Is testosterone important for women?
Testosterone is a physiologically relevant hormone for women, with the strongest evidence for sexual desire and sexual function. If you have symptoms consistent with low testosterone levels, it is worth discussing this with your doctor, including the choice of skin-based delivery.
Women have higher concentrations of testosterone in their blood than oestradiol. That makes testosterone, alongside oestrogen, one of the most abundant sex hormones in women. It acts directly on tissues throughout the body and is partly converted into oestradiol.
The best-supported effect is on sexual desire and sexual response. A meta-analysis of 36 randomised controlled trials involving more than 8,480 postmenopausal women showed that testosterone delivered through the skin (patch or cream) significantly improves sexual desire, arousal, orgasm and the frequency of satisfying sexual experiences compared with a placebo. Sexual distress and negative self-image also decreased.
The picture for mood, energy and wellbeing is less clear-cut. Low testosterone levels are associated with persistent fatigue, reduced motivation and lower self-esteem. Whether testosterone is a direct cause of these symptoms has not yet been fully established. For memory, muscle mass and bone density, the same meta-analysis found no statistically demonstrable benefit; the studies were too small to allow firm conclusions.
Testosterone levels can drop considerably following removal of the ovaries, with levels of testosterone and its precursor androstenedione falling by approximately 50%. Oral oestrogen therapy also lowers freely available testosterone, because it raises a binding protein in the blood that 'holds on to' testosterone. Women using oral hormone therapy therefore face a greater risk of a functional testosterone deficiency.
Anyone considering treatment should be aware that orally administered testosterone has unfavourable effects on cholesterol: LDL rises and HDL falls. This drawback does not occur with skin-based delivery, which is therefore preferred. Side effects such as acne and unwanted hair growth can occur, but serious problems were rare in the available trials. One practical obstacle: in most countries there is no officially approved testosterone preparation for women, meaning that doctors are obliged to prescribe outside the registered indication.
Claims based on four PMID sources, including a meta-analysis of 36 randomised studies (PMID 31353194) and multiple clinical review studies. Mechanistic claims are partly derived from animal research (genetically modified mice, PMID 26863277).
Does using testosterone help if you are over 50, and can it be dangerous?
Testosterone can be worthwhile for men over 50 with a medically confirmed testosterone deficiency, but it is not a treatment for everyone who is getting older: the benefits are real, the risks are too, and a doctor must establish the indication.
Do men need estrogen for their health?
Yes, men need oestrogen for strong bones, healthy blood vessels, and fertility. Both a deficiency and an excess are harmful, so it is a matter of finding the right balance.
Does testosterone decline in men with age, and should you do something about it?
Testosterone really does decline in men with age. TRT is well supported only in men with established hypogonadism and symptoms, primarily for sexual function. If you have symptoms, always have the underlying cause investigated first.
Does boron raise your testosterone?
The two randomised studies in men show no effect on testosterone; the only small study that did find a rise in men had no placebo group and just eight participants. If you want to improve your testosterone, boron currently has no reliable supporting evidence.
Can hormones explain why women live longer on average than men?
Sex hormones likely contribute to women's longer lifespan, but they do not fully explain the difference. Social factors also play a role, and the hormonal protection has a clear downside after the menopause.
Does hormone therapy help women age more healthily?
Hormone therapy relieves menopausal symptoms well and shows positive indications for bones and metabolism, but the effects on the heart and brain are uncertain and highly individual. Whether it is worthwhile for you depends strongly on your symptoms, timing and health history: discuss it with your doctor.