*Content reviewed by Audrey Hou, PharmD, CMPP

While not approved by the FDA for the treatment of menopause, testosterone gel is becoming an increasingly recognized option for managing certain menopause symptoms, especially in women experiencing a significant drop in libido, energy levels, and mood. Testosterone plays a crucial role in sexual function, bone density, muscle mass, and overall mood regulation. While it's commonly associated with male health, testosterone is also important for women, particularly as their bodies produce less of it leading up to and during menopause.

How Testosterone Gel Works

Testosterone is commonly prescribed off-label, often as a compounded topical cream or as a reduced dose of a testosterone gel (1%) FDA approved for men (e.g., AndroGel, Testim).Testosterone gel is applied topically and absorbed through the skin, delivering testosterone directly into the bloodstream. This method of application helps to maintain a steady level of testosterone, mimicking the body's natural rhythm more closely than oral or injectable forms. The goal is to restore testosterone levels to a normal range that supports overall health and well-being, without exceeding the levels typical for premenopausal women.

Potential Benefits of Testosterone Gel for Menopause

• Improved Libido: Testosterone plays a key role in sexual desire. Many women experience a noticeable improvement in libido after starting testosterone therapy.
• Increased Energy and Mood Enhancement: Restoring testosterone to premenopausal levels can help improve energy levels and mood, combating some of the emotional and psychological challenges of menopause.
• Bone Density and Muscle Mass: Testosterone helps maintain bone density and muscle mass, which are important for overall physical health and can reduce the risk of osteoporosis.

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Usage and Considerations

Testosterone gel should be used as prescribed by a healthcare provider. The National Institute for Health and Care Excellence (NICE) guidelines state that testosterone supplementation can be considered for menopausal women with low sexual desire if hormone replacement therapy (HRT) alone is not effective. The gel is typically applied to clean, dry skin on areas like the arms, shoulders, or abdomen. It's important to follow the application instructions carefully to ensure optimal absorption and to minimize the transfer of testosterone to others through skin contact.

Side Effects and Considerations

While testosterone therapy can be beneficial, it's not without potential side effects. These may include acne, hair growth in unwanted areas, and changes in cholesterol levels. Long-term effects with testosterone supplementation for menopause is not well-understood, as research is ongoing. Women with a history of hormone-sensitive cancers should approach testosterone therapy with caution, and it's generally not recommended.

Conclusion

Testosterone gel may be a valuable treatment option for women experiencing low libido, energy, and mood changes during menopause. By addressing the decline in testosterone levels, it offers a pathway to improving quality of life for those affected by these symptoms. However, as with all hormone therapies, individual responses can vary, and a personalized approach to treatment, under the guidance of a healthcare provider, is essential to achieving the best outcomes while minimizing risks.