Let’s Talk About Testosterone: Why It’s Not the Libido Fix You’ve Been Told It Is

There’s a lot of hype right now about testosterone being the answer to low libido in women—especially during perimenopause. But here’s the truth: most of the data simply doesn’t support that.

Testosterone has only shown modest benefit in a very specific group—postmenopausal women diagnosed with hypoactive sexual desire disorder (HSDD). And even in that group, the improvement is small, and the dose required is very low. For women in perimenopause or those just “not feeling like themselves,” testosterone hasn’t been proven effective—and using it outside of that narrow window comes with risks.

Side effects like acne, excess hair growth, voice changes, and unfavorable cholesterol shifts become more likely the higher the dose goes. And here’s the key point: we have no long-term safety data for women using testosterone therapy, especially off-label.

If libido is a concern, we need to look at the full picture—hormonal shifts, emotional health, sleep, relationship dynamics, stress, and more. A single hormone won’t fix it all.

📚 To read more:
“Testosterone and Menopause.” The Vajenda, 2024.*
https://vajenda.substack.com/p/testosterone-and-menopause