A recent BBC report described women posing as men to get hold of testosterone gel, hoping to improve their menopause symptoms, because female testosterone products are not easily available to them. But why is the appetite for this predominantly male hormone exploding and are there risks involved?

Testosterone is usually thought of as the defining male hormone. It is linked to puberty, muscle development and reproductive function. But this overlooks an important biological reality. Women also produce testosterone, and it plays important roles throughout the body.

Although blood concentrations are typically about ten to 15 times lower than in men, testosterone remains biologically active in women.

Women make testosterone in their ovaries and adrenal glands, and the body also makes it by changing other hormones in fat, skin and muscle. Some of this testosterone is then used to make oestradiol, the main form of oestrogen in women of reproductive age.

But testosterone is not simply an oestrogen reservoir. It also acts directly on tissues throughout the body, including the bones, muscles, heart and blood vessels, and the brain. This has led researchers to look more closely at how testosterone may affect women’s health.

Similar to men, testosterone declines gradually across the reproductive lifespan, although patterns vary between individuals. This fall begins well before menopause, and unlike oestrogen, it doesn’t fall sharply at menopause as the ovaries decline.

Measuring how far it’s fallen is its own problem. Female levels are so low that routine blood tests have........

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