Testosterone in women at midlife: what the evidence says

By Dot by Kindr Health · Published October 2, 2026 · Updated October 2, 2026

Medical review, clinical protocols and prescribing overseen by Kindr Health Inc. • NPI 1609792902

Women produce testosterone in the ovaries and adrenal glands, and levels decline gradually with age rather than suddenly at menopause. A 2019 international consensus found the only evidence-based use of testosterone in women is for postmenopausal women with hypoactive sexual desire disorder (distressing low desire) after evaluation. It is not supported for energy, mood, bone, or cognition.

What the consensus says

  • Testosterone may modestly improve desire, arousal and satisfaction in postmenopausal women with diagnosed HSDD.
  • Doses should aim for levels in the normal female range.
  • There is no FDA-approved testosterone product for women in the United States; male products are not designed for women's doses.
  • Blood levels alone should not be used to diagnose low desire.

Other causes of low desire

Low desire often has several contributors, including vaginal pain from GSM, sleep problems, mood, relationship factors and medicines. These are usually addressed first.

When to talk with a healthcare professional

  • Symptoms are affecting your sleep, work, relationships or daily life.
  • You want to know whether a treatment fits your personal and family health history.
  • Low desire is distressing to you, or sex has become painful.

How Dot can help

Dot offers a private place to note intimacy, sleep and mood changes together, which can make a sensitive conversation easier to start.

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Related topics

Sources

  1. Endocrine Society (with international menopause societies). Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab 2019;104(10):4660–4666 (2019).
  2. The Menopause Society. The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause 2022;29(7):767–794 (2022).

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