Testosterone has entered the cultural conversation.

Over the past few months, this sex hormone has received heightened media attention and celebrity exposure as a treatment for aging and menopause. Actress Halle Berry, 59, credited testosterone for reviving her sex drive. In October 2025, the New York Times reported that middle-aged women worldwide were enthusiastically seeing the same effects. 

There is no FDA-approved treatment for all the symptoms of menopause, which generally include hot flashes, brain fog, sleeplessness, lowered libido, and fatigue—though there are drugs designed to treat some of these. Now, with increased publicity around testosterone, many women who have silently endured stigma and symptoms around aging feel that a promising treatment may finally be in reach.  

Hype is one thing. Accessibility is another. Whether you’re a testosterone-curious woman in the throes of menopause, or a trans man with an ongoing gender-affirming care plan, there can be a big gap between wanting testosterone and getting it—unless you’re a cisgender man.

Hormone therapy for aging

“Lifechanging” is how Utah-based Marcella Hill, 45, described her experience being on testosterone over the past four years. Hill leads “Wake Her Up,” a community and provider directory for women seeking out hormone therapy. 

Hill spent years grappling with low sex drive, body aches, and a lack of motivation—problems often seen as an inevitable side effect of age. But after beginning testosterone in 2022, she said, her “body didn’t hurt” anymore, and she was “sleeping all night” for the first time in years. Hill felt she “had a regular happy energy” again.

In a youth-crazy society where women are publicly demoted as a result of aging, and where women’s health research is underfunded—especially around menopause and aging—finding treatment that made her feel more excited to be in her body was transformative, Hill said.

“We have lived in a world where women kind of just don’t exist after 40,” Hill said. 

The testosterone frenzy reflects changing science around hormone therapy.

In the early 2000s, Women’s Health Initiative—a federally-funded, long-term National Institutes of Health study focused on preventing serious health conditions in postmenopausal women—linked risks like  breast cancer to estrogen hormone replacement therapy (HRT) for menopausal treatment. 

“Testosterone was not a part of the study, but hormones in general got a bad rap after this,” Dr. Kudzai Dombo, an OB-GYN menopause expert, told RNG. 

The consequences were profound for both people in menopause—many of whom suddenly terminated their estrogen hormone therapy and were left to manage sometimes debilitating symptoms unaided—as well as providers. The potential of testosterone, which was never FDA-approved to treat menopause anyway, went unexplored. 

“A lot of clinicians that were trained during that time from 2002 onward, felt extremely uncomfortable prescribing hormone therapy,” Dr. Kudzai Dombo, an OB-GYN and menopause expert, told RNG. 

However, the safety conversation around HRT has evolved in the past decade as more critiques of the 2002 study emerged, alongside ongoing advocacy for destigmatizing menopausal care. In November 2025, the federal government removed the black box warning label about breast cancer risk that it had put on packaging for HRT used to treat menopause symptoms since 2003. (HRT may still pose a risk if an individual has a previous history of estrogen-responsive cancers like breast cancer and some other gynecological cancers.) 

Many people consider testosterone to be a “male hormone,” but that’s not the full picture. All bodies produce both testosterone and estrogen, said Dr. Siân West, a board-certified OB-GYN and menopause expert. But adult cis men generally produce about 10 to 20 times more testosterone than cis women.

While the ovaries produce testosterone, along with other hormones like estrogen and progesterone, “testosterone levels in [cis] women gradually decline with age, beginning well before menopause,” West said. 

Testosterone levels also decrease with age in cis men.

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Who is using testosterone?

Cis men who are interested in testosterone therapy have an almost direct line to access. If you can show evidence for low testosterone levels through a blood test, you can get testosterone prescribed to you online. 

But this isn’t the case for anyone else. Though transgender patients regularly use testosterone as a form of gender-affirming care, it is currently only FDA-approved for cis men with clinically-diagnosed low testosterone. 

That means if you’re a cis woman or a transgender person looking for testosterone, there are significantly more hoops to jump through for patients and providers alike. 

The leading guidelines for prescribing testosterone to women come from the International Society for the Study of Women’s Sexual Health. They are grounded in providing treatment only for hypoactive sexual desire disorder (HSSD). 

That “pretty much means you have to have a low sex drive that’s either impacting your quality of life [or] impacting your relationship,” Dombo said. 

You also may need a sympathetic doctor.

“There is a level of politics around who should get it based on the guidelines,” Dombo said. 

Smaller studies suggest potential benefits of testosterone beyond treating HSSD, such as improvements in mood and cognition. 

Low libido isn’t exclusively linked to menopause. But more cis women may notice changes in their sexual desire around this time, West said. 

Due to the lack of FDA approval of testosterone for cis women and transgender patients, providers must prescribe testosterone to patients in these groups off-label, meaning in a way that isn’t officially approved by the FDA. 

While medications are frequently prescribed off-label—the anti-depressant Wellbutrin, for example, is often prescribed to help people quit smoking—this can be difficult when it comes to testosterone. 

For one thing, testosterone to treat HSSD in women is almost never covered by insurance, West said. This means that depending on the type of prescription you have prices can range anywhere from $30 to over $100 a month to access testosterone. Midi, a menopause and perimenopause care company, sells a low-dose T cream starting at $60 for a $90-day supply. Long-lasting pellets inserted under the skin can cost upwards of $1,500 a year.

“Never mind dealing with the personal bias of the different pharmacists,” West added. “I have had some pharmacists refuse to fill it because it isn’t FDA approved for the female population.”

Barriers to testosterone therapy treating gender dysphoria can be even more intense. Despite a plethora of research indicating gender-affirming care, including testosterone therapy, can be life-saving, transgender patients still face medical and legal roadblocks to care. 

“[I] had to get multiple letters from people saying … why I deserve to get this medical care,” Felix, a transmasculine person on testosterone said. RNG is using a pseudonym  to protect Felix’s privacy.

Despite feeling “unstable and dysphoric,” Felix recounted facing difficulties obtaining a mental health diagnosis, letters of recommendation, and getting insurance to cover testosterone, sometimes called “T.” 

Medical decisions made by trans people are often more politicized and scrutinized than cisgender patients making similar choices for themselves. 

“Cis women pursuing T for vitality or longevity are often framed as empowered health optimizers, while trans people using T for gender affirmation continue to face moral panic and political targeting; the same hormone is being discussed in radically different registers,” Kate Steinle, a nurse practitioner and chief clinical officer at FOLX Health, an LGBTQIA+ telehealth platform that provides gender-affirming care and therapy, said.

Testosterone offers safe and necessary medical care for transgender people, suggesting it is suitable for cis women, too, who typically take a much lower dose. But that reality is not reflected in restrictive laws and a regulatory landscape that created barriers to testosterone access. 

“Trans people have been safely using testosterone for decades and represent a deep well of real-world evidence that has been systematically ignored,” Steinle added. 

And the process of accessing testosterone can be even more grueling depending on where you live. For example, a 2023 law in Florida restricting how and where minors can get gender-affirming care has also made adult access to hormones extremely difficult. 

If you search the words “testosterone” and “menopause” together, you’ll likely encounter testosterone being hailed as a “miracle drug” or the secret to anti-aging. 

But like any medication, it’s never going to affect everyone the same way. And despite Hill’s profound, full-body transformation on the hormone, the best research so far suggests that its main benefit for cis women is treating low libido.

“There is much less evidence supporting testosterone for other symptoms that are commonly promoted online, such as fatigue, mood changes, brain fog, muscle strength, weight management, or ‘anti-aging,’” West explained. 

Still, some media coverage, wellness influencers, health providers, and dozens of Reddit users on the menopause subreddit claim that testosterone essentially reverses the effects of aging. They say it gives people supple skin, better cognitive function and leaner bodies—leaving them feeling an age younger than they actually are.

But not everyone sees benefit, experts cautioned.

“I have some patients who you would think would have a great response feel nothing,” West said.

The growing demand and public hype demonstrates why there needs to be more research done on the potential benefits of testosterone, Steinle said.

“Our hope,” Steinle said “is that the increased spotlight on the other uses of testosterone will help drive that research funding that will inevitably benefit all patients.”

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