119: Testosterone in Menopause: What We Know, What We Don't

Testosterone is everywhere in menopause conversations right now, often framed as a solution for everything from low energy and brain fog to bone health and longevity. In this episode, Dr. Sarah Court breaks down what actually matters when it comes to testosterone for menopausal women, separating social media hype from clinical evidence. The real questions are not whether women have testosterone or whether levels change with age, but whether testosterone should be prescribed, for whom, and what the data truly supports.

Using current consensus guidelines, this episode explains why testosterone has one narrow, evidence-based indication, hypoactive sexual desire disorder, and why claims about mood, energy, cognition, bone health, and longevity are not supported by high-quality research. Dr. Court also walks through how testosterone is prescribed in the real world, why the lack of FDA-approved products for women creates problems, and what the safety data does and does not tell us about long-term risks. If you have heard confident claims about testosterone as a menopause cure-all, this episode provides the context you need to evaluate those messages with clarity and skepticism.

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Global Consensus Position Statement on the Use of Testosterone Therapy for Women — Davis et al., 2019, Journal of Clinical Endocrinology & Metabolism

ISSWSH Clinical Practice Guideline on Systemic Testosterone for Women — Parish et al., 2021

Testosterone Therapy for Women, Systematic Review & Meta-analysis
(Lancet Review) — Islam et al., 2019

Androgen Therapy in Women, A Reappraisal — Davis & Wahlin-Jacobsen, 2015

Kelly Casperson blog post — Testosterone Can Help With Libido, Energy, Focus, & More During Menopause

You Are Not Broken Podcast — Kelly Casperson, MD

YouTube Short: Testosterone and Bone Health

YouTube Short: Testosterone, Motivation & Vitality