So you’re scrolling Instagram way too late at night (because apparently sleep is optional in menopause), and there it is again: another post swearing that testosterone for women is the missing piece, with more energy, a sharper brain, and a better mood. I’ve received a lot of questions around this topic lately, and with the Menopause Society annual meeting that just took place, it seemed timely. I will be upfront, this post is a little more science-y than my usual ones. So if you are with me, let’s dive in!
At the Menopause Society 2026 annual meeting in San Diego Oct 21, a new study on testosterone and heart disease in women just came out. But as we know, context is everything, so before you freak out about the headline, or it becomes misconstrued into the instagram posts you will see in the next couple of weeks, I’ll try to keep explain it as plain as I can and I’ve put the quick answer right at the top.
The quick answer: is testosterone safe for women in menopause?
We don’t know yet, and that’s the honest answer. A new study found that postmenopausal women taking testosterone had more heart problems than similar women who weren’t, but it can’t prove that testosterone caused them, and it hasn’t been peer-reviewed. Testosterone does have solid evidence behind it for one thing in menopause (low sexual desire that truly bothers you), long-term safety data for women is still thin, and the smartest next step is a conversation with your doctor rather than panic or a rush to start.
What the new testosterone and heart disease study found
Researchers looked at health records from more than 6,300 postmenopausal women aged 45 and older, about half of whom had been prescribed testosterone, and compared them with similar women who hadn’t. Women with a history of heart disease were left out. Over roughly three years, about 3.8% of the women on testosterone had a new heart event (things like a heart attack, stroke, or heart failure), compared with about 0.5% of the women who weren’t taking it.
That’s a big difference on paper, and it’s why this study got so much attention. The researchers themselves described it as a possible safety signal and pointed out that the actual number of events was low. The medical director of The Menopause Society said it’s a good reminder for doctors to weigh each woman’s individual risks and benefits when prescribing testosterone, which is really the heart of this whole post.
Why this is a signal, not a verdict (and no, you don’t need to panic)
Here’s the part I want you to hear, because it matters just as much as the headline. This was an observational study, which means it can show a link between two things but can’t prove that one caused the other. It was also presented as a conference abstract, so it’s considered preliminary until it’s published in a peer-reviewed journal.
Doctors who have looked closely at it also point out that the kind of health-records database it used can’t tell us why a woman was prescribed testosterone, what dose or form she used, or whether she actually took it. Earlier studies on testosterone and the heart in women have been mixed, which is why what everyone really wants is a proper clinical trial. In other words, take it seriously, but please don’t take it as proof.
Testosterone doesn’t suddenly disappear at menopause
This is one of the biggest misconceptions I see online, so let’s clear it up. Unlike estrogen and progesterone, which drop sharply during the menopause transition, testosterone in women declines gradually, starting around age 30. So menopause doesn’t leave you with none, and menopause on its own isn’t a reason to take testosterone. (I know it’s tempting to think of it as one more thing that vanished overnight. It didn’t.)
What testosterone for women actually helps with: low libido
The strongest evidence is for something called hypoactive sexual desire disorder, or HSDD, which is a persistent and distressing loss of sexual desire. It affects roughly 10 to 15% of postmenopausal women, and low libido only counts as HSDD when it’s genuinely bothering you and has been checked from every angle, including medications, stress, relationship factors, and other health issues. The international consensus statement on testosterone therapy for women says HSDD in postmenopausal women is the only evidence-based reason to use it, and even then, experts say it helps about half of women at best.
For low energy, brain fog, weight, mood, or bone health, the evidence just isn’t there yet, no matter how many testimonials you’ve seen. This is good news in a way, because it means you’re not missing some secret fix, and there’s plenty we can do for those symptoms in other ways. Now, I do not want to down play women’s testimonials, they are valid, its just the relief being reported is not consistent and can be contributed to many other factors not taken into consideration, therefore, more research needs to be done, in addition to the fact they don’t even have approved dosage for treatment.
Is testosterone approved for women in Canada? What Health Canada says
If you’re in Toronto or anywhere else in Canada, this one’s worth knowing. Health Canada hasn’t approved any testosterone products or uses for women, so when a doctor prescribes it for menopause here, it’s considered off-label. The Society of Obstetricians and Gynaecologists of Canada and global guidelines do support off-label transdermal testosterone (a gel or cream applied to the skin) as an option specifically for HSDD. A Toronto endocrinologist quoted by Medscape News Canada cautioned against pellets and oral forms because of dosing inconsistency and the risk of too much testosterone, and the international consensus statement also advises against injections and pellets for the same reason.
It’s a similar story in the US, where the FDA hasn’t approved a testosterone product for women either, although a handful of countries, including the UK, Australia, New Zealand, and South Africa, have licensed products made specifically for women. Regulations change, so it’s worth asking your doctor or pharmacist what’s currently available.
4 questions to ask your doctor about testosterone
One simple framework I love for any menopause treatment is to ask these four questions, and it works just as well for testosterone. Bring them to your next appointment:
- What are the risks of taking it?
- What are the benefits of taking it?
- What are the risks of NOT taking it?
- What are the benefits of NOT taking it?
If you and your doctor decide to try it, ask about blood work too. The consensus guidance suggests checking a baseline testosterone level before you start and again a few weeks in, and it’s worth being honest with yourself (and your provider) about whether it’s actually doing anything for you.
If you’re already taking testosterone for menopause
Please don’t panic, and please don’t stop on your own. If testosterone is treating HSDD for you, that’s a legitimate use, and the right move is a calm conversation with your doctor. Bring this study along so you can talk it through together. It’s also worth knowing that testosterone is generally not recommended for women with a history of breast cancer, so make sure your provider has your full health history.
Protecting your heart in menopause starts with one small step
Here’s something that doesn’t make it into the headlines: heart disease risk already goes up for all women after menopause, whether or not testosterone is part of the picture. Heart experts point to the same basics we always come back to, which are staying physically active, getting enough sleep, eating well, and keeping an eye on your blood pressure and cholesterol. If that list feels like a lot, I get it, and it’s something I’ve learned myself over and over: you don’t need a full overhaul. Pick one small thing this week and start there please.
The bottom line on testosterone and menopause
Testosterone isn’t a cure-all for menopause, the new heart study is a signal worth watching rather than a final answer, and the only symptom with solid evidence is distressing low sexual desire. If you’re curious about it, ask the four questions, ask for labs, and make the decision with your doctor. And if all of this leaves you feeling a little overwhelmed, that’s completely normal. You don’t have to figure it out alone.
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Questions You’ve Probably Already Googled
Is testosterone safe for women over 50? We don’t know for sure. Long-term safety data for women is limited, and a new study presented in October 2026 linked testosterone to more heart problems in postmenopausal women, though it can’t prove cause and effect. Talk with your doctor about your personal heart health before starting.
Does testosterone cause heart disease in women? Not proven. The new study found a higher rate of heart events among women on testosterone (3.8% vs. 0.5%), but it was observational and preliminary, so experts are calling for a proper clinical trial before drawing conclusions.
Does testosterone help low libido in menopause? Sometimes. It has the best evidence for hypoactive sexual desire disorder (HSDD), a distressing loss of desire, but it helps about half of women at best. For other symptoms, like fatigue or brain fog, the evidence isn’t there yet.
Is testosterone for women approved in Canada? No. Health Canada hasn’t approved any testosterone product or use for women, so it’s prescribed off-label. Canadian and global guidelines support transdermal testosterone for HSDD only.
Do women need testosterone after menopause? No, not automatically. Testosterone declines gradually with age rather than dropping suddenly at menopause, and menopause alone isn’t a reason to take it.
Are testosterone pellets safe for women? It’s best to be cautious. Pellets and injections can push testosterone levels too high, and a Toronto endocrinologist told Medscape News Canada to avoid pellets and oral forms. Ask your doctor about safer options.
Can I take testosterone if I have a history of breast cancer? Generally it isn’t recommended, because testosterone can convert to estrogen in the body. Always discuss your full history with your doctor.
This post is for education only and isn’t medical advice. Please talk with your healthcare provider about your own situation.
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