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Testosterone Therapy for Women in Perimenopause and Menopause

We know that Testosterone is not just a “male hormone.” Women produce testosterone too, and it plays a role in sexual desire, arousal, energy, mood, cognitive clarity, and maintaining muscle and bone. Levels tend to decline gradually with age, and some women feel this shift more than others. (Women’s Health Concern)

At The Bespoke Clinic, we consider testosterone as one possible part of a wider menopause plan, not a quick fix. We focus on your symptoms, your story, your health history, and the data, then we decide together what is appropriate.

When might testosterone be helpful

The strongest evidence for testosterone in women is for low sexual desire that is distressing, particularly after menopause, when other contributing factors have been addressed and when standard HRT has not been enough. There have been circumstances where Testosterone alone has been required and seems to shift the dial in terms of symptoms and wellbeing. Every woman is different, as we know. This needs to be considered.

Some women also describe improvements in motivation, energy, confidence, and mental “spark.” These benefits can be more variable, and this is where careful clinical judgement matters.

Important context, licensing and what is changing in the UK

In the UK, most testosterone prescribing for women has been off-licence, meaning the medicine is licensed for another indication or population, but may be prescribed for women by a clinician taking responsibility for that decision, with informed consent and monitoring.

A major development is that AndroFeme, a female-specific testosterone cream, has been approved by the MHRA for postmenopausal women, with wider UK availability expected from 2026. Until availability is straightforward, many women are still prescribed testosterone using established off-licence approaches, or via specialist routes depending on individual circumstances and product access.

Bespoke prescriptions and compounded options

Some women come to us because they want a more personalised approach, particularly if they are sensitive to standard preparations, need careful dose tailoring, or have complex symptoms and treatment history.

Where appropriate, we may consider bespoke compounded prescriptions prepared by specialist pharmacies, within a structured medical framework and with clear monitoring. The point is not “more hormones,” it is the right plan for the right person, at the lowest effective dose, reviewed properly over time.

How we assess whether testosterone is right for you

We take a whole-person view, including:

  • Symptoms and what matters most to you (libido, confidence, energy, brain fog, strength)
  • Current or previous HRT, and whether oestrogen and progesterone have been optimised first
  • Medication review, relationship factors, stress, sleep, mood, and other drivers of low desire
  • Baseline bloods to guide safe prescribing and avoid overtreatment
  • SHBG and why “normal testosterone” does not always tell the full story
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Monitoring and safety

Testosterone for women should aim for a female physiological range, not a male range, and should be monitored with symptoms and bloods.

Possible side effects, usually dose-related, can include acne, oily skin, increased hair growth in unwanted areas, or scalp hair thinning. Voice change and clitoral enlargement are uncommon at appropriate female dosing but are reasons we monitor closely and adjust early.

If testosterone is prescribed as a cream or gel, we will also guide you on practical safety, such as avoiding skin transfer to partners or children until fully absorbed.

What results to expect, and how quickly

If testosterone is going to help, women often notice early changes in sexual interest and responsiveness within weeks, with broader changes in confidence, energy or strength taking longer. We typically review response and tolerability at a planned interval, then decide whether to continue, adjust, or stop.

Consultations in clinic and remotely

We see women in person at The Bespoke Clinic, and we also support women remotely across the UK. If you are not local, we can usually arrange blood testing through partner phlebotomy services and laboratories closer to you, and follow-ups can be done by video or phone where preferred.

Book a consultation

If you would like to explore whether testosterone is appropriate for you, we would be pleased to support you with a doctor-led, personalised plan and careful follow-up.

Is testosterone only for postmenopausal women

Not necessarily. Most guidance focuses on menopause, but we assess on symptoms, stage, and overall hormone context, particularly whether oestrogen and progesterone have been optimised first.

Not when prescribed carefully and monitored. The aim is to restore levels into a female physiological range, not to push levels high. (Women’s Health Concern)

Why do my testosterone blood results look “normal” but I feel low

Because symptoms do not always correlate neatly with a single blood value. SHBG and tissue sensitivity can matter, and your overall hormone picture matters too.

Historically, most prescribing has been off-licence. AndroFeme has now been MHRA approved for postmenopausal women, with UK availability expected from 2026.

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