Testosterone and Menopause: The Forgotten Hormone That Can Change Everything

When we talk about menopause and hormone replacement therapy (HRT), estrogen and progesterone tend to get all the attention. But there’s another hormone—one that’s often overlooked, misunderstood, or even stigmatized—despite its critical role in how we feel as women.

That hormone is testosterone.

A portion of the content in this blog was inspired by the FDA Expert Panel on Hormone Replacement Therapy for Women, which highlights the growing recognition of testosterone’s role in women's health.

Yes, Testosterone Is a Female Hormone

Most people think of testosterone as a “male” hormone. But here’s the truth: women have more testosterone than estrogen for most of our lives. It’s made by both the ovaries and adrenal glands and plays a key role in how we feel—physically, mentally, and emotionally.

It’s often called the “libido hormone,” and yes, it can improve sex drive. But its benefits go far beyond the bedroom.

Why Women Feel Better with Testosterone

When testosterone levels decline—as they naturally do with age, especially during and after menopause—many women begin to feel off. I hear it all the time in my clinic: “I just don’t feel like myself.”

Testosterone can help with:

• Mental clarity and mood

• Cognitive sharpness

• Motivation and energy

• Exercise performance and recovery

• Muscle tone

• Libido and sexual satisfaction

  
  

I often tell my patients: testosterone is estrogen’s best friend. When you have both hormones in balance, you’re much more likely to feel like you again.

So Why Is It So Hard to Get?

Here’s the frustrating part: women who want to transition to men are readily prescribed 10 times the amount of testosterone that we use for HRT in midlife women. Yet women who simply want to feel better—who want to reclaim their energy, drive, and vitality—often struggle to find a physician who will prescribe even low-dose testosterone.

As a menopause specialist, I have to jump through hoops just to get it for my patients. But I’m happy to do it. Because it can be life-changing.

Is It Safe?

Unfortunately, we lack large, long-term safety data for testosterone use in women, which makes many physicians understandably hesitant. But let’s put that into perspective.

I work in the emergency department. I’ve seen overdoses (intentional and unintentional) of many medications. But in 15+ years of practice, I’ve never seen a testosterone overdose.

Testosterone is a natural, bioidentical hormone. We dose it slowly and carefully. It can take 4–6 months to feel the full effects, just like estrogen. But for many women, it’s well worth the wait.

There’s even emerging evidence that testosterone may reduce the risk of dementia—a major concern for women in midlife and beyond.

What to Expect

• A baseline lab panel is required before starting

• Insurance doesn’t cover it, but I work to make it affordable

• We go slow and steady, monitoring your response and adjusting as needed

  
  

Want to Learn More?

If this topic speaks to you, I highly recommend the podcast You Are Not Broken by Dr. Kelly Casperson. She’s a brilliant voice in women’s sexual health and hormone therapy—and one of the few talking honestly and openly about the power of testosterone.

You deserve to feel like yourself again.

If you're curious whether testosterone therapy is right for you, I’d love to talk. At Dragonfly Menopause Care, I create personalized, evidence-informed treatment plans designed to help you thrive—not just survive—through menopause and beyond.

Schedule your consultation today and let’s get you feeling like yourself again. I can't wait to meet you!

— Dr. Christa Waymire

Board-Certified Family Physician & Menopause Specialist