Tafiq Akhir aka Mr. Menopause: [00:00:00] Everywhere you look right now, someone is saying testosterone is the missing link for menopause. They promise that it'll fix your energy, your sleep, your mood, even your weight. But here's the thing, while testosterone does have its place, the science shows that it's not the magic solution for every symptom that you're facing.
And the danger of testosterone hype is that women are spending money. Taking risks and sometimes even harming themselves, chasing a promise that is only partly true. Now, by the end of this episode, you will know the difference between fact and fiction when it comes to testosterone therapy and menopause.
You'll understand where the science is solid, where it's still uncertain, and why. Relying only on influencer claims could leave you more confused, frustrated, or even unsafe. But most importantly. You will walk away with the clarity to have a smarter conversation with your doctor and to make choices that actually support your [00:01:00] body, your health, and your future.
But before we dive in, if you find value in honest conversations about menopause and healthy aging, be sure to subscribe and hit the bell so that you never miss an episode. I'm Tafiq Akhir, Mr. Menopause here and welcome to the Mr. Menopause Show.
Let's start with what testosterone really is and why it matters. Well, testosterone is not just a male hormone. Women naturally produce it in their ovaries and adrenal glands, and it supports sexual desire, bone density, lean muscle, and even aspects of mood and motivation. Levels decline with age, and many women Notice this drop around perimenopause and then moving beyond.
Now, here's where the confusion begins. In recent years, [00:02:00] testosterone has been painted as the missing puzzle piece for women in menopause. You may have heard promises that testosterone therapy will restore your energy, will sharpen your memory, erase mood swings, and melt away body fat. Sounds appealing, right?
Especially if you've been struggling to make sense of the endless changes that are happening in your body during this stage of life. But the reality is much more nuanced. The strongest evidence for testosterone therapy in women is in the treatment of low libido, specifically hypoactive Sexual Desire Disorder, or HSDD.
E. Now, multiple clinical trials and reviews have consistently shown for women who are postmenopausal and struggling with lack of sexual desire that causes distress. Testosterone can improve sexual interest, arousal, and satisfaction. Now, this is the one area where medical guidelines agree that testosterone [00:03:00] can be helpful when monitored by a qualified provider, but outside of sexual function, the evidence is limited.
Inconsistent or still under investigation. And with that, let's break it down so that you can see the whole picture. As it relates to brain fog and cognitive function. Many women report feeling sharper, more focused, and mentally clearer after beginning testosterone therapy. Now there are small pilot studies suggesting improvements in aspects of cognition and memory.
However, larger randomized controlled trials have not confirmed these benefits across. The board. So this means that while some women do notice changes, science has not yet proven that testosterone is the reliable treatment for a brain fog or memory decline. In menopause, the improvements could be related to indirect effects, like better sleep or improved mood, rather than direct action on the brain for mood and anxiety.
Some women also [00:04:00] report feeling calmer, less anxious, and less depressed when using testosterone therapy. Again, the studies are mixed. Now, a few small trials suggest mood benefits, but large scale data is still lacking. It's also possible that these improvements stem from the overall sense of wellbeing that comes from libido and intimacy improvements rather than testosterone acting directly as an antidepressant.
In other words, the benefit may be real, but the pathway may not be what is being marketed online. Money. Energy is another area that often comes up in influencer posts. Women describe feeling more motivated to exercise, more resilient against fatigue, and even more productive at work. And while testosterone does play a role in lean muscle and metabolic health, the research again, is mixed.
There is no strong evidence that testosterone consistently improves fatigue in menopausal women. So it's important to remember that energy is influenced by [00:05:00] sleep. Stress levels, nutrition and overall hormone balance, not just testosterone alone. Now, testosterone does help maintain lean muscle in men, and it is strongly associated with strength and muscle building.
For women, though the effects are a little more subtle, some evidence suggests that testosterone therapy can help to preserve muscle and possibly bone density, especially when used alongside estrogen. But these benefits are not as dramatic as online claims suggest. Testosterone is not a shortcut to muscle tone or weight loss.
In fact, if the goal is fat reduction, your body composition improvement. Lifestyle factors like strength training, balance, nutrition, and adequate sleep are still the main drivers, not testosterone. Another critical point, often overlooked in influencer posts. Is that hormones do not act in isolation. It's not just about boosting testosterone.[00:06:00]
The ratio between estrogen, progesterone, and testosterone plays a huge role in how your body feels and functions. Research has shown that when testosterone to estrogen ratio is too high, it may actually worsen mood symptoms, or sleep quality. So simply adding testosterone without considering your full hormone picture, well, that could create more problems than it solved.
And when it comes to safety, testosterone therapy is not without its risks either. The most common side effects are acne, increased body or facial hair, and sometimes hair thinning on the scalp at higher doses. Women may also experience voice deepening or changes in cholesterol levels, and these risks highlight why professional monitoring is crucial.
And keep in mind though, that in the US there is no FDA approved testosterone products specifically designed for women. So that means that many treatments are compounded [00:07:00] formulations which vary in quality and dose accuracy. And this makes working with a menopause informed healthcare provider so much more essential and long-term safety is another area where evidence is.
Is thin, most studies are short term, often lasting less than a year, and we still don't fully know the long term effects on heart health, breast cancer risk, or metabolic disease. And this uncertainty makes the blanket promotion of testosterone therapy by influencers, irresponsible and potentially dangerous, in my opinion.
So then the big question is, if the evidence is so mixed, why is testosterone suddenly everywhere? Well, one reason is the growing frustration that women feel about the lack of effective menopause care. Many women feel ignored, depressed, or given only partial solutions, so when someone comes along claiming there's one quick fix, it is tempting to believe it.
See, social [00:08:00] media also thrives on simple messages and dramatic claims, which makes nuanced evidence-based conversations harder to amplify. And of course there is also a commercial element. Clinics and providers offering testosterone therapy often make bold promises as part of their marketing. And while some genuinely do want to help others, especially non menopause certified influencers may be capitalizing on the lack of awareness and the desperation that many women feel.
Oh four relief. Look, the truth about testosterone is menopause therapy is that it can be valuable for specific women in specific circumstances, particularly those struggling with sexual desire that has significantly declined. Beyond that, the evidence for benefits in areas like mood, brain function, energy, or weight is still being studied, and the results so far are not definitive.
And this does not mean testosterone is used. But it does mean it is [00:09:00] not the universal solution. It is often portrayed to be. So before you assume that testosterone is the missing piece of your menopause journey, remember this, every woman's journey is unique and hormones must be understood in context.
The hype oversimplifies a very complex. So next up we're gonna look at what medical experts and organizations actually recommend about testosterone. How to know if it might be right for you and what to watch out for if you are considering it. When it comes to testosterone and menopause, the conversation is complicated.
And that is exactly why hearing what top specialists actually see in their patients and, and the research is so important because while some women experience life changing results, others find themselves facing side effects, disappointments, or even unnecessary risks. So let's look [00:10:00] at both sides of the story through the eyes of some of the leading voices in menopause Met.
Dr. Mary Claire Haver has been outspoken about the need to take sexual health seriously during menopause. She has explained that testosterone acts on regions of the brain responsible for sexual behavior, which means that therapy can literally help the brain respond more strongly to intimacy by increasing testosterone.
She says these brain centers become more responsive to sexual stimuli. And that is why women who feel disconnected from desire may find therapy useful for haver. The lesson is clear. Low libido is a legitimate medical issue, not something that women should be told to simply push through. Now, imagine a woman in her early fifties thriving in her career and family life, but silently worried about the sudden loss of sexual desire.
This is not about vanity. It's about connection, confidence, and wellbeing. [00:11:00] Dr. Haber's perspective shows that testosterone when used with precision can get back a piece of themselves that menopause seem to take away, and this is where the strongest evidence lies. Dr. Florence Mte takes a precision medicine approach.
She tells stories of women who were not just battling hot flashes, but also struggling with stubborn weight gain around the waist fatigue and creeping insulin. Sense one of her patients found herself gaining pounds no matter how carefully she ate or exercised. And after careful testing, Dr. Comite discovered her testosterone was lower than expected.
Instead of flooding her with hormones, she optimized her dose adjusting until the patient felt better without side effects. Within weeks, the woman noticed her weight stabilizing and her energy improving. Dr. Kte explains this philosophy as. Limiting side effects, but increasing response. It's about finding the right dose for the right [00:12:00] woman at the right time.
And this kind of story illustrates why testosterone can be powerful, but only in the hands of a skilled provider who understands how to balance all hormones, not. Just one. She also points to emerging evidence that testosterone optimization can improve insulin sensitivity and metabolic health, which are potential benefits that may matter for midlife women facing increased risk of diabetes and heart disease.
These results are promising, but they require careful over. Right. Dr. Steven Goldstein sees testosterone therapy for women as a hot topic. He uses this phrase to highlight just how much buzz surrounds the issue from social media influencers to aggressive marketing campaigns. But Dr. Goldstein is quick to point out that hype does not equal proof.
He's seen women arrive in his office after being prescribed testosterone pellets by boutique clinics only to discover that their [00:13:00] hormone levels. We're three to four times higher than what's safe. The consequences, acne, facial hair growth, even voice changes that were difficult to reverse. Dr. Goldstein's caution is not about withholding care, it's about ensuring that women do not get hurt by poorly regulated treatments.
And he also reminds us that in the US there is no FDA approved testosterone product specifically designed for women. So that means compounded formulations are common, but these are not standardized and can vary dramatically in dose, and his message is sobering, but necessary. Before women embrace testosterone as a cure-all they need to separate myth from medicine and ask whether the benefits outweigh the risks for them.
Dr. Joanne Manson, one of the most respected researchers in women's health, takes a curious and measured state. She agrees that [00:14:00] testosterone has a place in treating low libido that does not improve with estrogen therapy alone, but she also underscores the limits of evidence when it comes to brain fog, depression, memory loss, or weight changes.
She says the data is not strong enough to justify routine prescribing. Larger long-term studies are still needed, and her perspective reflects her broader approach to menopause care. Women deserve full transparency about what is proven and what is still speculative. And that means being clear that testosterone is not the female fountain of youth is being touted as.
Now, for some women it can be life changing, but for others it may offer little beyond side effects. A Manson's voice is vital in reminding women that they should demand honesty and clarity from their providers, not promises based on small or inconclusive. Studies. And then there's Dr. [00:15:00] Wolf Ian, co-founder of the North American Menopause Society, who has long emphasized the importance of basing all menopause treatments on rigorous science.
And while he has not focused specifically on testosterone in the same way as doctors Haver, Comite, Manson, and Goldstein. His legacy is a reminder that no hormone therapy should be prescribed without strong evidence and careful monitoring. His role in establishing standards for menopause care makes his perspective highly relevant, in my opinion, because women should not be Guinea pigs for untested or poorly regulated treatments.
Now taken together, these expert voices paint a complex picture. Testosterone can be transformative for women with hypoactive sexual desire disorder. Both the clinical trials and patient stories do back that up. Dr. Aver shows us how it can reignite brain pathways [00:16:00] tied to intimacy. Dr. Comite demonstrates his potential impact on metabolism when carefully optimized.
But on the other side, Dr. Goldstein, Dr. Manson warned us that claims about mood, energy, and cognition are not yet supported by strong. Own data and Dr. Ian reminds us that the gold standard must always be rigorous evidence-based care, and this is why testosterone, therapy and menopause cannot be painted as all good or all bad.
It's neither villain nor hero. It's a tool, one that can help or one that can harm depending on how and why it's used. Now for you, the woman navigating menopause right now, the message is sent. You deserve individualized care, not a social media trend, not a one size fits all prescription. What works for one may not work for another, but the only way to know is through careful evaluation, honest conversations with your provider and treatment [00:17:00] discussions grounded in both science and your unique needs.
Now, up next I'm gonna walk you through how to approach testosterone therapy in real life. The practical questions to ask. The red flags to avoid and how to make sure any plan you choose truly supports your personal long-term health and vitality. When it comes to testosterone therapy, the real challenge is not just understanding the science, but applying it in everyday life.
And this is where many women get lost between influencer promises. Medical jargon and the lack of clear support from providers. And in this segment, I wanna give you real stories, real research, and a roadmap that you can actually use starting today. Now let me start with the story about Karen. A 52-year-old executive who had been following several influencers online.
She was convinced that testosterone pellets were [00:18:00] the answer to her brain fog and low energy. She invested thousands of dollars into a clinic promising miracle. At first, she felt a slight boost, but within six months, she started experiencing acne and dark facial hair growth, and when she finally had her levels checked by a certified menopause specialist, her testosterone was three times the recommended range for women.
Karen's story highlights why unregulated treatments can do more harm than good. Now, compare that to Elena 55 who struggled with complete loss of sexual. Of desire that was affecting her marriage and her sense of self after trying estrogen therapy without improvement. She and her doctor discussed adding testosterone.
They opted for a carefully dose transdermal cream monitored with regular blood work, and within three months, Elena noticed a renewed interest in intimacy and felt like herself again, no side effects, no gimmicks, just evidence-based [00:19:00] treatment tailored to her needs. Weeks. And these stories are not just anecdotes.
They reflect what real research shows. Testosterone can be life changing in the right circumstances, but risky and disappointed when misused. So what does the data actually tell? Well, according to a 2019 global consensus position statement, led by the Menopause Society and endorsed by more than 30 medical organizations, the only evidence-based indication for testosterone therapy in women is for postmenopausal women.
Diagnosed with HSDD in clinical trials, women reported a significant increase in sexual satisfaction. Compared to placebo, and that's a significant difference when we're talking about quality of life, right? However, when the same studies looked at cognition, mood, and energy, the findings were inconsistent.
Some small trials suggested improvements, but larger reviews found no statistical [00:20:00] significant difference between testosterone and placebo. And this is why experts caution against prescribing testosterone as a cure. Now another statistic worth noting is that up to 40% of women in perimenopause and menopause report low libido, yet only a fraction are even offered testosterone as an option.
Often because their providers are either not trained in menopause care or hesitate due to regulatory gas. And again, in the US there's no FDA approved testosterone product. For women, that means every prescription is off label or compounded. Creating an additional layer of complexity. In fact, Dr. Susan Davis, a leading researcher on female testosterone therapy says It is one part of a very complex hormonal environment, and it should be prescribed with caution and precision.
That statement is echoed across guidelines. Testosterone is not useless, but it's not [00:21:00] magic. Then on the flip side, Dr. Louise Newsome, a prominent menopause specialist in the uk, has noted that many women in her practice experience improvements beyond libido, including mood and energy. She argues that while more research is needed, dismissing women's lived experiences equally problematic.
This tension between evidence and anecdote is exactly why carefully personalized care is so. So important. Now, with all that being said, how do you apply this knowledge, right? Well, first, let's talk about red flags. If you encounter any of these, proceed with caution. First is pellet therapy marketed as a cure?
All pellets can deliver unregulated high doses that are difficult to adjust, so move with caution Nexus, promises of weight loss or anti-age. These claims simply are not supported by science. First of all, there's no [00:22:00] baseline blood tests or follow up monitoring either. And safe prescribing requires checking your levels before and during treatment.
Another red flag is risking high doses designed for men. When women only need one 10th, the dose of men and more is not better. If any provider or clinic skip these steps, those are warning signs. Signs, and here are a few important questions to ask your provider. In fact, you should feel empowered to ask these questions.
First is, what specific symptoms are we targeting with testosterone therapy? Second, what does the research say about using it for this particular symptom? How will my dose be monitored and adjusted? Are we using an FDA approved preparation when available or a compounded product? And if it is compounded, how is quality controlled?
And number five, what side effects should I [00:23:00] watch for and report immediately? Just five simple questions that can have a big impact on your care. Now these questions not only protect you, but also set the tone for a collaborative, informed relationship with your provider. Now, here's the bigger picture.
Testosterone is just one piece of the menopause care puzzle. Evidence shows that lifestyle interventions like nutrition, exercise, sleep, and stress management, of course, still remain foundational no matter what therapy, for example, resistance training is proven to preserve lean muscle and bone density.
Balanced nutrition supports stable blood sugar and energy. Stress reduction lowers cortisol, which in turns helps with mood and sleep. And if these pillars are missing, testosterone alone will not deliver the results that you are hoping for anyway. No therapy can do it alone. So what is the real truth about testosterone as menopause [00:24:00] therapy?
The truth is, it can be effective for low libido when nothing else works. And for some women it feels like a lifeline. But it is not the one size fits all solution that many influencers make it out to be. The risks of unregulated or inappropriate use are real, and the science does not support claims that testosterone also fix many menopause symptoms.
Instead, think of testosterone as a specialized tool when used carefully with the right dose monitoring and clear purpose, it can change lives, but when it's misused. S, it can create real problems and false hope. Now, my goal with this episode is not to scare you away from testosterone, but to give you the clarity, to make informed decisions because you deserve better than hype.
You deserve science, safety, and support that truly honors your unique menopause journey. I hope you got value today, and I want to thank you [00:25:00] so much for joining me for this episode. And if you found this helpful. Please share it with another woman who may be wondering about testosterone therapy during menopause.
And if you are ready to take the next step, start with the menopause clarity quiz, which is your two minute gateway to understanding what is happening in your body and how to move forward with confidence. And one last thing before I wrap up. I want to share something special. My new book, decoding the 80 symptoms and side effects of menopause is going to be going up for presale next week.
The first 50 Women who Order will receive a signed copy and invitation to join me for a private q and a later in the month. Click the link in the bio of this episode to reserve your copy today. Until next time, stay safe and be [00:26:00] well.
