Testosterone for women: what the evidence actually shows vs. what social media is selling you.

Testosterone has become the hormone every midlife woman is told she is missing: the third hormone lost at menopause, the fix for brain fog, low energy, stubborn weight, and thinning muscle.

The science tells a different and more reassuring story.

In this episode, Dr. Ayesha Sherzai sits down with Professor Susan Davis, MBBS, FRACP, PhD, the clinician-researcher and academic endocrinologist who gathered much of the data and helped write the global guidelines, to separate what the research supports from what is simply being sold.

Your Brain On... Testosterone [Season 7, Episode 7]

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In this episode:

• Why testosterone does not crash at menopause the way estrogen does, and what actually changes across a woman's life
• What the research shows about testosterone and memory, brain fog, and dementia risk
• The real story on testosterone for muscle, bone, and anti-aging claims
• Why women tend to gain a little weight on testosterone rather than lose it
• The one use with genuine evidence behind it: low sexual desire after menopause that causes real distress
• Why more is not better, and what high-dose testosterone actually does
• What is really inside compounded creams, injections, and testosterone pellets sold at med spas
• Why routine testosterone blood testing generates bills and anxiety rather than answers
• Why there is no such thing as testosterone deficiency in women
• How to tell an evidence-based clinician from a sales pitch
• What genuinely protects a woman's aging brain, and why connection matters more than any hormone

Professor Susan Davis is a consulting endocrinologist at Monash University in Melbourne, where she directs a leading women's health research program. She has studied testosterone in women since the 1990s and is the lead author of the Global Consensus Position Statement on the Use of Testosterone Therapy for Women, endorsed by the International Menopause Society, The Endocrine Society, and menopause and obstetric societies around the world.

References:

Does testosterone crash at menopause? Wang Y, Islam RM, Bond M, Davis SR. Testosterone and pre-androgens by age and menopausal stage at midlife: findings from a cross-sectional study. EBioMedicine. 2025;121:105972. PMID: 41106025. Davis SR, Bell RJ, Robinson PJ, et al. Testosterone and estrone increase from the age of 70 years: findings from the Sex Hormones in Older Women Study. J Clin Endocrinol Metab. 2019;104(12):6291–6300. PMID: 31408149. Islam RM, Bell RJ, Handelsman DJ, Robinson PJ, Wolfe R, Davis SR. Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over. Clin Endocrinol (Oxf). 2021;94(3):443–448. PMID: 33351205.

Does testosterone improve memory or protect against dementia? Sultana F, Davis SR, Wolfe RS, McNeil JJ, Islam RM. Associations between blood sex hormones, cognitive decline and incident dementia in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2025;28(4):446–455. PMID: 40085743. Sultana F, Islam RM, Davis SR. Associations between declining testosterone concentrations and cognitive performance in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2026;29(1):46–52.

What does testosterone therapy actually do? Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754–766. PMID: 31353194.

What do the global guidelines say? Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666. PMID: 31498871.

Can a blood test diagnose low testosterone? Wang Y, Islam RM, Hodge A, Handelsman DJ, Karim MN, Bond M, Davis SR. Associations between testosterone and pre-androgens and sexual function: findings from the Australian Women's Midlife Years Study. Fertility and Sterility. 2026.

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Hosted by Drs. Ayesha & Dean Sherzai.

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