For years, testosterone therapy for women has largely been discussed through one narrow lens: libido.
While improving sexual desire remains one of the most well-established reasons to prescribe testosterone, new research suggests that may only tell part of the story.
A 2026 study published in the Journal of Personalized Medicine found that women receiving individualized testosterone therapy reported improvements in energy, mood, concentration, motivation, and overall quality of life, with many participants ranking these benefits even higher than improvements in sexual function.
The findings don’t change current clinical guidelines, but they do raise an important question:
Could testosterone influence far more than sexual health in appropriately selected women?
At 1st Optimal, we believe hormone therapy should never be about chasing numbers on a lab report. It should be about helping patients feel, perform, and live better using evidence-based, individualized care.
Testosterone Is More Than a “Male Hormone”
Many people are surprised to learn that women naturally produce testosterone.
Although women produce much lower amounts than men, testosterone plays an important role in multiple body systems, including:
- Energy production
- Muscle maintenance
- Bone health
- Brain function
- Mood
- Motivation
- Sexual health
- Physical performance
Production naturally declines with age, particularly during perimenopause and menopause, although there is no single “normal” level that applies to every woman.
More importantly, symptoms and laboratory values don’t always correlate perfectly.
Some women with relatively low levels feel great.
Others experience significant symptoms despite being within laboratory reference ranges.
That’s one reason individualized assessment is so important.
The New Research
Researchers published a retrospective observational study in the Journal of Personalized Medicine (2026) evaluating 332 women between the ages of 27 and 78 who received individualized testosterone replacement therapy.
Rather than using a one-size-fits-all approach, clinicians adjusted therapy using symptoms and laboratory biomarkers with the goal of achieving physiologic premenopausal testosterone levels.
The study followed patients for approximately 12 weeks.
What Did Researchers Find?
The most striking finding wasn’t libido.
It was energy.
Women reported improvements across several symptoms.
Reported Symptom Improvement
| Symptom | Percentage Reporting Improvement |
| Energy/Fatigue | 84.3% |
| Depression | 70.8% |
| Irritability | 69.0% |
| Loss of Motivation (Anhedonia) | 67.5% |
| Sexual Interest | 66.9% |
| Relationship Satisfaction | 58.1% |
| Concentration | 57.8% |
| Memory | 54.5% |
Researchers also noted that nearly 90% of participants reported improvements in overall quality of life.
Perhaps even more interesting, participants ranked:
- Energy
- Mood
above improvements in sexual desire as their most meaningful benefits.
That challenges one of the biggest misconceptions surrounding testosterone therapy for women.
Biomarker Improvements
Researchers also evaluated laboratory changes.
Average total testosterone increased from:
16.8 ng/dL
to
42.3 ng/dL
after treatment.
Additional findings included improvements in:
- Free testosterone
- Sex hormone-binding globulin (SHBG)
- Triglycerides
- Hemoglobin (modest increase)
Importantly, clinicians targeted physiologic testosterone levels rather than excessively high levels.
The goal was optimization, not supraphysiologic dosing.
Why These Findings Matter
Fatigue is one of the most common complaints among women entering perimenopause and menopause.
Unfortunately, fatigue rarely has one single cause.
Potential contributors include:
- Hormonal changes
- Poor sleep
- Stress
- Thyroid dysfunction
- Iron deficiency
- Insulin resistance
- Nutrient deficiencies
- Depression
- Medication side effects
Testosterone isn’t the answer for everyone.
However, this research suggests it may deserve consideration as one piece of a comprehensive evaluation when clinically appropriate.
Current Clinical Guidelines
It’s important to separate emerging research from established evidence.
Current international guidelines continue to recognize hypoactive sexual desire disorder (HSDD) in postmenopausal women as the strongest evidence-based indication for testosterone therapy.
Evidence supporting benefits for:
- Energy
- Mood
- Cognition
- Physical performance
is growing but remains less definitive.
That doesn’t mean these benefits aren’t real.
It simply means additional randomized controlled trials are needed before guidelines expand their recommendations.
What the Study Does Not Prove
This study is exciting, but it also has limitations.
It was:
- Retrospective
- Observational
- Conducted through a single clinical practice
- Based primarily on patient-reported outcomes
- Not placebo-controlled
Because of this, researchers cannot conclude that testosterone alone caused every improvement.
Lifestyle changes, expectation effects, concurrent therapies, or other factors may also have contributed.
This distinction matters.
Good medicine requires balancing enthusiasm with scientific rigor.
Who Might Benefit From Evaluation?
Women experiencing symptoms such as:
- Persistent fatigue
- Low motivation
- Brain fog
- Reduced exercise recovery
- Loss of muscle strength
- Low libido
- Difficulty maintaining lean body mass
may benefit from a comprehensive hormone assessment.
That assessment should never rely on testosterone alone.
At 1st Optimal, we evaluate the broader picture, which may include:
- Estradiol
- Progesterone
- Testosterone
- DHEA-S
- Thyroid function
- Cortisol (when appropriate)
- Iron studies
- Vitamin deficiencies
- Metabolic health markers
- Inflammation markers
Hormones rarely work in isolation.
Neither should your evaluation.
Why “Normal” Doesn’t Always Mean Optimal
One of the biggest frustrations women share is hearing:
“Your labs are normal.”
Laboratory reference ranges are designed to identify disease.
They’re not designed to identify why someone feels tired, mentally foggy, or unlike themselves.
Symptoms, health history, lifestyle, and laboratory results all need to be interpreted together.
That’s the difference between simply treating disease and optimizing health.
Individualized Therapy Matters
Not every woman needs testosterone.
Not every woman should receive testosterone.
When treatment is appropriate, success depends on:
- Proper patient selection
- Appropriate dosing
- Ongoing monitoring
- Regular laboratory testing
- Symptom tracking
- Adjustments over time
More isn’t better.
The goal is restoring healthy physiologic function while minimizing risks.
The 1st Optimal Approach
At 1st Optimal, hormone optimization starts with understanding the entire picture.
Our clinicians look beyond a single laboratory value to evaluate:
- Symptoms
- Medical history
- Lifestyle
- Nutrition
- Sleep
- Stress
- Comprehensive blood work
If hormone therapy is appropriate, treatment is individualized and monitored over time rather than following a standardized protocol.
Because the goal isn’t simply improving one symptom.
It’s helping you perform better, recover better, and feel like yourself again.
Key Takeaways
The newest research adds to growing evidence that testosterone therapy may offer benefits extending beyond libido in appropriately selected women.
While larger clinical trials are still needed, this study found improvements in:
- Energy
- Mood
- Motivation
- Concentration
- Memory
- Overall quality of life
Testosterone is not a cure-all, nor is it appropriate for every woman.
But when combined with a thorough evaluation and individualized care plan, it may become one valuable tool in helping women optimize their health.
If you’ve been told your labs are “normal” but you still don’t feel like yourself, a comprehensive hormone evaluation may help identify what’s contributing to your symptoms.
Ready to Understand What Your Hormones Are Telling You?
At 1st Optimal, we combine advanced blood work, comprehensive hormone testing, and personalized treatment plans designed around your unique biology.
If you’re experiencing fatigue, brain fog, low motivation, or changes that don’t feel like “just aging,” we’re here to help you find answers.
Schedule your consultation today and discover what optimal health can look like.
FAQs:
Can women benefit from testosterone therapy?
Some women with symptoms and appropriately evaluated hormone deficiencies may benefit from testosterone therapy. The strongest evidence currently supports treatment for hypoactive sexual desire disorder, while research into benefits for energy, mood, and cognition continues to grow.
What symptoms can low testosterone cause in women?
Symptoms may include low libido, fatigue, reduced motivation, brain fog, decreased muscle strength, and reduced exercise recovery. These symptoms can also have many other causes, so a comprehensive evaluation is important.
Is testosterone therapy safe for women?
When prescribed appropriately, monitored regularly, and dosed to achieve physiologic levels, testosterone therapy can be used safely in selected patients. Treatment should always be supervised by a qualified healthcare provider.
Can testosterone improve energy in women?
Emerging research suggests many women report improvements in energy after individualized testosterone therapy, although more randomized clinical trials are needed to establish cause and effect.
References
- Elggren M, et al. Testosterone Replacement Therapy in Women Is Associated with Improved Symptom Burden and Favorable Biomarker Changes: A Retrospective Observational Study. Journal of Personalized Medicine. 2026;16(5):231.
- Davis SR, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. Journal of Clinical Endocrinology & Metabolism. 2019.
- The Menopause Society (formerly North American Menopause Society). Clinical guidance on testosterone therapy in women.
- International Society for the Study of Women’s Sexual Health (ISSWSH). Clinical Practice Guideline for Systemic Testosterone Therapy in Women.
This article is intended for educational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional before starting or changing any treatment.
