Testosterone has effects throughout your body, including your brain, bones and muscles, and levels naturally decline with age - discover how low testosterone can affect you
- Testosterone has a significant influence on libido but also across your whole body
- Testosterone levels usually start to decline around the late 20s and early 30s
- Some women find testosterone replacement can help to alleviate their symptoms
Testosterone is an important hormone. It’s often referred to as the 'male hormone' but while men have higher circulating levels of testosterone than women, it’s the most abundant biologically active hormone in women.
Testosterone is produced by your ovaries, adrenal glands and the brain but when levels decline, this can lead to a lack of energy, brain fog and reduced libido (sex drive).
RELATED: How do perimenopause and menopause affect my sex drive?
What does testosterone do?
Testosterone is perhaps best known for influencing libido – the level of interest in sex, and the amount of pleasure felt from it. But testosterone has a significant impact beyond this – you have testosterone receptors all over your body so its effects can be felt all over.
Testosterone plays a substantial role in a number of physiological processes in your brain. It strengthens nerves in your brain, and contributes to mental sharpness and clarity. It strengthens arteries that supply blood flow to your brain, which protects against loss of memory. It regulates serotonin levels and plays a role in its uptake in your brain, which helps improve overall mood. Testosterone also stimulates the release of dopamine, another neurotransmitter responsible for your feelings of pleasure.
Testosterone also helps with muscle mass and bone strength, cardiovascular health, and overall energy levels and quality of sleep.
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What happens if I have low testosterone?
Levels of testosterone in women gradually decline as you enter your 30s but drop around the time of perimenopause and menopause. If you have a surgical menopause (if you have your ovaries removed, or an operation or treatment that impacts ovarian function), you can experience a more sudden drop in hormones than women who go through menopause naturally.
When your levels of testosterone reduce, you may find that you desire sex less often and when you do have sex, it’s not as enjoyable as it used to be (even when you still desire and love your partner).
Other symptoms of lower testosterone may include:
• Anxiety, irritability, or depression
• Feeling generally unwell
• Fatigue
• Bone and muscle loss
• Difficulty thinking clearly or remembering things
• Trouble sleeping
• Hot flushes
• Joint pain
• Urinary issues such as frequent infections, cystitis, or incontinence (leaking urine when you don’t want to).
RELATED: Brain fog and testosterone: what's the link?
Should I consider testosterone replacement?
Research shows that testosterone therapy may help improve mood, energy, mental health, joint and muscle pain, migraines, urinary symptoms, stamina, sleep, skin and hair changes, heart palpitations, and other symptoms in women [1,2,3,4,5,6]. It may also lower the risk of heart disease, osteoporosis, type 2 diabetes, and possibly dementia [7].
If you're experiencing symptoms such as low energy, brain fog, poor sleep, low mood, anxiety, reduced motivation, or low libido, it may be worth discussing testosterone therapy with your healthcare provider.
While checking your testosterone level can be helpful, it’s important to know that blood levels don’t always reflect how much testosterone is available to your tissues. For this reason, healthcare providers often consider your symptoms alongside lab results when deciding whether a trial of testosterone replacement may be appropriate. Newson Clinic can provide testosterone blood tests and its healthcare professionals can offer support and treatments with symptoms of testosterone deficiency.
RELATED: Can HRT and testosterone prevent osteoporosis?
How is testosterone prescribed?
Testosterone is commonly given as a cream or gel, which you rub into your skin, often on your thighs, butt, inner arms, or the back of your knees, depending on individual absorption and preference. It is then absorbed directly into your bloodstream.
AndroFeme cream is formulated for women and in August 2025 it was approved for use in the UK by postmenopausal women.
Testogel, Testim and Tostran are gels that are made for men but can be prescribed off licence and safely used in lower doses for women.
Your healthcare provider will help determine the most appropriate form and dosage based on your symptoms, absorption, and treatment goals.
It should be rubbed onto clean, dry skin like a moisturiser, and it usually takes about 30 seconds to dry. You should wash your hands thoroughly after using it. Applying the cream or gel at the same time each day will have the best effect and help you remember to apply it. Avoid swimming or showering until around 30 minutes after application and initially avoid using perfume, deodorant or moisturising creams on the area.
It can sometimes take a few months for the full effects of testosterone to work in your body. If absorption through the skin is a concern, other delivery methods may be considered.
Testosterone can be taken alongside estrogen and progesterone or can be used on its own.
RELATED: Testosterone gel and cream: what you need to know
What are the benefits of testosterone replacement?
Many women find that taking testosterone as part of their hormone treatment (HRT) provides further improvements than taking estrogen alone (with or without a progesterone). Benefits you might experience include:
• Increased libido and sexual arousal levels
• Improved energy and stamina
• Improved muscle mass and strength
• Improved concentration, clarity of thought and memory
• Improved sleep
Newson Research has written up 19 studies about testosterone, including about its safety and beneficial effects, especially with improving mental health symptoms, memory and brain fog.
In our newly published study of 279 women already taking transdermal estradiol, with or without progesterone, we found that adding transdermal testosterone was associated with significant improvements in 15 of 24 symptoms assessed after three months [8].
These included 59% of patients reporting an improvement in vaginal dryness, 55% in hot flushes, 55% in libido, 54% in dizziness, 45% in musculoskeletal pain and 44% in tension headaches.
Our research has also explored the potential effects of testosterone on mood and cognition. In a study of 510 women who had already been using HRT and who were treated with transdermal body-identical testosterone for four months, we found significant improvements in cognition and mood [1].
The study found 56% of women reported an improvement in ‘loss of interest in most things’ and 55% in ‘crying spells’. Mood and libido improved to a similar degree, adding to the growing evidence that the testosterone has a wider role in women’s health than its established use for low sexual desire.
RELATED: Testosterone has whole body benefits, new study finds
What are the risks of testosterone replacement?
Side effects are uncommon when testosterone is prescribed at the right dose to replace what your body is missing. You might notice some hair growth where you apply the cream or gel, but other side effects are rare.
Some women may worry about potential side effects from testosterone therapy, such as changes to their voice, increased hair loss, or increased facial hair. These concerns are understandable, but when testosterone is prescribed at the right dose and monitored appropriately, these effects are uncommon. Any side effects are usually reversible.
If you use AndroFeme, this contains almond oil so should not be used if you have an allergy to almonds.
Long-term use of safely prescribed testosterone replacement is not associated with any adverse health risks and is shown to be beneficial for the health and strength of your muscles, bones, cardiovascular health and brain health.
RELATED: Testosterone and hair during menopause
What else should I know about testosterone replacement?
You’ll need a blood test to check your testosterone levels about three months after starting treatment. Ongoing monitoring is recommended at least twice per year, which typically includes both lab testing and a review of your symptoms. Lab values alone don’t always reflect how much testosterone is available to your tissues, so your healthcare provider will also assess how you're feeling to guide dosing and treatment decisions.
Healthcare professionals at Newson Clinic can provide testosterone blood tests, individualised support and treatments around testosterone replacement.
RELATED: Testosterone levels in women: what do they actually mean?
