The Women's Health Edition
Testosterone for Women: The Benefits, the Evidence and the 2026 Label Changes
Desire, pleasure and feeling like yourself again. Here is what testosterone can do.
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The short version
Testosterone is not just a men's hormone. For many women after menopause, it can bring back desire, pleasure and satisfaction in their sex lives. That benefit is backed by randomized trials and by every major menopause society that has reviewed the evidence. Global Consensus, 2019 Islam et al., 2019
2026 has also been a turning point for hormone care. The FDA removed the boxed warnings about heart disease, breast cancer and dementia from menopausal hormone therapy, and testosterone labels for men have been updated twice. In September, the FDA held its first public workshop on testosterone for women and invited companies to develop products made for women. FDA, February 2026 FDA, February 2025 HHS, June 2026 Reuters, September 2026
- The clearest benefit: more desire, more satisfying sex and less sexual distress for women with hypoactive sexual desire disorder (HSDD). Islam et al., 2019 ISSWSH guideline, 2021
- Growing evidence: mood, energy and focus often improve when testosterone is added to hormone therapy, though randomized proof is still coming. Glynne et al., 2024 Glynne et al., 2025
- The status today: no testosterone product is FDA-approved for women in the United States, so licensed medical providers prescribe it off-label. ACOG review, 2025 Reuters, September 2026
Testosterone is a women's hormone, too
Women make testosterone in the ovaries and adrenal glands. In fact, before menopause, women make more testosterone than estrogen by weight. Levels fall gradually with age, and they drop sharply when the ovaries are removed. Global Consensus, 2019 ACOG review, 2025
Testosterone acts on the brain, the genital tissues, muscle and bone. That is why low desire after menopause or surgery is such a common and real concern, not something to brush off as "just stress" or "just aging." Global Consensus, 2019 Korean Society of Menopause, 2025
One important point: there is no blood level that defines "low testosterone" in women. A lab number cannot diagnose the problem on its own. Your experience, your health history and what you want to change matter more. ISSWSH guideline, 2021 ACOG review, 2025
What testosterone can do for women
The best evidence comes from a 2019 review of 36 randomized trials with 8,480 women. Compared with placebo or estrogen alone, testosterone improved nearly every part of sexual wellbeing that was measured. Islam et al., 2019
- Desire: more interest in sex.
- Satisfying sex: about one more satisfying sexual event each month, on average.
- Arousal, orgasm and responsiveness: all improved.
- Pleasure and self-image: both rose.
- Distress: sexual concerns and worry went down.
These benefits showed up whether or not women were also using estrogen, and in both natural and surgical menopause. Islam et al., 2019 Korean Society of Menopause, 2025 The 2019 Global Consensus, endorsed by major international medical societies, concluded that testosterone is effective for postmenopausal women with distressing low desire. Global Consensus, 2019
Where testosterone helps women most
Results from 36 randomized trials with 8,480 women, mostly after menopause.
For distressing low desire after menopause
- Desire
More interest in sex, the clearest benefit.
- Satisfying sex
More satisfying sexual events each month.
- Arousal and orgasm
Easier arousal and better orgasm.
- Pleasure
More pleasure and responsiveness.
- Self-image
Better sexual self-image.
- Less distress
Fewer sexual concerns and less worry.
How big is the benefit?
For many women, the change is meaningful. Desire returns, sex feels better and the worry that often comes with low desire eases. Guidelines describe the average effect as moderate, and each woman's response is different. ACOG review, 2025 Global Consensus, 2019
Benefits usually build over several weeks. Guidelines suggest checking in after a few months to see whether the change matters to you. If there is no worthwhile improvement by about six months, the advice is to stop, so no one stays on a treatment that is not helping. ISSWSH guideline, 2021
Major guidelines now support testosterone as part of menopause care:
- United Kingdom: NICE says to consider testosterone for menopausal women with low desire when hormone therapy alone has not helped. NICE, 2024
- UK menopause societies: they agree it can be considered once estrogen is adequately replaced. British Menopause Society, 2022
- United States: an ACOG review calls it a modestly beneficial option for well-selected women with HSDD. ACOG review, 2025
- South Korea: the 2025 guidelines note benefits for desire, satisfaction, arousal and orgasm, with a low risk of masculinizing effects when it is prepared and monitored for women. Korean Society of Menopause, 2025
Beyond the bedroom: mood, energy and focus
Many women say they simply feel more like themselves on testosterone. Research is starting to back that up, though it is earlier-stage than the sexual-health data.
- A UK clinic study of 510 women found that adding transdermal testosterone to hormone therapy improved libido, mood and cognitive symptoms over four months. Mood improved in nearly half of the women. Glynne et al., 2024
- A larger study of 920 women found that hormone therapy cut mood-symptom scores by about 45%. Regimens that included testosterone did as well as the others, though no better. Glynne et al., 2025
- A 2026 review described testosterone as a possible add-on for persistent brain fog, citing gains in energy, memory and concentration. Glasgow & Iqbal, 2026
- A 2026 survey of 332 women using testosterone through a telehealth service reported improved energy, mood and focus. Some authors advise that company, and the study had no comparison group. Elggren et al., 2026
These results are encouraging. However, none of these studies were randomized trials. Guidelines do not yet recommend testosterone for mood, energy, bone, muscle or brain health alone, and evidence for muscle effects in women is still unclear. ACOG review, 2025 Taylor et al., 2023 Reuters, September 2026
Benefits, sorted by how well they are proven
After menopause
Randomized trials; backed by major guidelines
When estrogen alone is not enough
NICE and UK societies say consider adding it
Added to HRT
Clinic studies show gains; no randomized proof yet
Trials too small or not done
The 2026 label changes, explained
The boxed warning came off hormone therapy
For more than 20 years, estrogen and progestogen products carried a boxed warning, the FDA's strongest label warning, about heart disease, breast cancer and dementia. Many women avoided helpful treatment because of it. HHS, November 2025
In November 2025, the FDA asked companies to remove those risks from the boxed warning. It also dropped the advice to use hormones for the shortest time possible. And it added guidance that women under 60, or within 10 years of menopause, may consider starting hormone therapy for hot flashes. FDA, November 2025
In February 2026, the FDA approved the first six updated labels. The approved products covered all four types of hormone therapy, including vaginal estrogen. FDA, February 2026 One boxed warning remains: estrogen-only pills, patches and gels still warn about uterine cancer for women who have a uterus. Heart and breast risks are still described in the full label, just not in the box. FDA, November 2025
What changed for testosterone
In February 2025, the FDA removed the boxed warning language about heart risk from all testosterone products. The change followed the TRAVERSE trial, which found no meaningful rise in heart attacks or strokes in men. The FDA added warnings about higher blood pressure instead. FDA, February 2025
In June 2026, HHS announced more requested updates. These would drop the statement that testosterone is unproven for age-related low testosterone in men, and would ease prostate warnings. HHS, June 2026 Testosterone gels still carry a separate boxed warning about the gel rubbing off on children or partners. AndroGel label, 2025
What this means for women
These testosterone label changes apply to products approved for men. There is still no FDA-approved testosterone product for women. Women who use it get a carefully adjusted, off-label prescription. FDA, February 2025 Reuters, September 2026
That may change. At its September 17, 2026, workshop, the FDA called for more studies and said it is ready to work with companies on products made for women. The public comment period ends today, October 19. FDA workshop, 2026 Reuters, September 2026 Holland & Knight, 2026
How hormone warnings changed, 2025 to 2026
- Feb 2025Testosterone heart warning removed
FDA drops boxed language on heart risk after the TRAVERSE trial; adds blood pressure warnings.
- Nov 2025FDA moves to clear HRT boxed warnings
Asks companies to remove heart disease, breast cancer and dementia from the box.
- Feb 2026First new HRT labels approved
Six estrogen and progestogen products get the updated box.
- June 2026More testosterone label updates
FDA requests changes on age-related low testosterone and prostate warnings in men.
- Sept 2026FDA workshop on women
First public FDA meeting on testosterone after menopause; calls for women-specific products.
What a useful evaluation includes
A good visit starts with your story. A licensed medical provider may ask when the change began, whether sex is painful, how you are sleeping, and which medicines or life changes came first. ISSWSH guideline, 2021
Low desire often has more than one cause. Vaginal dryness, hot flashes, depression, some antidepressants, relationship stress and fatigue can all play a part. Treating those can work alongside testosterone, and estrogen therapy is often the first step. ISSWSH guideline, 2021 NICE, 2024
Before your visit, write down what you hope will improve in your own words. "I want to feel interested again" is a better starting point than "I want a higher number."
Getting the best results safely
The goal is to bring testosterone back to the normal range for a younger woman, not above it. That is where the benefits show up and side effects stay low. Global Consensus, 2019 ISSWSH guideline, 2021
- Skin products are preferred. Creams and gels keep cholesterol steady. Pills raised "bad" LDL cholesterol in trials and are not recommended. Islam et al., 2019 ISSWSH guideline, 2021
- Blood tests guide safety. Providers check a baseline level, recheck after a few weeks, then monitor over time to keep you in the female range. ISSWSH guideline, 2021
- Approved products are more consistent. Compounded creams lack the same quality testing. ISSWSH guideline, 2021 ACOG review, 2025
Side effects to know about
Most side effects are mild when levels stay in the female range. Acne and extra hair growth are the most common. Weight gain was also seen in trials. Islam et al., 2019
- See your provider promptly if your voice deepens, scalp hair thins or you notice other changes from too much testosterone. Some of these may not fully reverse. ISSWSH guideline, 2021
- Avoid it in pregnancy. Testosterone is not used during pregnancy or when pregnancy is possible. ISSWSH guideline, 2021
- Protect others. Gel or cream can transfer to children and partners, so wash your hands and cover the area. AndroGel label, 2025
- Long-term heart and breast safety is still being studied. Trials up to about two years were reassuring, but most excluded women at high risk. Global Consensus, 2019
Questions to take to your appointment
Ask what is driving your symptoms, whether estrogen or other treatments should come first, what off-label use means, and how your progress and blood levels will be checked.
Do I need testosterone just because I am getting older?
No. Age alone is not the reason to start. Distressing low desire, plus a full evaluation, is what guides the choice. Global Consensus, 2019
What if my level is "normal" but my desire is low?
A normal result does not rule out HSDD, and a low result does not prove it. Your history and goals guide the decision. ISSWSH guideline, 2021
Did the 2026 label changes make testosterone approved for women?
No. The boxed-warning changes apply to estrogen and progestogen products and to men's testosterone products. Testosterone for women is still off-label, though the FDA has signaled interest in approving products for women. FDA, February 2026 HHS, June 2026 Reuters, September 2026
The bottom line
Testosterone deserves a place in women's health. For women with distressing low desire after menopause, it is one of the best-proven ways to restore desire, pleasure and satisfaction. Its potential for mood, energy and focus is promising. With the 2026 label changes and the FDA's new interest, care for women is moving forward. The best results come from a careful evaluation, a plan that keeps levels in the female range, and regular follow-up. Islam et al., 2019 ACOG review, 2025 Reuters, September 2026
Your next step
Bring your questions, medication list and recent lab results to a conversation with licensed medical providers. Infinity Functional Performance can help you explore whether an individualized evaluation is right for you; no particular test, medication or result is promised.
Visit ifp.life, call 972-619-5350, or email info@ifp.life to learn about becoming a patient.
Educational content only. This article is not a diagnosis, prescription, or substitute for individual medical advice. Do not start, stop, or adjust treatment based on a blog.
Numbered references
- Davis et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019)
- Islam et al. Safety and efficacy of testosterone for women: systematic review and meta-analysis, Lancet Diabetes & Endocrinology (2019)
- Parish et al. ISSWSH clinical practice guideline for systemic testosterone for HSDD in women (2021)
- Kling. Testosterone for the treatment of HSDD in perimenopausal and postmenopausal women, Obstetrics & Gynecology (2025)
- NICE NG23. Menopause: identification and management, recommendations (updated 2024)
- British Menopause Society and partners. Optimising the menopause transition: joint position statement (2022)
- Kim et al. The 2025 Menopausal Hormone Therapy Guidelines, Korean Society of Menopause (2025)
- Glynne et al. Transdermal testosterone and mood and cognitive symptoms in peri- and postmenopausal women, Archives of Women’s Mental Health (2024)
- Glynne et al. Transdermal oestradiol and testosterone therapy for menopausal depression and mood symptoms, British Journal of Psychiatry (2025)
- Glasgow & Iqbal. Treatment of cognitive symptoms during perimenopause: a review, Current Treatment Options in Psychiatry (2026)
- Elggren et al. Testosterone replacement therapy in women: a retrospective observational study, Journal of Personalized Medicine (2026)
- Taylor et al. Endogenous testosterone and muscle mass, strength and performance in women: systematic review, Clinical Endocrinology (2023)
- FDA. FDA requests labeling changes to clarify benefit-risk considerations for menopausal hormone therapy (November 2025)
- FDA. FDA approves labeling changes to menopausal hormone therapy products (February 2026)
- HHS. Fact sheet: FDA initiates removal of “black box” warnings from menopausal hormone replacement therapy products (November 2025)
- FDA. FDA issues class-wide labeling changes for testosterone products (February 2025)
- HHS. HHS announces requested updates to testosterone therapy product labels (June 2026)
- FDA. AndroGel 1% prescribing information, boxed warning on secondary exposure (2025)
- FDA. Public workshop agenda: Testosterone Use in Menopausal Women (September 2026)
- Reuters. US regulators urge more research on testosterone therapy for women (September 2026)
- Holland & Knight. FDA workshop signals potential approval pathway for testosterone therapy (2026)