Testosterone Therapy for Women (TTW): Benefits, Risks, and Who May Be Eligible
August 06, 2026
Changes in hormone levels can affect women in many different ways. During perimenopause and menopause, symptoms such as low sexual desire, reduced sexual satisfaction, tiredness and changes in wellbeing may become more noticeable.
While testosterone is often thought of as a male hormone, women naturally produce it too. It contributes to normal sexual function and plays a wider role in women’s health throughout adult life.
For some menopausal women with persistent and distressing low sexual desire, testosterone therapy for women may be considered when appropriately managed hormone replacement therapy has not provided sufficient improvement.
However, testosterone is not a general treatment for every symptom associated with menopause. It is a prescription-only medicine that should only be used following a clinical assessment, with appropriate blood testing and ongoing monitoring.
In this guide, we explain what testosterone treatment for women in the UK involves, its potential benefits and risks, and who may be eligible.
Understanding Testosterone Therapy for Women
Testosterone is produced naturally by the ovaries and adrenal glands. Although women have lower testosterone levels than men, the hormone still contributes to sexual desire, arousal and general sexual wellbeing.
Testosterone levels tend to decline gradually with age. The reduction may be more sudden in women who have had their ovaries surgically removed or whose ovarian function has been affected by certain medical treatments.
A lower testosterone blood result does not automatically mean treatment is necessary. Testosterone levels vary between individuals, and there is no single blood result that confirms whether a woman’s symptoms are caused by low testosterone.
Instead, eligibility for treatment is assessed by considering the woman’s symptoms, medical history, current HRT, medicines, blood test results and other possible causes of low sexual desire.
Current UK guidance primarily supports testosterone therapy for menopausal women experiencing distressing low sexual desire when conventional HRT has not been sufficiently effective.
Who May Be Eligible for Testosterone Therapy?
A woman may be considered for testosterone therapy when she is experiencing persistent low sexual desire associated with menopause and the symptom is causing personal distress or affecting her wellbeing or relationships.
Treatment may be considered for women who:
- Are perimenopausal or postmenopausal
- Have experienced natural or surgical menopause
- Have persistent and distressing low sexual desire
- Have already had their conventional HRT reviewed and optimised, where appropriate
- Have had other possible causes of reduced sexual desire considered
- Have no contraindications that would make treatment unsuitable
- Are willing to attend follow-up reviews and blood tests
Testosterone therapy is not prescribed based on a blood test result alone. Before recommending treatment, a clinician should also consider whether the symptoms may be related to another physical, psychological, relationship or lifestyle factor.
Possible contributors to low sexual desire include vaginal dryness, pain during sex, stress, poor sleep, relationship difficulties, low mood, thyroid problems and side effects from certain medicines.
Some antidepressants, for example, can affect sexual function. Menopause symptoms such as night sweats, disturbed sleep and vaginal discomfort may also reduce sexual interest without testosterone being the main cause.
There is currently less evidence supporting testosterone therapy in premenopausal women. Treatment in younger women requires careful clinical consideration and may not be suitable in many cases.
What Are the Benefits of Testosterone Therapy for Women?
The best-supported benefit of testosterone therapy is an improvement in sexual desire and sexual wellbeing in appropriately selected postmenopausal women.
For eligible patients, potential benefits may include:
- Boost Libido, improve sexual desire and arousal, Greater sexual satisfaction
- Enhance energy levels and decrease fatigue
- Improve cognitive function: Promotes mental clarity, memory, and attention
- Lowers the incidence of osteoporosis and aids in maintaining muscle mass
- May alleviate irritation, anxiety, and depressive feelings
The response to treatment varies between individuals. Some women may experience a noticeable improvement, while others may find that testosterone makes little or no difference.
Some women also report improvements in energy, motivation, concentration or general wellbeing. However, the evidence for these wider benefits is less conclusive.
Testosterone should not be promoted as a proven treatment for weight loss, depression, anxiety, brain fog, tiredness, muscle gain or general anti-ageing. These symptoms can have many different causes and may require separate investigation.
Risks and Possible Side Effects
Testosterone therapy is generally prescribed at a much lower dose for women than for men. The aim is to keep testosterone levels within the normal physiological range for women.
When the dose is appropriate and treatment is properly monitored, side effects may be less likely. However, all prescription medicines carry potential risks.
Possible side effects of testosterone therapy include:
- Acne or oily skin
- Increased facial or body hair
- Hair growth around the application area
- Scalp hair thinning (rare)
- Deeper voice (rare)
- Enlarged Clitoris (rare)
- Changes in mood
- Weight gain or fluid retention
- Testosterone levels rising above the female physiological range
Less common androgenic side effects may include deepening of the voice, enlargement of the clitoris, or male-pattern hair loss. Some of these effects may not be fully reversible, particularly when treatment continues despite excessively high testosterone levels.
The long-term effects of testosterone therapy in postmenopausal women are not yet fully understood. The BNF notes that unwanted hair growth, frontal balding and voice deepening are among the possible adverse effects.
Patients should contact their prescribing clinician if they develop unexpected hair growth, significant acne, scalp hair loss, voice changes or other concerning symptoms.
How Does Testosterone Therapy Work?
Testosterone treatment for women is commonly supplied as a gel that is applied to the skin. The testosterone is gradually absorbed through the skin and into the bloodstream.
Products that may be considered include:
Many testosterone gels available in the UK were originally licensed for treating testosterone deficiency in men. A qualified clinician may prescribe one of these medicines at a significantly lower dose for a woman when they consider it clinically appropriate.
This is known as off-label prescribing. It means the medicine is being used outside the specific terms of its UK marketing authorisation. It does not mean that the medicine is illegal, but the prescriber must be satisfied that there is sufficient clinical justification for its use.
The exact dose and application instructions depend on the product and the individual patient. Women should never estimate their own dose, increase the amount without medical advice or use testosterone prescribed for another person.
Applying Testosterone Gel Safely
Patients should always follow the instructions given by their prescriber and the patient information leaflet supplied with the medicine.
General precautions may include applying the prescribed amount to clean, dry skin, allowing it to dry before dressing and washing the hands thoroughly after application.
It is also important to prevent the gel from transferring to another person through skin-to-skin contact. Once the gel has dried, the application area may need to remain covered by clothing.
Contact with the treated area should be avoided until the gel has dried fully. Particular care should be taken around children, partners and pregnant women.
The application site and instructions can differ between products, so patients should follow the directions given for the specific medicine they have been prescribed.
Testosterone Therapy and HRT
Testosterone therapy is not usually a replacement for conventional hormone replacement therapy.
Standard HRT commonly replaces oestrogen and, when needed, progesterone or another progestogen. It may help relieve symptoms such as hot flushes, night sweats, disturbed sleep, vaginal dryness and menopause-related mood changes.
For women experiencing low sexual desire, a clinician will usually review whether their existing HRT is suitable and properly optimised before considering testosterone.
This may include reviewing:
- The type and dose of oestrogen
- Whether oral or transdermal HRT is more appropriate
- Whether vaginal oestrogen is required for dryness or discomfort
- Whether another medicine is affecting sexual function
- Whether pain during sex is contributing to reduced desire
Vaginal dryness and discomfort should be addressed because painful sex can significantly affect sexual interest and satisfaction. Testosterone alone may not resolve these symptoms.
NICE recommends considering testosterone supplementation for low sexual desire associated with menopause when HRT alone has not been effective.
This means testosterone may be used as an additional part of female hormone therapy, rather than as a substitute for appropriately prescribed menopause HRT.
Is Testosterone Therapy Safe?
Testosterone therapy may be suitable for selected women when it is prescribed at an appropriate dose and monitored by a qualified healthcare professional.
However, it will not be suitable for everyone.
Treatment may be unsuitable or require specialist input for women who:
- Are pregnant, trying to conceive or breastfeeding
- Have active or significant liver disease
- Have unexpectedly high testosterone levels before treatment
- Have symptoms or a medical condition associated with androgen excess
- Have certain hormone-sensitive cancers
- Have unexplained symptoms requiring further investigation
Women with a history of breast cancer or another hormone-sensitive condition may need advice from a clinician with appropriate specialist expertise before testosterone is considered.
The benefits and risks should always be discussed individually. Completing a consultation does not guarantee that testosterone will be prescribed.
Safety and Monitoring During Treatment
Clinical monitoring is an essential part of testosterone treatment for women. It helps confirm that the medicine is providing a meaningful benefit and that testosterone levels remain within the normal female physiological range.
Before Starting Treatment
Before prescribing testosterone, the clinician will usually review the patient’s symptoms, medical history, current medicines and HRT.
A baseline total testosterone blood test is normally required. This does not diagnose low sexual desire, but it helps identify unexpectedly high levels and provides a baseline for future monitoring.
Depending on the individual’s medical history, other blood tests may also be recommended.
Monitoring After Treatment Begins
A follow-up testosterone blood test is usually arranged after treatment has started. The timing will depend on the product, dose and clinical plan.
Further reviews may assess:
- Whether sexual desire has improved
- Whether the improvement is meaningful to the patient
- Whether any side effects have developed
- Whether the gel is being applied correctly
- Whether testosterone levels remain within the appropriate range
- Whether the dose should be adjusted
- Whether treatment should continue
The latest British Menopause Society guidance recommends checking testosterone before treatment, repeating testing after treatment begins and continuing monitoring during longer-term use. Women who benefit from treatment should continue to receive regular clinical reviews.
It can take several months to establish whether testosterone is helping. If there is no meaningful improvement after an adequate trial, the prescriber may recommend stopping treatment.
How RapidMeds Can Help
RapidMeds provides a confidential, GP-led service for women seeking an assessment for testosterone therapy in the UK.
The purpose of the consultation is to determine whether treatment is safe, suitable and clinically appropriate. Testosterone is not supplied automatically following a request.
The RapidMeds process may include:
- A confidential online medical consultation
- A review of your symptoms and medical history
- Assessment of your current or previous HRT
- Blood testing where clinically required
- Treatment prescribed for eligible patients
- Ongoing clinical monitoring and reviews
- Fast, discreet UK delivery of prescribed treatment
You can explore Testosterone Therapy for Women at RapidMeds to learn more about the assessment process and available treatment options.
RapidMeds currently provides information about:
Both medicines require a clinical assessment. A prescription will only be issued when a qualified prescriber determines that treatment is appropriate.
Frequently Asked Questions
What is testosterone therapy for women?
Testosterone therapy for women uses a carefully controlled dose of testosterone to help treat persistent, distressing low sexual desire in eligible menopausal women. Treatment must be prescribed and monitored by a healthcare professional.
Who can have testosterone therapy in the UK?
It may be considered for perimenopausal or postmenopausal women whose low sexual desire has not improved sufficiently after other causes have been assessed and conventional HRT has been reviewed.
Eligibility depends on the woman’s symptoms, medical history, blood test results and the clinician’s assessment.
Can testosterone help with menopause symptoms?
The strongest evidence is for improving low sexual desire associated with menopause. Testosterone is not a proven general treatment for every menopause symptom, including fatigue, low mood, brain fog or weight gain.
Do I need to take HRT before testosterone?
In many menopause-related cases, conventional HRT will be reviewed and optimized before testosterone is considered. Testosterone may then be added if low sexual desire continues despite suitable HRT.
Does a low testosterone blood result mean I need treatment?
No. A blood result alone cannot determine whether testosterone therapy is suitable. The result must be considered alongside symptoms, medical history and other possible causes.
How long does testosterone therapy take to work?
Some women may notice an improvement within several weeks, while for others it can take a few months. Treatment should be reviewed if there is no meaningful benefit after an adequate trial.
Can testosterone therapy help with weight loss?
Testosterone is not a weight-loss medicine and should not be prescribed for this purpose. Weight changes during menopause can have several causes and should be managed separately.
Can testosterone cause facial hair?
Increased facial or body hair is a possible side effect, particularly if testosterone levels become too high. Regular blood tests and clinical monitoring help reduce this risk.
Is testosterone gel licensed for women in the UK?
Many testosterone gels used for women were originally licensed for treating men. They may be prescribed off-label at a much lower female dose when a qualified clinician considers this appropriate.
Can I use someone else’s testosterone gel?
No. Testosterone is a prescription-only medicine, and the dose used for women is usually much lower than the dose used for men. Using another person’s treatment could lead to dangerously high testosterone levels and significant side effects.
Final Thoughts
Testosterone therapy may provide meaningful benefits for selected menopausal women experiencing persistent and distressing low sexual desire.
However, it is not suitable for everyone and should not be viewed as a general solution for tiredness, low mood, weight gain or every symptom associated with menopause.
A detailed medical assessment is needed to identify other possible causes, review existing HRT and determine whether testosterone is an appropriate option. When treatment is prescribed, careful dosing, follow-up blood tests and regular clinical reviews are essential.
Through its GP-led service, RapidMeds can assess your symptoms, medical history and treatment needs before determining whether testosterone therapy is suitable for you.
Check your eligibility for Testosterone Therapy for Women with RapidMeds.
Medical disclaimer: This article is for general information only and does not replace personalised medical advice. Testosterone is a prescription-only medicine. Always speak to a qualified healthcare professional before starting, stopping, or changing hormone treatment.
