Testosterone Replacement

The ovary is an important source of testosterone. Testosterone production can decrease as a woman gets older and this decline is thought to be age-related rather than directly related to the menopause, and  unlike the other ovarian sex hormones, the ovary continues to produce it after menopause.  Decreased testosterone production can be associated with reduced libido in some women, however libido remains a complex symptom in itself, and frequently other factors are also at play. Testosterone may be used on a trial basis to help with reduced libido for some women, particularly those that have had their ovaries surgically removed, or experienced POI.  It should be discontinued if no improvement is obtained.

The amount of testosterone that is used is a much smaller dose than that of male testosterone replacement. Unfortunately, there are no licenced female versions available in Ireland at present, so it remains off-licence for MHT. A blood test is necessary during treatment to ensure that levels don’t increase above the normal female range. The most common side-effect of treatment is localised hair growth which can be avoided by varying the site of application. If the dose remains within the female range, testosterone as MHT should not cause virilising effects such as male-patterned baldness or voice changes.