Testosterone is a key hormone for women's health, and declining levels during menopause can affect libido, energy, mood, and cognitive function. A women-specific transdermal testosterone therapy is available in Australia for postmenopausal women with low sexual desire, and a menopause-focused doctor can assess whether it's appropriate for your individual circumstances.
Many women are surprised to discover that testosterone isn't just a male hormone — it's produced naturally in the female body and plays a genuine role in sexual function, energy, mental clarity, and bone health. When levels decline during the menopause transition, the effects can be significant. If you've noticed a persistent drop in low libido, unexplained fatigue, or difficulty concentrating, low testosterone could be one piece of the puzzle.
For Australian women, there's a distinct advantage: Australia was the first country in the world to have a women-specific testosterone therapy listed in the ARTG (AndroFeme 1; ARTG 324274). This article explains what testosterone therapy involves, who it may suit, what the evidence shows, and how to access it through the Australian healthcare system.
Testosterone is often thought of as a 'male hormone', but women produce it too — in the ovaries and adrenal glands. In fact, women have more testosterone circulating in their bodies than oestrogen at any given time, though in much smaller amounts than men.
In women, testosterone contributes to sexual desire and arousal, energy and motivation, muscle strength and bone density, mood and cognitive function, and vaginal and urinary tissue health. When these levels fall during the menopause transition, some women experience a cluster of symptoms that are hard to attribute to a single cause. Recognising testosterone as part of the hormonal picture is an important step in understanding your menopause experience.
Testosterone levels in women peak in the mid-20s and gradually decline from that point onward. By the time a woman reaches natural menopause — confirmed 12 months after her final period — levels may have dropped to roughly half of their peak values. Women who experience surgical menopause face a more abrupt loss, as the ovaries are a primary production site.
During perimenopause — the transitional phase that can begin in the early-to-mid 40s — hormones fluctuate widely. Oestrogen tends to get the most attention, but testosterone is quietly declining at the same time. Some women notice mood swings, reduced motivation, or a shift in libido during this phase, which may partly reflect changing androgen levels.
A sustained, distressing drop in sexual desire in postmenopausal women is clinically recognised as hypoactive sexual desire disorder (HSDD). It's one of the most common sexual health concerns in this life stage: a nationally representative Australian study of 2,020 midlife women aged 40 to 65 years found that approximately one in three experience HSDD [5]. HSDD has both hormonal and psychosocial dimensions, and when it causes genuine distress, it warrants professional assessment.
The evidence base supporting testosterone therapy for postmenopausal women has grown substantially over the past decade.
A major systematic review and meta-analysis published in The Lancet Diabetes & Endocrinology — covering 36 randomised controlled trials involving 8,480 women — found that testosterone therapy significantly improved sexual function, including desire, arousal, orgasm, and pleasure, while reducing sexual distress [1]. Transdermal delivery (creams and patches) showed a more favourable safety profile than oral testosterone, particularly for lipid health.
A global consensus statement, developed by researchers from 10 international societies and endorsed by the Australasian Menopause Society (AMS), confirmed that transdermal testosterone at physiological premenopausal doses is an evidence-based treatment for postmenopausal women with HSDD [2].
Emerging research also suggests broader benefits. A 2025 pilot study of 510 women using transdermal testosterone therapy for four months found significant improvements in mood (47% of participants), cognition (39%), and libido (52%) [3]. These findings are promising, though larger randomised trials are needed to confirm them.
An international clinical practice guideline from the International Society for the Study of Women's Sexual Health (ISSWSH) recommends transdermal testosterone at approximately one-tenth of standard male doses, with improvements typically emerging at 6–8 weeks and maximal effects around 12 weeks [4].
Note: The evidence is strongest for postmenopausal women with HSDD. Evidence for perimenopausal women and for other indications — mood, cognition, bone health — is still developing. Treatment decisions should always be individualised with your doctor.
Testosterone therapy is not appropriate for every woman, and it's not a first-line treatment for every menopause symptom. It's best approached after an individualised assessment of your full hormonal picture and medical history.
You may be a candidate if you are a postmenopausal woman with a persistent, distressing drop in sexual desire (HSDD) that hasn't resolved with oestrogen therapy alone; if you have had appropriate MHT (menopausal hormone therapy) optimised first or cannot take oestrogen; or if you have undergone surgical menopause and are experiencing significant hormone deficiency symptoms.
Current guidance does not support testosterone for premenopausal women with low libido, or for women seeking it for weight management or athletic performance. Women with active breast cancer, pregnancy, liver disease, or elevated calcium levels should not use testosterone therapy.
It's also worth noting that vaginal dryness and pain during intercourse — common symptoms of the genitourinary syndrome of menopause — can themselves reduce sexual desire and should be explored as part of a thorough assessment.
In Australia, testosterone therapy for women is delivered transdermally — applied directly to the skin. This approach avoids the lipid side effects associated with oral testosterone and keeps hormone levels within a physiological range.
The cream is applied once daily to clean, dry skin, typically on the upper outer thigh or buttock. Women need approximately 5–10% of the testosterone dose used in male therapy. A measured applicator ensures dosing consistency.
Your doctor will check your baseline testosterone levels before starting, arrange a follow-up blood test 3–6 weeks after starting, and review levels every 6 months once treatment is stable. Many women notice early improvements at around 4–6 weeks, with full benefits apparent by 12 weeks.
Testosterone therapy can be used alongside oestrogen-based menopause treatment, or as a standalone option when oestrogen is not suitable.
When used at physiological doses within the normal premenopausal range, transdermal testosterone therapy has a generally reassuring safety profile. Available data suggest it does not negatively impact cardiovascular health or breast cancer risk with properly monitored short-term use, though long-term data beyond two years remain limited.
Common side effects include mild acne, increased hair growth at the application site, and oily skin. These are dose-related and usually manageable with correct dosing and rotating application sites. Serious virilising effects — such as voice deepening or significant facial hair growth — are associated with doses well above the physiological range and should not occur with properly monitored therapy.
Tip: 'More is not better' with testosterone therapy. Exceeding the physiological premenopausal range increases side effect risk without adding clinical benefit. Regular blood monitoring is non-negotiable.
Using an ARTG-listed product specifically formulated for women ensures appropriate dosing, purity, and consistency. Compounded preparations are not recommended when a commercially available body-identical option exists.
Testosterone therapy for women requires careful clinical assessment, appropriate baseline and follow-up testing, and ongoing monitoring. Decisions about suitability are individualised — weighing your symptoms, health history, and risk factors — and any prescription is one part of a broader conversation about your hormonal care.
Telehealth has transformed access to specialist menopause care across Australia. You can consult with a menopause-focused doctor from home, wherever you live, including regional and rural areas.
The Australian Menopause Centre has provided menopause care to over 100,000 Australian women since 2003. With a multidisciplinary team of menopause-focused doctors, naturopaths, and nutritionists, the centre offers personalised assessment and treatment programs through telehealth.
For those managing other concerns alongside libido — such as weight gain, sleep disorders, or anxiety — holistic care addressing the full picture often produces the best outcomes. Learn more about the full range of signs and symptoms of menopause and how they can be managed.
At physiological doses, short-term transdermal testosterone therapy has a reassuring safety profile. Current data do not show increased cardiovascular or breast cancer risk with properly monitored use. Long-term data beyond two years are limited, which is why ongoing medical monitoring is recommended.
Most women notice early improvements at 4–6 weeks, with the full effect typically seen by 12 weeks. If there is no improvement after 6 months at an appropriate dose, your doctor will reassess.
Yes. Specialist menopause telehealth services can assess your suitability, arrange blood tests, and prescribe and monitor therapy if indicated — all from home. This is particularly valuable for women in regional and rural areas.
Preliminary research suggests it may benefit mood and cognition in some women. A 2025 pilot study found improvements in mood (47%), cognition (39%), and libido (52%) after four months [3]. These findings need confirmation through larger trials. If memory loss or depression are significant concerns, discuss them specifically with your doctor.
Testosterone is a genuinely important hormone for women's wellbeing, and declining levels during menopause can meaningfully affect quality of life. The evidence supporting therapy for postmenopausal women with HSDD is substantial, and Australia's ARTG-listed, women-specific option means Australian women have access to a body-identical, appropriately dosed therapy that women in most other countries do not.
If persistent low libido, reduced energy, or mood difficulties haven't fully responded to other treatments, testosterone therapy may be worth discussing with a menopause specialist. The key is an individualised assessment, appropriate monitoring, and care from a doctor who understands the full hormonal landscape of menopause.
The Australian Menopause Centre offers bulk-billed telehealth consultations with menopause-focused doctors who can assess whether testosterone therapy — alongside other body-identical hormone therapy options and holistic support — is right for you.
This information is for educational purposes only and is not medical advice. Consult your healthcare provider for personalised recommendations. Treatment decisions should be individualised based on your medical history and circumstances.
Hormone therapy is not suitable for everyone. Your doctor will assess whether it's appropriate for you based on your individual health history, symptoms, and risk factors. Individual results may vary.