The ovary is an important source of testosterone. Testosterone production decreases as a woman gets older. This decline is age-related rather than directly related to the menopause and production has often halved as a woman reaches her mid-40s and continues to decline further thereafter. Decreased testosterone production is linked with loss of libido and poor energy levels in some women although the ovary continues to produce it after menopause but in smaller amounts. Some women may benefit from the addition of topical testosterone, in addition to their oestrogen/ progesterone regimen, to improve these symptoms. It is not always required and is discontinued if no improvement is reported.
The amount of testosterone that’s used is a much smaller dose than that of male testosterone replacement although it remains off-licence for this purpose. A blood test is necessary during treatment to ensure that levels don’t increase above normal limits. The main potential side-effect of treatment is localised hair growth which is often avoided by changing the site where the gel or cream is applied. As the dose is so low, testosterone used in this way does not increase the risk of developing facial hair, skin changes or a deepening of the voice.
Women who have had their ovaries surgically removed often benefit from the addition of testosterone replacement as there is a sudden drop in testosterone production after surgery, although a small amount of testosterone continues to be produced in the adrenal glands.