Postmenopausal women using testosterone therapy may have a greater risk of heart attack, stroke and other cardiovascular problems, according to new research.
The study, presented last month at The Menopause Society’s 2026 annual meeting in San Diego, examined more than 6,000 women aged 45 and older. Researchers compared women who received testosterone with those who did not, excluding anyone with a previous history of cardiovascular disease.
Among women who used testosterone, 3.8% experienced a first cardiovascular event, compared with 0.5% of women who did not receive the therapy, The Menopause Society reported. Events included heart attacks, strokes, heart failure and other cardiovascular conditions.
Testosterone is produced by the ovaries and adrenal glands. It plays a role in sexual desire, muscle and bone health, mood and cognition, according to the Cleveland Clinic.
Anna Cabeca, a Dallas-based OB-GYN and menopause specialist who was not involved in the research, said the difference between the two groups is worth taking seriously, though the results need to be interpreted carefully.
“The difference between 3.8% and 0.5% is certainly significant enough to warrant attention, but we need to be careful about what these numbers actually tell us,” Cabeca said.
Put another way, the figures represent about 38 cardiovascular events per 1,000 women receiving testosterone, compared with five per 1,000 among those who were not, she noted.
Cabeca said clinicians considering testosterone for a patient should take her overall health into account, including heart history, blood pressure, cholesterol, metabolic health, medications and family history.
“Sexual health is an essential part of overall health, and women deserve to have their concerns about libido, arousal and intimacy taken seriously, particularly during and after menopause,” she said.
Testosterone may improve sexual desire and satisfaction for some postmenopausal women, Cabeca said, but those potential benefits should be weighed against possible risks. When the treatment is appropriate, she favors careful dosing and ongoing checks of symptoms and lab results.
The researchers cautioned that the findings have limitations. The study was observational: it tracked outcomes among women already using testosterone rather than assigning treatment in a controlled trial. That means it can identify an association but cannot establish that testosterone caused the cardiovascular events.
Women taking testosterone may also have differed from those who did not in ways that affect heart risk, including age, blood pressure, diabetes, cholesterol or other health factors, Cabeca said.
“This is an important safety signal that deserves further investigation, not definitive evidence of causation,” she said.
