Testosterone

Testosterone plays a key role in women’s sexual desire by increasing dopamine, enhancing sensitivity to sexual stimuli, and supporting energy, motivation, and overall well-being. It also improves genital blood flow and responsiveness, helping desire and arousal feel more natural.

During perimenopause and menopause, testosterone levels drop sharply—sometimes by more than 50%—because ovarian and adrenal production declines with age and hormonal fluctuations. As levels fall, many women notice reduced libido, less spontaneous desire, and lower sexual motivation.

Testosterone is a key driver of motivation, drive, and initiative in women. It supports dopamine pathways in the brain—the same circuits responsible for focus, ambition, and the “get-things-done” feeling. When levels are healthy, women often experience better mental clarity, productivity, and a stronger sense of purpose and follow-through.

In perimenopause and menopause, testosterone naturally declines, as both the ovaries and adrenal glands produce less over time. As levels drop, many women notice decreased motivation, lower drive, mental fatigue, and less enthusiasm for tasks that once felt easy.

Testosterone plays an important role in energy production, stamina, and overall vitality in women. It supports mitochondrial function (your cells’ energy factories), helps maintain muscle mass, and stabilizes mood and motivation—all of which contribute to feeling strong and energized throughout the day.

During perimenopause and menopause, testosterone levels naturally decline, as ovarian and adrenal production decreases. When levels drop, many women experience persistent fatigue, reduced stamina, slower recovery, and a sense of physical or mental exhaustion that doesn’t improve with rest.

Testosterone supports key aspects of executive function in women—focus, mental clarity, decision-making, and the ability to organize and follow through on tasks. It works by enhancing dopamine signaling in the brain’s prefrontal cortex, the region responsible for attention, planning, and cognitive efficiency.

As testosterone declines in perimenopause and menopause, women may notice brain fog, distractibility, slower processing, difficulty multitasking, and more mental fatigue. These changes reflect reduced androgen support to the areas of the brain that regulate executive skills.

Testosterone is essential for maintaining lean muscle mass, strength, and a healthy metabolism in women. It supports protein synthesis, muscle repair, and the ability to build and preserve muscle—one of the biggest drivers of metabolic rate and long-term weight stability.

As testosterone drops during perimenopause and menopause, women naturally lose muscle and gain fat more easily, even if diet and exercise haven’t changed. Lower testosterone slows metabolism, reduces strength, and makes the body more prone to storing fat—especially around the abdomen.

Testosterone plays an important role in maintaining strong, healthy bones in women. It supports bone-building cells (osteoblasts), helps preserve bone density, and works synergistically with estradiol to keep the skeletal system strong and resilient.

As testosterone levels decline in perimenopause and menopause, bone turnover becomes imbalanced—bone breaks down faster than it’s rebuilt. This increases the risk of thinning bones, loss of strength, and ultimately osteoporosis.