What (important) role does testosterone play during menopause?

In women, testosterone is produced in the ovaries and adrenal glands, fulfilling several important functions. It aids in the development of muscles and bones, influences energy levels, and contributes to libido or sexual desire.

During menopause, the production of not only oestrogen and progesterone but also testosterone gradually declines. These hormonal changes can have an impact on your body and how you feel.

Good to know: you may sometimes encounter the term "androgens." This refers to a group of hormones, with testosterone being the most well-known.

In women, the sex hormones testosterone, oestrogen, and progesterone play a crucial role. Together, they regulate essential functions and help maintain the body's balance.

While testosterone supports libido and muscle mass, oestrogen and progesterone work closely together to regulate the menstrual cycle. However, these hormones also have numerous other important functions in the female body. You can read more about the specific roles of oestrogen and progesterone here.

Testosterone levels fluctuate throughout a woman’s life. During puberty, testosterone levels increase, contributing to the development of muscle and bone structures. During the reproductive years, testosterone levels remain relatively stable but may vary during events such as menstruation.

Around the age of 45, most women enter perimenopause. During this phase, as oestrogen levels begin to decline, testosterone levels generally remain relatively stable and may even increase slightly at first. This can result in feelings of irritability, restlessness, and more pronounced emotional fluctuations.

As menopause progresses, testosterone levels decline, although less sharply than oestrogen and progesterone levels. The decrease in oestrogen and progesterone is typically faster, more pronounced, and abrupt.

During postmenopause—the phase when menstruation has definitively ceased—hormone production, including testosterone, stabilises at a lower level. The adrenal glands and ovaries continue to produce small amounts of testosterone, but overall production is significantly reduced compared to earlier stages of life.

The decline and fluctuations in oestrogen levels are responsible for many common menopausal symptoms, such as hot flushes or mood swings. While testosterone levels decrease less abruptly, they can still contribute to symptoms such as reduced energy, decreased sexual desire (research shows that 40% of postmenopausal women experience a reduced libido), or diminished muscle strength.

Because oestrogen levels drop more quickly and abruptly than testosterone levels, an imbalance can occur where testosterone becomes relatively more dominant than oestrogen. This can lead to symptoms such as hair loss, excessive hair growth in unusual areas, acne, mood swings, restlessness, anxiety, and even depression. It is worth noting that these symptoms can also stem from other factors, such as poor sleep, and are not always directly linked to testosterone levels.

Although every individual is different and the effects of higher testosterone levels vary from woman to woman, a relatively high testosterone level compared to oestrogen can also contribute to insulin resistance. This means the body no longer responds effectively to insulin, preventing glucose from being efficiently absorbed into the cells. The result? Weight gain, particularly around the abdomen.

By making lifestyle adjustments, incorporating regular physical activity into your routine, and adopting other healthy habits, you can often reduce the symptoms of hormonal changes during menopause. It is important to:

• Eat healthily. Include plenty of fruits, vegetables, whole grains, healthy fats (such as avocados, nuts, and seeds), and proteins in your diet to support hormonal balance. Learn more about the right nutrition during menopause.
• Rest regularly. Stress can disrupt hormonal balance and worsen menopausal symptoms. Incorporate relaxation techniques such as yoga, meditation, or breathing exercises into your daily routine.
• Incorporate physical activity into your life. Aim to move every day, whether it’s through walking, cycling, playing tennis, or working out at the gym. Exercise not only helps reduce stress but also stimulates the release of endorphins, which promote feelings of happiness.