A recent study published in The Lancet eBioMedicine has brought new insights into the relationship between testosterone levels and menopause. Contrary to popular belief, researchers found that testosterone levels in women do not significantly decline at menopause, but rather decrease gradually with age. This revelation has implications for how testosterone is viewed in the context of menopausal hormone therapy (MHT).
Social media has widely promoted testosterone as a crucial component of MHT for alleviating symptoms such as low mood and loss of vitality. As a result, many women who do not receive testosterone as part of their treatment may feel they are missing out. The study, led by researchers including Susan Davis of Monash University, analyzed blood testosterone levels in women aged 40 to 69 years, providing robust evidence that challenges misconceptions about hormone changes during menopause.
The research builds on findings from earlier studies, including a significant one from 2005 involving 1,400 women, which indicated that testosterone levels remain stable through menopause. Previous tests were limited in accuracy, prompting the need for more reliable methods. In a subsequent study in 2019, researchers identified an average decline of approximately 25% in testosterone levels between the ages of 18 and 39. The latest study involved 1,104 participants and took into account menstrual cycle data to classify women as premenopausal, perimenopausal, or postmenopausal.
Findings revealed that testosterone levels declined by an average of 25% between the ages of 40 and 59, with no significant differences across the menopausal stages. Interestingly, postmenopausal women who had undergone surgical removal of their ovaries exhibited lower testosterone levels than those who retained at least one ovary, indicating that ovaries continue to produce some testosterone even after menopause.
The study also noted an unusual increase in testosterone levels starting around age 58 or 59, echoing findings from earlier research which suggested that levels may stabilize or even rise in later decades. This gradual increase could partially explain common age-related changes in women, such as hair thinning and unwanted facial hair growth.
Understanding testosterone fluctuations throughout a woman’s life has been a topic of debate for over two decades. Researchers previously proposed a “testosterone deficiency syndrome” in menopausal women, but the new study refutes the notion that menopause triggers testosterone deficiency. Current international clinical guidelines recommend that testosterone therapy should be prescribed only for women experiencing low sexual desire after menopause, as evidence supporting broader benefits remains inconclusive.
Multiple clinical trials have indicated that testosterone treatment could modestly enhance sexual desire in postmenopausal women experiencing bothersome changes. However, there is no substantial evidence linking testosterone therapy to improvements in mood, muscle mass, or other symptoms typically associated with menopause.
Future research is underway, with ongoing investigations into the effects of testosterone on muscle function and bone density, and results are expected to be released in 2026. This evolving understanding of testosterone’s role in women’s health emphasizes the need for careful consideration of hormonal treatments and highlights the complexities of hormonal changes with age.
The findings from this comprehensive study contribute to a clearer picture of how testosterone functions in women’s bodies and challenge longstanding assumptions about menopause and hormone therapy. As research continues, it will be crucial to examine the implications for women’s health and treatment options moving forward.
