If your interest in sex has faded since menopause and you’ve wondered whether something is missing, you’ve probably heard testosterone mentioned. You may also have discovered that getting it is complicated. Both experiences are common, and both have explanations.
What everyone was told
Testosterone is usually filed as a men’s hormone. Desire, in the popular version, is supposed to arrive on its own: you either want sex or you don’t, and if you don’t, something has gone wrong. Put those two ideas together and low desire after menopause looks like a hormone problem with a hormone answer that women can’t easily get.
It’s easy to see where that version came from. Testosterone does play a role in desire, and levels in women fall gradually with age. A simple story of cause and fix is appealing, especially when so few other explanations are offered.
The story leaves out two things. The first is what the evidence actually says about testosterone. The second is how desire works for many women in the first place.
The inversion
Women produce testosterone in the ovaries and adrenal glands, at much lower levels than men. In 2019, an international group of medical societies reviewed the trial evidence and published a global consensus position statement. They found good evidence for one use: postmenopausal women with low desire that causes them distress, after other causes have been assessed, at doses that approximate premenopausal levels. Long-term safety is still being studied. They found no benefit for general wellbeing or mood, and too little evidence to recommend it for cognition, bone health or anything else.
In the United States, no testosterone product is approved for women. An FDA advisory panel voted against the first one in 2004. Australia and several other countries have since approved products. Without one here, women who are prescribed testosterone usually receive formulations made for men, or compounded versions, at doses that are hard to standardize. The 2019 consensus specifically advises against compounded products, pellets and injections. On September 17, 2026, the FDA held a public workshop and said it stands ready to talk with drug makers about bringing a product to market.
The second part of the inversion is about desire itself. In 2000, the physician and researcher Rosemary Basson proposed a model of women’s sexual response that is now widely used in clinical practice. For many women, especially in long relationships, desire doesn’t come first. It arrives after the body has started to respond, once touch, warmth and time have done some of the work. Researchers call it responsive desire, to distinguish it from the spontaneous kind the popular version assumes.
Think of an appetite that appears once you smell dinner cooking, rather than one that sends you to the kitchen. Both are real hunger. One just needs a starting signal.
Davis et al., Journal of Clinical Endocrinology & Metabolism, 2019 · FDA Reproductive Health Drugs Advisory Committee, December 2004 · FDA public workshop, September 17, 2026 · Basson, Journal of Sex & Marital Therapy, 2000
What this means in real life
It means two things can be true at once. Testosterone is a legitimate, evidence-supported option for one specific group of women, and the lack of an approved US product is a real gap worth naming. Low desire also isn’t always a hormone deficit. For many women, it’s a response system waiting for a starting signal that rarely comes.
That second point matters because of how often women wait. If you believe desire should come first, you’ll wait for it before anything begins, and when it doesn’t arrive, you’ll take that as the answer. If your desire is responsive, waiting for it is like waiting to feel hungry before you’re willing to walk into the kitchen.
None of this makes low desire imaginary or something to push through. Desire that causes you distress deserves a clinical conversation. Thyroid function, medications such as some antidepressants, sleep, pain during sex and relationship strain can all play a part, and a clinician can help sort out which ones apply. Testosterone is one possible answer, for one possible cause.
What actually helps
Start by noticing which kind of desire you have. If wanting tends to show up once things begin rather than before, that’s useful information, not a flaw.
Build the conditions on purpose. Warmth, time and the absence of anything else due are the ingredients the responsive model points to. Scheduling time for intimacy can feel unromantic, but for responsive desire it is often what makes desire possible.
Let the body go first. Touch, alone or with a partner, can be the starting signal, and a personal massager is one simple way to provide it. In a nationally representative US study, women who had recently used one scored higher on desire and other measures of sexual function than women who hadn’t. That study can’t show which came first, so it isn’t proof that a device raises desire. It does fit the responsive model. A broad, gentle wand is the easiest place to start, and the ones we carry are in Wands.
Herbenick et al., Journal of Sexual Medicine, 2009
If low desire is causing you distress after menopause, ask about testosterone directly. Ask whether it fits your situation, what form and dose your clinician would use, how your levels will be monitored, what the evidence supports, and how long to try it before deciding whether it’s working. The 2019 consensus statement is a good document to bring.
Close
Testosterone is one lever on desire, and for some women after menopause it’s a good one. It isn’t the only lever. For many women, wanting is the result, not the requirement.
Start with the body, and let wanting catch up.
