By Katie Sorensen, NP-C | Weight Loss NP

Testosterone for Women in Menopause: What the FDA Is Reviewing and What Patients Should Know

By Katie Sorensen, NP-C | Weight Loss NP

Testosterone for women is having a moment.

Women are hearing about it on podcasts, Instagram, menopause forums, and from friends who say it helped their libido, energy, strength, mood, or motivation.

Some of that conversation is helpful. Some of it is oversimplified.

And some of it makes testosterone sound like the missing hormone that explains everything about midlife, which is not clinically accurate.

On September 17, 2026, the FDA held a public workshop on testosterone use in menopausal women. The agency noted that testosterone use in women approaching or after menopause has increased, while important questions remain about safety, dosing, testing, long-term outcomes, sexual function, mood, cognition, muscle, and bone health.

This is a timely conversation, and one that requires nuance.

Why women are asking about testosterone

Many women in perimenopause and menopause feel like something changed.

They may describe:

• Lower libido
• Less sexual response or pleasure
• More fatigue
• Loss of strength
• More belly weight
• Less muscle tone
• Lower motivation
• Brain fog
• Mood changes
• Poor sleep
• Feeling less like themselves

When women ask about testosterone, they are often not just asking about a lab value.

They are asking, “Why do I not feel like myself?” That question deserves to be taken seriously.

But it also deserves a full evaluation, not a one-hormone answer.

Learn more about our hormone replacement therapy services.

What does testosterone do in women?

Women naturally make testosterone.

Levels are much lower than in men, but testosterone still plays a role in sexual desire, arousal, muscle, bone, energy, and overall sense of vitality.

Perimenopause and menopause involve changes in estrogen, progesterone, testosterone, sleep, insulin sensitivity, stress response, body composition, and metabolism.

So when a woman is tired, gaining weight, losing strength, and noticing low libido, the answer might involve testosterone.

It might also involve poor sleep, hot flashes, low estrogen, thyroid disease, iron deficiency, depression, relationship stress, medication side effects, over-restriction with food, lack of strength training, insulin resistance, or several of these at once.

What is the evidence for testosterone therapy in women?

The strongest evidence for testosterone therapy in women is for hypoactive sexual desire disorder, often called Hypoactive Sexual Desire Disorder (HSDD)

HSDD is not just “I am busy, tired, and less interested in sex.”

It usually means persistently low sexual desire that causes personal and relational distress and is not better explained by another medical, relationship, medication, or psychological factor.

The Global Consensus Position Statement on testosterone therapy for women found that testosterone can improve sexual wellbeing in postmenopausal women with HSDD, including sexual desire, arousal, orgasmic function, pleasure, responsiveness, and reduced distress.

The International Society for the Study of Women’s Sexual Health also supports systemic testosterone therapy for postmenopausal women, and in some guidance late reproductive-age women, with HSDD after appropriate evaluation.

That is meaningful.

But it is not the same as saying testosterone is a general treatment for fatigue, weight gain, brain fog, or “anti-aging” for any woman in midlife and beyond.

Why the FDA meeting matters

The FDA workshop matters because testosterone use in women is increasing, but the regulatory and clinical landscape is still messy.

There is currently no FDA-approved testosterone product specifically indicated for menopausal women in the United States.

That means clinicians who prescribe testosterone for women are often using carefully adjusted off-label options or compounded formulations.

This makes dosing and monitoring especially important. Women should not be given testosterone at male doses.

They also should not be told that a testosterone prescription is harmless because it is “natural.”

Hormones are powerful. Helpful, yes. But still powerful.

Symptoms testosterone may help

Testosterone may be considered for some women with low sexual desire that causes distress, especially after evaluating other contributors.

Potentially relevant symptoms may include:

• Low sexual desire
• Reduced arousal
• Less sexual pleasure
• Reduced orgasmic response
• Sexual distress related to low desire

The goal is not to chase a high testosterone number.

The goal is to determine whether symptoms fit the clinical picture, whether other causes have been addressed, and whether a carefully monitored trial is appropriate to support them.

Symptoms testosterone should not be expected to fix by itself

Testosterone is not a magic midlife repair tool.

It should not be used as the only answer for:

• General fatigue
• Weight gain
• Belly fat
• Brain fog
• Low motivation
• Mood swings
• Poor sleep
• Muscle loss
• Joint aches
• “Hormone optimization”
• Anti-aging

Could testosterone play a role for some women? Yes.

But if a woman has poor sleep from night sweats, untreated insulin resistance, low protein intake, no strength training, high stress, thyroid issues, or under-treated menopause symptoms, testosterone alone is unlikely to be the full answer. It’s likely multi-faceted an deserves a full evaluation.

At Weight Loss NP, we look at the whole picture.

Testosterone, weight, and body composition

Many women ask about testosterone because their body composition changes in midlife.

They may notice more belly fat, less muscle, slower recovery, and less strength.

Testosterone may play a role in muscle and body composition, but it should not be marketed as a weight loss medication.

If body composition is the main concern, the plan usually needs to include:

• Adequate protein
• Strength training
• Sleep improvement
• Insulin resistance evaluation
• Menopause symptom treatment
• Nutrition that is not overly restrictive
• GLP-1 medication when appropriate
• Long-term maintenance support

This is where hormone care and medical weight loss often overlap.

Read more about our medical weight loss services.

What should be checked before considering testosterone?

Before testosterone is considered, a provider should review the full clinical picture.

That may include:

• Symptoms and how long they have been present
• Whether low libido is causing personal distress
• Relationship, stress, sleep, and mental health factors
• Current medications
• Menopause stage
• Hot flashes or night sweats
• Vaginal dryness or pain with sex
• Estrogen and progesterone therapy status
• Thyroid history
• Iron or anemia concerns
• PCOS or acne history
• Hair loss or facial hair concerns
• Cardiovascular risk
• Breast health history
• Pregnancy possibility when relevant
• Baseline labs when appropriate

Testing can be helpful, but symptoms and safety matter too.

A “normal” testosterone level does not always explain symptoms. A “low” testosterone level does not automatically mean testosterone is the right treatment.

What are possible side effects?

Testosterone side effects in women are usually dose-related.

Possible side effects include:

• Acne
• Oily skin
• Increased facial or body hair
• Scalp hair thinning
• Voice changes
• Mood changes
• Clitoral enlargement
• Changes in cholesterol or liver markers depending on formulation
• Unintended over-treatment

Some changes, such as voice deepening, may be irreversible.

This is why dosing matters. Expert monitoring matters. And more is not better.

How Weight Loss NP approaches testosterone for women

At Weight Loss NP, we do not treat testosterone as a trend, but we do use it as a tool, as appropriate, within a broader menopause and metabolic health plan.

For women in perimenopause and menopause, we look at:

• Symptoms
• Sleep
• Libido and sexual distress
• Estrogen and progesterone needs
• Weight and body composition
• Muscle preservation
• Insulin resistance
• Nutrition and protein intake
• Strength training
• Thyroid or iron concerns
• Medication side effects
• Risk factors
• Patient goals

Testosterone may be part of the conversation. Sometimes the better starting point is estrogen, progesterone, vaginal hormone support, sleep, GLP-1 care, nutrition, strength training, or labs.

A good menopause plan should be individualized.

Testosterone and HRT care in Denver, Arvada, Colorado, Utah, and Florida

Weight Loss NP provides hormone-informed care for women in perimenopause and menopause, with local roots in Denver and Arvada and telehealth options in Colorado, Utah, and Florida.

We help women understand what is changing, what is treatable, and what should be evaluated more carefully.

That may include HRT, GLP-1 medical weight loss, lifestyle support, and a women’s testosterone discussion when clinically appropriate.

The bottom line

Testosterone for women deserves a serious, evidence-based conversation.

It should not be dismissed, but It also should not be oversold.

The FDA’s public workshop is a good reminder that women deserve better research, better options, and more thoughtful care.

At Weight Loss NP, our goal is to help women sort through the noise and make decisions that are medically grounded, personalized, and realistic. If you’d like to discuss what your treatment plan might entail, book a FREE consultation with us now.