Exploring Testosterone Treatment in Midlife Women
At 42, I learned from a menopause specialist that my testosterone levels were low enough to consider treatment. Honestly, I was skeptical. I had spent several years trying to find out what was going on with my health, thinking it was perimenopause, only to discover it was something else entirely—premenstrual dysphoric disorder. This condition brought about severe PMS and significant mental health challenges during the last part of my menstrual cycle. I was eager for something, anything, to help with my low mood, anxiety, joint pain, and sleepless nights. So, being advised to apply testosterone gel to my thighs took me by surprise. But by that point, I felt I’d try just about anything to feel better.
I began joining a growing group of midlife women who are taking testosterone daily. Notable figures like Kate Winslet, Halle Berry, and Prue Leith have come forward about their experiences. Leith, at 86, recently talked in an interview about using testosterone to enhance her libido and overall well-being. Women’s testosterone levels typically peak in their twenties before gradually declining until menopause, where they stabilize. While our testosterone levels are much lower than men’s, this hormone plays a crucial role in sex drive, sexual satisfaction, and is also important for various reproductive functions. Recent research suggests it may even influence memory, cognitive function, bone health, and recovery from injuries. Some studies are now looking at the connection between decreasing testosterone and muscle loss in women.
There’s significant debate in the medical community regarding the appropriateness of prescribing testosterone to midlife women. Some private doctors and menopause advocates argue that low doses can be safe—as long as blood levels are monitored—and that if it helps with issues like bone density or anxiety, women should have better access to it. However, others caution that there’s insufficient evidence supporting these claims.
According to the National Institute for Health and Care Excellence (NICE), decreased libido is the sole approved reason for NHS doctors to prescribe testosterone to women, and only after trying other treatments. Receiving a prescription for different reasons could mean getting it “off label.” I found this incredibly frustrating. My doctor had a hopeful outlook that testosterone might alleviate my mental fog and insomnia, while NICE seemed primarily focused on whether I was still interested in sex, which wasn’t my primary concern.
Upon doing some research, I noticed the prevailing theme in medical literature focused almost exclusively on libido, relegating mental health, fatigue, and bone density topics to afterthoughts in later paragraphs. There’s a reason for this, and it ties into more systemic issues in women’s health. Dr. Helen Wall, a GP specializing in menopause, pointed out that both the British Menopause Society and NICE maintain there’s no strong evidence supporting testosterone use outside of low libido. Moreover, she emphasized a lack of long-term safety data regarding its effects on breast or heart tissue, complicating the decision to prescribe something that isn’t licensed.
Dr. Wall has seen benefits in about half of the women she prescribes testosterone to, who report improvements in mood and energy. Yet, for others, there are no noticeable changes—so it’s not a guaranteed solution. She’s open to the positive testimonials but acknowledges the gap in supporting research.
Professor Susan Davis, a leading expert on women’s hormones, is critical of prescribers who don’t adhere strictly to the low libido guideline. She notes that blood tests meant to identify low testosterone aren’t reliable since they struggle to accurately indicate low levels and the concept of a clinical diagnosis for low testosterone doesn’t currently exist.
Some women’s health activists, like Kate Muir, argue against these restrictions. Muir believes testosterone affects energy, mood, and cognitive function, not just libido. She shares her commitment to continue using testosterone, emphasizing how broader knowledge about its effects on women’s health has, unfortunately, been overshadowed by antiquated views that focus solely on sexual desire. Muir advocates for a reevaluation of NHS guidelines to consider the hormone’s potential impact on overall brain health and well-being.
After trialing testosterone for six months, I wasn’t sure it was really addressing my other symptoms aside from boosting my libido, but I did experience side effects like acne and chin hair, which led me to stop. Following a return of my previous symptoms several months later, I resumed treatment four months ago, this time with Testogel. I wish there were clearer safety data and guidelines, yet unless significant risks are identified, I feel that remaining on it is my best option.
