Testosterone has seen a surge in demand in recent years. The hormone can boost sex drive in menopause, so it’s not surprising people want to try it! Compared to 2015, there are now 10 times more menopausal women with an NHS prescription for testosterone gel. But this treatment isn’t right for everyone. To find out if it could help you, your first port of call is to speak to your doctor. They can refer you for a blood test. Find out what they are testing for and what your results mean.
Find what you need quickly
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What is testosterone?
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Why is testosterone important in menopause?
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Who can get prescribed testosterone for menopause?
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Is there a test for testosterone?
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When should you get a testosterone test?
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Testosterone blood tests for HRT
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What is a normal testosterone level?
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What happens if your testosterone level is too low?
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What happens if your testosterone level is too high?
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Final word
What is testosterone?
Both sexes need a certain level of testosterone. It’s the hormone responsible for building muscle, maintaining healthy bone density and your desire for sex. Men have higher levels of testosterone than women, but you may be surprised to learn that premenopausal women produce three times more testosterone than oestrogen, which is the main female sex hormone.
Why is testosterone important in menopause?
Testosterone levels decline gradually once you hit 30, but the effect becomes more obvious during menopause because your body also stops producing as much oestrogen.
Some people are more sensitive to this change than others and it can cause:
- Low sex drive – also known as low libido
- Hypoactive sexual desire disorder (HSDD) – when a lack of sexual desire disrupts your life for a long period of time and leaves you distressed
Those who go through a medically induced or surgical menopause experience a more dramatic fall in testosterone and may struggle with more severe symptoms as a result.
Things like stress, relationships, mental health and some medication also affect your sex drive. Your doctor will consider the whole picture before deciding if testosterone is the best choice for you.
Find out more about menopause and anxiety in our symptoms library.
Who can get prescribed testosterone for menopause?
Testosterone is usually only recommended if you are already taking oestrogen and/or progesterone HRT. It is also only currently recommended for people with HSDD.
Some people say it also helps with mood, brain fog, energy and aches and pains, but there is not enough scientific evidence to back this up at the moment. Read more about HRT and testosterone.
Is there a test for testosterone?
Yes, your testosterone levels can be checked with a blood test. Blood is either taken from a vein or by a finger prick.
There are a few different testosterone tests, but testosterone treatment for menopause involves what is called a total testosterone level check, as recommended by the British Menopause Society.
It can be difficult to get your testosterone levels tested on the NHS, particularly if your surgery doesn’t have a menopause specialist. Choose a properly regulated company if you decide to go private.
You can get tested through our fully regulated testosterone service. We use finger-prick blood tests from Thriva, which is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA).
When should you get a testosterone test?
A testosterone test can help:
- If you are already on HRT and you’re struggling with distressingly low libido, or HSDD
- To find out your baseline before starting testosterone treatment
- To check your testosterone treatment is working ok
- To check if you have a medical condition linked to high testosterone, such as polycystic ovary syndrome (PCOS)
A testosterone test won’t tell you:
- If you are in menopause or not
- Why you are tired, weak or gaining weight
- If your HRT is working if it’s oestrogen and/or progesterone only
Testosterone blood tests for HRT
Your testosterone levels will usually be checked about 6-12 weeks after you start testosterone. Your testosterone dose may be changed as a result and you will have another blood test three months later.
You will still need to have your levels checked every 6-12 months even if you notice an increase in your sex drive and your testosterone levels are in the recommended range.
Read more about HRT and testosterone.
What is a normal testosterone level?
Normal values change throughout your life and depend on your sex. There are also many different types of testosterone tests and each laboratory has slightly different ‘normal’ ranges.
Thriva provides Stella’s blood tests. Their normal testosterone level is between:
- 0.29 – 1.67 nmol/L – if you’re under 50
- 0.101-1.42 nmol/L – if you’re over 50
If you are taking testosterone as part of your HRT, your doctor will aim to keep your levels within the normal range for under 50s. This is to minimise the risk of side effects.
What happens if your testosterone level is too low?
This depends on why the test has been done.
Low testosterone levels don’t always cause problems. You could have low testosterone and a normal sex drive, or testosterone in the middle of the range and be struggling.
A low result only needs treatment if your symptoms are having an impact on your life and relationships.
What happens if your testosterone level is too high?
Testosterone might not be a suitable treatment for you if your testosterone level is in the top third of the normal range.
Higher than normal levels of testosterone increase your risk of side effects, although these can still happen at normal levels. Common side effects can include:
- Extra hair growth on your face or body
- Oily skin or acne
- Weight gain
Rare side effects include hair loss, voice deepening and clitoral enlargement.
There isn’t enough data at the moment, but early research suggests there may be a link between increasing testosterone levels and certain types of cancer.
If you are taking testosterone as part of your HRT and your level becomes too high your dose will likely be decreased. You should have a repeat blood test three months later to make sure your treatment remains safe.
If your testosterone levels are very high and you are experiencing significant side effects, for example if your voice has deepened, it’s likely you will be advised to stop testosterone therapy altogether.
Read more about possible risks and side effects in our guide to testosterone for menopause.
Final word
Testosterone treatment can help those struggling with low sex drive alongside standard HRT. A blood test will help your doctor decide if it is right for you. To keep your levels within a safe range you will have blood tests every few months if you do start treatment.
We offer testosterone as part of our clinical services. Email hello@onstella.com if you want to find out more.
- British Menopause Society 2022, Testosterone Replacement in Menopause
- Dunsmoor-Su R, Fuller A, Voedisch A 2021, ‘Testosterone Therapy in Women: A Clinical Challenge’, Obstetrics & Gynecology, vol. 138, no.5, pp. 809-812
- Parish SJ, James, A, Simon, S.R, Davis, AG, Goldstein, I, Goldstein, SW, Kim, NN, Kingsberg, SA, Morgentaler, A, Nappi, R.E, Park, K, Stuenkel, C.A, Traish, AM, Vignozzi, L 2021, ‘International Society for the Study of Women’s Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women’, The Journal of Sexual Medicine, vol. 18, no. 5, pp. 849–867
- Stella, HRT and testosterone – what you need to know
- Stella, Testosterone and menopause – beginner’s guide
- Watts, EL, Perez‐Cornago A, Knuppel A, Tsilidis KK, Key TJ, Travis RC, 2021, ‘Prospective analyses of testosterone and sex hormone‐binding globulin with the risk of 19 types of cancer in men and postmenopausal women in UK Biobank’, International Journal of Cancer, vol. 149, pp. 573–584
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