The level of testosterone in premenopausal women is higher than that of estrogen, but it starts to decline usually in our 30s. There is a further dip in testosterone at menopause. Testosterone, along with estrogen and progesterone contributes to overall wellbeing and sexual function in women. Low libido can be problematic for women in the perimenopause and menopause, but low libido is multifactorial in nature, e.g. being affected by hormones, poor sleep, fatigue, relationship issues and stress. Your symptoms may improve with estrogen replacement, but if this does not seem to be the case then we can consider the addition of testosterone replacement. Furthermore, before the addition of testosterone, it is essential that women are adequately treated for vaginal dryness as this can contribute to painful sexual intercourse and negatively impact libido. A full assessment of symptoms and treatment options will be discussed at your appointment.
Last updated: May 2026
