The frightening truth about testosterone for the menopause – loved by Davina: It’s linked to heart attacks and stroke…try these safer (and more effective) libido-boosters instead DR CHANNA JAYASENA

Ten years ago, very few women would have asked their doctor for testosterone, a hormone typically associated with men. 

But today, a day rarely passes without a patient enquiring about it. The treatment, gel applied to the skin, is, according to swathes of menopausal women in my hormone clinic, the answer to everything from low mood, brain fog and a rapidly fading sex drive. Or so they’ve read online.

I’m not surprised patients have been won over by the testimonies of famous mid-life women like Davina McCall and Kate Winslet, who credit a daily dose of testosterone for easing the life-wrecking symptoms of the hormonal change. 

Demand for testosterone among menopausal women had increased 15-fold over the previous decade in England, studies show. 

The menopause can be wretched, and women are desperately seeking solutions. But testosterone is not the answer. In fact, there are crucial details that advocates have left out of the story.

At best, the hormone is useless and, at worst, it can cause a roster of side effects including hair loss, acne and voice changes. Most recently, experts have linked the treatment to a particularly alarming problem; heart disease.

Earlier this month, US researchers presented findings that showed women taking testosterone are around eight times more likely to suffer heart disease than those on traditional HRT – usually a combination of oestrogen and progesterone.

Strikingly, the increased risk was apparent even with relatively low doses. 

Given that cardiovascular disease remains the number one killer of women, these findings – by researchers at Drexel University College of Medicine – must not be ignored. 

And just last week, another study suggested any benefits may be negligible.

The trial of 244 women, published in the British Medical Journal, found there is ‘insufficient’ evidence that testosterone can ease brain fog – one of the symptoms it is commonly said to treat. 

While testosterone is often seen as a male hormone, women also produce it in smaller amounts in the ovaries and adrenal glands. 

It plays a key role in sexual desire by boosting dopamine – the ‘feel-good’ hormone linked to pleasure, decision-making, mood and focus.  

Levels generally peak in mid-to-late 20s, then gradually decline with age. But this does not mean all women will need to take it. 

Most women who experience menopause symptoms in midlife, such as hot flushes, sleep problems and a drop in libido, will respond well to standard HRT, which usually comprises the two female sex hormones, oestrogen and progesterone. 

But some argue replenishing testosterone can further restore sexual desire, improve energy levels and sharpen focus. 

Celebrities including Halle Berry and Kate Winslet have publicly credited the hormone with helping them feel more like themselves during menopause. 

TV favourite Davina McCall described adding testosterone as the ‘missing link’ that helped her feel like herself again after suffering menopause-related low energy, brain fog, and a loss of confidence.

Testosterone is currently available on the NHS for a specific subset of menopausal women. 

Current UK guidelines recommend it in gel or cream form – applied to the skin – to treat low sexual desire that has significantly affected quality of life, usually after standard HRT has been tried. 

Crucially, it is not intended as a treatment for brain fog, low mood, tiredness or poor concentration. Nor is it recommended as a first-line menopause treatment. 

That’s because the evidence for wider benefits is weak. Claims that testosterone can improve brain fog, boost energy, sharpen cognition or improve mood have not been convincingly demonstrated in clinical trials.

Studies that have found a benefit show symptom relief in small numbers of women – around one in ten.

Worryingly, the long-term cardiovascular effects of testosterone in women remain unclear – but experts think the hormone could boost levels of ‘bad’ cholesterol as well as blood pressure; both leading risk factors for heart attack and stroke.

Doctors already know that excessive testosterone exposure in men can increase the risk of heart and kidney problems. 

The concern is that women taking the hormone unnecessarily, or at higher-than-intended doses, could also be exposing themselves to similar risks. 

When prescribed on the NHS, women must undergo a blood test to ensure their levels of the hormone are not too high before they use the treatment. But today, many women are accessing the medication privately, in clinics subject to far less scrutiny.  

I’ve met private doctors who prescribe it without trying HRT first, which is against the guidelines as it puts more women than necessary at risk.

The problem is compounded by the fact there are currently no testosterone products licensed specifically for women in the UK. 

Instead, women are usually prescribed small amounts of products designed for men, typically an eighth of a sachet, or around 5mg per dose.

This can make accurate dosing difficult and increases the risk of women taking more testosterone than intended. 

This could be particularly dangerous for women with polyendocrine metabolic ovarian syndrome (PMOS) – formerly known as polycystic ovary syndrome – who already have slightly elevated testosterone levels and a higher risk of heart disease. 

Excessively high testosterone levels can cause a myriad of distressing side effects. 

Hair loss is quite a common symptom, because testosterone programmes the skin to take on more male characteristics, including hair thinning and recession around the hairline.

Some women develop painful acne on their face, chest and back – a result of testosterone’s stimulation of the skin’s oil glands which clogs pores.

Excessive testosterone can also deepen a woman’s voice by thickening the vocal cords. Unlike some side effects, the change can be permanent, even after treatment is stopped. 

My concerns don’t mean that those who are appropriately prescribed the treatment on the NHS should stop taking it. 

It just means women should be mindful of the potential risks – and ensure they undergo vital monitoring. 

The truth is women do not need testosterone to address many of the symptoms they are experiencing. 

The majority will feel some relief with traditional HRT alone – which has been proven to relieve most perimenopause and menopause symptoms including hot flushes, night sweats, sleep problems, anxiety and low mood and vaginal dryness. 

There are also ways to boost testosterone levels naturally. 

A 2023 study, published in the journal Andrology, found sleeping for less than six hours was linked to a dip in testosterone – as well as sleeping for more than nine.

Avoiding caffeine and alcohol, as well as exercising regularly, may also help alleviate symptoms and boost levels -as well as libido – in as little as two months, studies have found.

The good news is that the effects of testosterone generally wear off when you stop taking it. 

This means that anyone currently taking the hormone who is not sure whether they should be can safely stop taking the drug without any lingering side effects. 

I am open-minded as to the potential benefits of testosterone; further studies may indeed reveal it to be a menopause wonder drug.

But for now, it’s safe to say that, for the majority of women, the benefits don’t justify the risks.