When women think of menopause, estrogen often takes center stage. The ovaries stop producing estrogen, menstruation ceases, and symptoms such as mood swings, anxiety, depression, insomnia, night sweats and urinary and sexual issues commonly arise. Treatment typically involves estrogen, antidepressants and sleep medications. However, many of these symptoms are also linked to a deficiency in testosterone—a critical hormone that often gets overlooked.

Like men, women have testosterone receptors in almost every organ and tissue in their bodies. Testosterone plays a vital role in numerous bodily functions and is, in fact, the most abundant active hormone in both men and women. In women, the ovaries produce more testosterone than estrogen. Even after estrogen production stops during menopause, the ovaries continue to produce testosterone, albeit at lower levels.

Women’s testosterone levels decline earlier and more rapidly than estrogen. Starting in their 20s, women experience a gradual decline in testosterone, losing about half of it by age 40.

Symptoms of low testosterone in women can include:

• Fatigue
• Brain fog
• Insomnia
• Irritability
• Anxiety
• Depression
• Weight gain
• Mood swings
• Decreased sex drive

In addition to these symptoms, low testosterone in women is associated with an increased risk of breast cancer, Alzheimer’s disease, osteoporosis, diabetes and heart disease. 

Research suggests that testosterone can protect the heart, brain, bones and breasts. Women who undergo testosterone replacement therapy often report improved well-being, increased strength, decreased weight, and even thicker skin with fewer wrinkles.

If you suspect you might benefit from testosterone replacement, it’s important to consult with a provider experienced in hormone replacement therapy. A thorough evaluation, including lab work and a detailed history and physical exam, is essential.

Despite extensive research supporting the safety and effectiveness of testosterone therapy for women, no FDA-approved testosterone formulations are currently available for women outside of treating hypoactive sexual desire disorder (HSDD). Most options—such as bioidentical creams, pellets or troches—are provided by compounding pharmacies and are considered “off-label” use. Your provider will discuss the risks and benefits to help you make an informed decision.

Testosterone replacement can benefit women of all ages, from their 30s to their 70s, when medically indicated. Its potential to prevent disease and improve quality of life makes it a treatment worth exploring.