Testosterone for Women During Menopause: Benefits, Side Effects, and What to Expect

Updated July 2026

If you've been reading my blogs for a while, you probably know that I'm a big believer in testosterone for women.

In fact, one of the biggest reasons I opened Dragonfly Menopause Care was because I couldn't find a physician willing to prescribe testosterone. It made no sense to me. If we're replacing estrogen and progesterone because they naturally decline during menopause, why would we ignore another hormone that is just as physiologic and can profoundly affect how women feel?

I owe much of my early understanding of testosterone to Dr. Rachel Rubin. I was fortunate enough to take her very first educational courses on menopause therapy for women, and it completely changed the way I thought about menopause care-- including testosterone.

Today, after treating hundreds of women, I am an even bigger believer in testosterone than I was when I started.

But my approach has evolved.

And honestly, that's exactly how medicine should work.

As we gain experience, listen to our patients, and continue learning, we become better physicians.

Testosterone Is a Female Hormone

One of the biggest myths surrounding testosterone is that it's a "male hormone."

It isn't.

Women naturally produce testosterone throughout their lives. It is made by both the ovaries and adrenal glands and plays an essential role in physical, emotional, and sexual health.

As we move through perimenopause and menopause, testosterone levels gradually decline alongside estrogen and progesterone.

Many women begin noticing changes they simply can't explain.

"I've lost my drive."

"I don't recover from workouts like I used to."

"My brain just doesn't work the same."

"I don't feel motivated."

"I don't feel like myself anymore."

These are conversations I have every single day in my clinic.

Testosterone Does Much More Than Improve Libido

Testosterone has earned the nickname "the libido hormone."

It certainly helps many women regain sexual desire.

But that's only part of the story.

When testosterone is optimized, many women notice improvements in:

• Libido and sexual satisfaction

• Mental clarity

• Motivation

• Mood

• Confidence

• Lean muscle mass

• Exercise performance and recovery

• Bone health

• Overall vitality

  
  

I often tell my patients that testosterone is estrogen's best friend.

Many women don't truly feel like themselves again until both hormones are working together.

Why My Practice Has Changed

When I first started prescribing testosterone, I practiced much like many experts taught.

I started women at doses that are commonly recommended by leaders in menopause medicine.

Over time, however, my own clinical experience changed my practice.

Today, I start lower.

Why?

Because I have seen firsthand that every woman absorbs testosterone differently.

Two women using the exact same prescription can have dramatically different hormone levels and dramatically different responses.

Some women feel wonderful.

Others develop side effects far sooner than expected.

Experience has taught me that slower is usually better.

Why I Start Much Lower Than Many Experts Recommend

Many respected leaders in menopause medicine recommend a starting dose of approximately 5 mg of transdermal testosterone daily.

I have enormous respect for the physicians who have helped move women's hormone care forward.

But after treating hundreds of women, I've chosen a different approach.

I now start much lower.

Why?

Because my first priority is simple.

I want women to feel better—not worse.

The side effect I worry about most is hair loss.

For many women, losing their hair is far more devastating than the symptoms that

brought them into my office in the first place.

Hair can recover, but it often takes months.

If I can reduce that risk by starting lower and increasing gradually, that's exactly what I'm going to do.

Hormones are incredibly powerful.

Small changes in dose can make a very big difference.

This hormone stuff is not for the weak.

It deserves respect.

Why I Prescribe Daily Testosterone Cream

I prescribe daily compounded testosterone cream because I believe women generally do better with steady hormone exposure.

Daily cream creates relatively stable hormone levels instead of dramatic peaks and valleys.

While injections certainly have a place, I don't believe they best recreate normal female physiology. They also tend to be more expensive and make small dose adjustments much more difficult.

My goal is not to create hormone highs.

My goal is to recreate healthy female physiology as closely as possible.

Slow and steady almost always wins.

How I Monitor Testosterone

One thing that makes my practice different is how carefully I monitor therapy.

At Dragonfly Menopause Care, we use saliva testing because we believe it provides the best picture of what is happening at the tissue level, where testosterone actually does its work.

Testosterone spends relatively little of its time doing meaningful work while circulating through the bloodstream.

I want to understand what is happening where hormones are actually interacting with receptors.

Laboratory testing is only one part of the picture.

Symptoms matter.

Energy matters.

Mood matters.

Libido matters.

Exercise performance matters.

The laboratory results simply help me put the entire picture together.

Testosterone Is a Waiting Game

One phrase my patients hear over and over again is this:

Trust the process.

Testosterone is not an overnight treatment.

Unlike caffeine or stimulant medications, it doesn't produce an immediate rush.

It works gradually.

Brain fog improves.

Mood improves.

Motivation returns.

Workouts become easier.

Muscle slowly comes back.

Libido often follows.

Patience is one of the most important parts of successful testosterone therapy.

Ironically, one of the things I've noticed over time is that many women don't need progressively higher doses.

In fact, I often find myself lowering doses while maintaining the same benefits.

Testosterone isn't a race.

It's a long game.

More Testosterone Is Not Better

This may surprise people.

I do not believe more testosterone is always better.

Some women with very high testosterone levels feel incredible.

But feeling incredible today doesn't necessarily mean your body will thank you five years from now.

Excess testosterone can contribute to:

• Hair thinning and hair loss

• Acne

• Increased facial or body hair

• Oily skin

• Enlargement of the clitoris (not nearly as fun as it sounds)

• Worsening of insulin resistance

I have very little tolerance for side effects caused by excess hormones.

That applies equally to estrogen, progesterone, and testosterone.

There is another aspect of testosterone that deserves discussion.

It can be incredibly tempting to keep increasing the dose because higher levels often make women feel amazing.

More energy.

More motivation.

Higher libido.

Better workouts.

Greater confidence.

But feeling amazing doesn't automatically mean the dose is healthy.

Just because something feels good doesn't mean more is better.

My job is to help women find the sweet spot where they feel incredible while minimizing unnecessary long-term risk.

Do I Ever Push Testosterone Limits?

I do.

Some women come to me specifically wanting to optimize strength, exercise performance, motivation, or libido.

If a woman understands both the benefits and the potential risks, I'm comfortable aiming toward testosterone levels we might expect in a healthy woman in her twenties.

Notice what I didn't say.

I didn't say I want women to have male testosterone levels- or high levels in general.

I don't.

I'm simply trying to restore physiology—not create something unnatural.

Every woman is different.

Every woman deserves an individualized approach.

Testosterone Isn't the Entire Libido Story

Low libido is one of the most common reasons women ask about testosterone.

It absolutely deserves consideration.

But testosterone isn't the entire answer.

I have women with excellent testosterone levels who still struggle with desire.

That's because libido is wonderfully complex.

Sleep matters.

Stress matters.

Relationships matter.

Pain during intercourse matters.

Vaginal health matters.

Mental health matters.

Estrogen matters.

Progesterone matters.

Hormones are an important piece of the puzzle, but they are rarely the entire picture.

That's why comprehensive menopause care matters.

Why I Believe Testosterone Matters

I didn't open Dragonfly Menopause Care because I wanted to prescribe more hormones.

I opened it because I wanted women to finally have access to excellent, individualized menopause care.

Testosterone has become one of my favorite tools—not because it's a miracle, but because, when used properly, it can genuinely change lives.

My philosophy is simple.

I don't want to help women just feel better today.

I want to help them feel amazing now, two years from now, five years from now, and live well for decades to come.

That means looking beyond today's symptoms.

It means thinking about muscle, bone, metabolism, brain health, sexual health, confidence, and quality of life.

It also means respecting hormones enough to avoid unnecessary side effects.

Sometimes the fastest way to get a woman feeling her best is by slowing down at the beginning.

If you've been told that testosterone is only for men, or that your symptoms are simply part of getting older, I would encourage you to find a physician who understands the full picture.

You deserve to feel strong.

You deserve to feel vibrant.

You deserve to feel like yourself again.

And if we work together, I hope to help you become the healthiest, strongest version of yourself—not just for today, but for decades to come.

— Dr. Christa Waymire

Board-Certified Family Physician

NAMS Certified Menopause Practitioner

Founder, Dragonfly Menopause Care