Testosterone therapy for postmenopausal women

A study by the School of Public Health and Preventive Medicine at Monash University reveals important benefits and mild side effects.

This is part of a series of articles showcasing Sax Institute members, and the diverse range of research that’s informing future health policy and practice.

The dizzying effects of the menopause – night sweats, hot flashes, declining oestrogen levels – can cause a dip in libido and wreak havoc with women’s wellbeing. But testosterone might just be the key to changing this, according to a recent study which found that testosterone significantly improved sexual wellbeing in postmenopausal women.

Image of Professor Susan Davis
Professor Susan Davis and her team at the School of Public Health and Preventive Medicine have shown that testosterone can be beneficial for postmenopausal women.

The study was led by Professor Susan Davis, Head of the Women’s Health Research Program at Monash University’s School of Public Health and Preventive Medicine. The School, which is a Sax Institute member, is at the forefront of healthcare improvement research, and this particular study is the most comprehensive meta-analysis of testosterone treatment for women ever undertaken, including 46 reports on 36 trials involving 8,480 women.

The study is significant given that testosterone replacement in women remains controversial, with little evidence about safety or side effects. However, the meta-analysis showed that, compared with a placebo or an alternative hormone treatment such as oestrogen, with or without progestogen, testosterone significantly increased sexual function, including satisfaction, sexual desire, pleasure, arousal and even self-image.

While the study indicated testosterone may be associated with some mild side effects in some women, such as weight gain, acne and increased hair growth, no participants withdrew from the trials due to these side-effects, suggesting they were not significantly problematic to cause concern.

Professor Davis said the results suggest it is time to develop testosterone treatment tailored to postmenopausal women, rather than treating them with higher concentrations formulated for men.

“Women live a third of their lives after the menopause, but no approved testosterone formulation or product exists for them in any country, which is a missed opportunity considering the benefits we found for their sex lives and personal wellbeing.”

Professor Davis went on to explain that the beneficial effects go beyond simply increasing the frequency of sexual activity, but also impact on general wellbeing. “Many women who are sexually active report dissatisfaction,” she said. “Increasing the frequency of a positive sexual experience from never or occasionally to once or twice a month can improve self-image and reduce concerns and distress.”

While more needs to be done to understand long-term safety and develop expert guidelines, this research by the School of Public Health and Preventive Medicine brings much-needed attention to an issue that many women worry about, and could be a glimmer of hope for postmenopausal women across Australia.


The Sax Institute’s unique organisational structure, with 55 members from public health and health services research groups and their universities, connects us with a powerful public health network and world leading research expertise. 

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