, skin, and musculoskeletal health when testosterone is used appropriately under specialist supervision [2][3].

Recent Developments – AndroFeme Cream

In 2025, AndroFeme® testosterone cream was approved by the MHRA for postmenopausal women in the UK [4]. This is the first licensed testosterone product for women in the UK, providing reassurance around quality, safety, and consistency of prescribing. It is applied topically and dosed specifically for women, unlike previous “off-label” adaptations of male products.

Potential Benefits of Testosterone Therapy

When prescribed carefully by an accredited specialist, testosterone therapy may help to:

Improve sexual desire, arousal, and satisfaction (in cases of HSDD)
Enhance energy and vitality
Support cognitive function and clarity
Improve sleep and mood regulation
Maintain muscle and bone health

Safety and Side Effects

Testosterone for women should always be prescribed at low, carefully monitored doses. Side effects are usually mild and may include skin irritation at the application site, mild acne, or increased hair growth in treated areas.

When used correctly, testosterone therapy has not been shown to increase risks of breast cancer, cardiovascular disease, or clotting events [2]. Regular monitoring by a menopause specialist is essential to ensure safety and effectiveness.

How It Works in Practice

Testosterone is usually prescribed as a low-dose transdermal gel or cream (such as AndroFeme®). Treatment is typically trialled for 3–6 months to assess impact. If beneficial, ongoing prescribing may be managed in partnership between a specialist and the patient’s GP.

When to Discuss Testosterone Therapy

You may wish to explore testosterone therapy if you are:

Experiencing low sexual desire (HSDD) not improved with HRT
Struggling with persistent fatigue, cognitive fog, or low mood despite other treatments
Interested in understanding whether testosterone could form part of a tailored menopause management plan

Specialist Support Across the UK

At The Menopause Medic, testosterone replacement therapy is offered by specialist accredited clinicians following a detailed consultation. Appointments are available in person in Berkhamsted and St Albans, or virtually across the UK, giving women nationwide access to safe and evidence-based care.

References

[1] NICE NG23 – Menopause: Diagnosis and Management: https://www.nice.org.uk/guidance/ng23
[2] British Menopause Society – Testosterone in the management of HSDD: https://thebms.org.uk
[3] Health in Menopause – Testosterone cream for women: https://healthinmenopause.co.uk/testosterone-cream-for-postmenopausal-women-uk/
[4] Lawley Pharma – AndroFeme approved for UK postmenopausal women: https://www.lawleypharm.com.au/news/mhra-approves-testosterone-cream-for-uk-postmenopausal-women/

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