Menopause
What women need to know about testosterone during menopause

By Sarah Bolt, Forth
Following recent approval from the Medicines and Healthcare products Regulatory Agency, testosterone is set to become much more widely available to women in the UK.
Offering greater access to testosterone treatment through their GP, the move marks a significant shift in how menopause symptoms are recognised and treated.
However, despite the increased access, many women are still in the dark about the role testosterone plays.
As conversations around women’s health continue to evolve, testosterone is becoming an increasingly important part of the menopause discussion.
Already licensed in Australia, New Zealand and South Africa, the UK becomes among only a handful of countries making testosterone more accessible for women.
The development marks a significant step forward in recognising the full impact hormonal changes can have during midlife and menopause and the benefits that taking testosterone can have.
Testosterone is often misunderstood, and more closely associated with men, but it also plays a vital role in women’s health.
From energy levels and cognitive function to mood and libido, its influence on the body is far-reaching.
Here are the eight things women need to know about testosterone:
1. Testosterone is a vital female hormone
Testosterone is essential for women.
Produced naturally in the ovaries and adrenal glands it supports a wide range of functions in women including maintaining libido, energy levels, mood, concentration and overall wellbeing.
It also contributes to muscle strength and bone health, both of which become increasingly important during later life.
For many women, low testosterone can leave them feeling a bit out of sorts, impacting confidence, memory, motivation and other areas of life.
Because symptoms are often gradual these are often dismissed as part of ageing or the pressures of life and juggling everything that comes with it.
2. Testosterone levels decline with age
Like oestrogen and progesterone, testosterone levels naturally decline as women get older, particularly during perimenopause and menopause.
Our research found that testosterone levels in women decline by more than 51 per cent with age.
These changes can have a significant impact on daily life, affecting everything from relationships and self-esteem to work performance and sleep quality.
Despite this, many women are unaware that low testosterone may be contributing to how they feel.
3. Signs of low testosterone can vary
Low testosterone symptoms show up differently for everyone. This is why diagnosis and treatment can sometimes be overlooked.
Common symptoms include fatigue, low energy, hot flushes, night sweats, thinning hair, dry skin, muscle weakness, weight gain, mood swings and difficulty concentrating.
Some women may also experience reduced confidence, lower motivation or a loss of interest in sex.
Because many of these symptoms overlap with menopause itself, it is important that women have access to informed conversations and personalised medical advice to determine whether testosterone could help.
4. Testosterone supports more than libido
One of the biggest misconceptions surrounding testosterone is that it is only linked to sex drive.
While testosterone can help improve libido, its benefits extend much further, helping to regulate energy, motivation, emotional wellbeing, muscle strength, bone density and much more.
For some women, restoring testosterone levels can contribute to feeling more energised, confident and mentally sharp again.
5. Testosterone can support cognitive function
One of the main struggles with menopause is brain fog and difficulties with memory and concentration.
Taking testosterone can help protect brain health by supporting communication between brain cells and increasing blood flow.
As awareness around the cognitive impact of menopause continues to grow, testosterone is increasingly being recognised as a tool that helps women better manage these symptoms.
6. Testosterone does not make women masculine
Many concerns around testosterone come from the misconception that it will cause women to develop masculine features.
However, when prescribed appropriately at the right dosage by a qualified healthcare professional, this is unlikely.
The aim of testosterone for women is to help restore hormones to a healthy female range, supporting wellbeing and symptom management.
7. Testosterone is not linked to an increased risk of breast cancer
Another common myth is that testosterone increases a woman’s risk of breast cancer. Current evidence does not support this.
Testosterone does not stimulate breast tissue growth and studies have not shown an increased risk of breast cancer linked to testosterone therapy in women.
In fact, some research has suggested a lower occurrence of breast cancer among women taking testosterone, although more long-term research is still needed in this area.
8. The benefits of testosterone can take time
Testosterone therapy tends to work gradually.
Many women will start to notice improvements in mood, motivation and energy levels within the first few months with the full benefits building over time.
Because testosterone has a cumulative effect, consistent use and regular medical monitoring is important.
Patience is key and ongoing support from healthcare professionals can help ensure treatment remains safe and effective.
Despite growing awareness around hormone replacement therapy, testosterone remains one of the lesser understood hormones.
Our own research shows that testosterone levels in women decline by more than 51 per cent with age with a debilitating impact for many.
Knowledge is power and it’s really important that women are aware of the role testosterone plays in their health, particularly in midlife, so they can see their GP armed with the information they need.
Hormones will fluctuate but hormone mapping is a great place to start and will give women a greater insight into what is happening in their bodies.
It’s imperative that women are able to advocate for themselves and having this information is crucial for this.
Making testosterone more accessible in midlife gives women another treatment option to consider beyond HRT, helping them to manage menopausal symptoms and improve their overall quality of life.
News
Premature menopause is a high blood pressure risk, study finds

Premature menopause is linked to a higher risk of developing high blood pressure, according to a study of more than 107,000 women.
The risk was highest among women who reached menopause between the ages of 25 and 35.
Researchers said the findings support earlier cardiovascular screening for women who reach menopause before the age of 40.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “The results of this study highlight the potential adverse long-term health outcomes associated with premature menopause, and in particular, the need to regularly screen for cardiovascular risk factors such as hypertension.
“Use of hormone therapy is also routinely recommended in women with premature menopause at least until the natural age of menopause unless contraindications exist.”
Hormonal changes during menopause are known to affect women’s wider health, while earlier menopause has previously been linked to coronary heart disease and stroke.
Coronary heart disease develops when the blood vessels supplying the heart become narrowed or blocked.
However, previous evidence directly linking the timing of menopause to high blood pressure has been mixed.
High blood pressure, also known as hypertension, puts extra strain on the heart and blood vessels and can increase the risk of heart disease and stroke.
Researchers said it can be difficult to separate the direct effects of hormonal changes from factors that often accompany menopause, including weight gain, metabolic changes and other cardiovascular risks.
Metabolic changes affect how the body processes and uses energy, including sugar and fat.
The study analysed data from 107,836 postmenopausal women who joined the UK Biobank between 2006 and 2010. They were followed for a median of almost 15 years.
Researchers divided the women into three groups based on their age at menopause: after 45, between 40 and 45, or before 40.
They also examined whether menopause occurred naturally or followed surgery.
During the follow-up period, 18,508 women, or 17.2 per cent, were diagnosed with high blood pressure.
The proportion increased as the age at menopause fell. Hypertension developed in 16.6 per cent of women who experienced menopause after 45, compared with 18.8 per cent of those who reached menopause between 40 and 45.
Among women who experienced menopause before 40, 22.6 per cent developed the condition.
After taking account of more than 50 factors, including weight, lifestyle habits, family history and laboratory results, premature menopause remained linked to a 12.3 per cent higher risk of hypertension than menopause after age 45.
Further analysis suggested the risk peaked among women who reached menopause between the ages of 25 and 35.
The researchers said this may mean that the cardiovascular risk associated with premature menopause is concentrated among a younger group than the conventional under-40 definition suggests.
Surgical menopause was initially linked to higher rates of hypertension, but the association was no longer significant after other risk factors were taken into account.
The authors said clinicians should consider age at menopause as a distinct cardiovascular risk factor, particularly for women who experience it before 40.
They also called for earlier detection and management of hypertension, alongside individual discussions about hormone therapy.
Hormone therapy replaces hormones that decline during menopause and may be recommended for some women, depending on their individual health and medical history.
Menopause
Menopause care failing women worldwide, review finds

Menopause care remains fragmented and unequal worldwide, leaving many women without evidence-based support, a major review has found.
The review identified significant gaps in care despite menopause affecting millions of people around the world.
Drawing on 89 studies from several countries and diverse populations, it found that many women experience fragmented services, limited access to evidence-based treatment and inadequate support from healthcare providers.
Women often reported feeling dismissed, unsupported and uninformed about menopause and the treatments available.
The review also found persistent inequalities in access to menopause support.
Race, socioeconomic status, cultural background and geography often shaped the barriers women faced when seeking care.
Researchers found that healthcare professionals often receive insufficient training on menopause.
National clinical guidelines were also applied inconsistently, while culturally responsive care remained limited.
These gaps were particularly evident among marginalised groups, including LGBTQ+ people, Indigenous communities, migrant women and those experiencing surgical menopause.
The review found that telehealth could improve access to menopause care, although the authors said it was not a universal solution.
They said its acceptability and suitability varied across different populations and settings.
The review called for better education and training for healthcare providers, clearer roles and responsibilities across health services and patient-centred, culturally competent models of care.
It also highlighted the need for a greater focus on equity to ensure everyone can access high-quality menopause support.
The findings were based on a review of 4,056 published records, with 89 studies meeting the inclusion criteria.
Most of the evidence came from the UK, US and Australia and included qualitative, quantitative, mixed-methods and intervention studies.
News
Disadvantaged neighbourhoods linked to faster heart health decline in midlife women, research shows

Women in disadvantaged areas may face poorer heart health and faster decline as they approach menopause, new research suggests.
Researchers followed 1,200 women in eastern Massachusetts for more than 20 years, from pregnancy into midlife.
The study measured heart health at five points using a score based on eight health and lifestyle factors, including blood pressure, cholesterol, sleep, diet and physical activity.
Women living in the most socially vulnerable neighbourhoods scored about six to 10 points lower on heart health across more than two decades of follow-up than those in the least disadvantaged neighbourhoods.
The differences were already clear three years after enrolment and continued into midlife.
Researchers also found that women in these neighbourhoods had faster declines before menopause, the stage when periods stop and cardiovascular risk can rise. Cardiovascular health means the health of the heart and blood vessels.
Socioeconomic factors also appeared to shape outcomes. Women with lower income, less education, or who identified as non-Hispanic Black had lower heart health scores throughout the study.
The findings highlight how long-term exposure to social and environmental conditions may affect cardiovascular risk over time.
Even modest differences in heart health scores may matter, as previous research has linked small decreases in these scores with higher risks of cardiovascular disease and death.
Senior author Izzuddin Aris, associate professor at Harvard Medical School and the Harvard Pilgrim Health Care Institute, said: “Our study shows that heart health in midlife is shaped by more than personal choices. Income, education, and neighbourhood conditions may all play a role.”
Neighbourhood conditions continued to affect heart health even after researchers took income and education into account.
Women who lived for years in highly vulnerable neighbourhoods had persistently lower scores and poorer cardiovascular health trajectories.
Aris added: “The years before and around menopause may be an important time to support women’s heart health.
“This is especially true for women living in under-resourced neighbourhoods.”
The findings suggest prevention efforts could include better access to healthy food, safe places to be active and quality healthcare, particularly for women seeking to protect their heart health over time.
The study used data from Project Viva, a long-term research study that has followed women since pregnancy in the early 2000s through midlife.
Researchers collected repeated health data over more than two decades, allowing them to track long-term patterns in heart health.
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