A University College London review published in Reproduction and Fertility found insufficient evidence that testosterone therapy improves cognitive symptoms or brain fog during menopause. Analyzing trials with 244 post-menopausal women, researchers found no statistically significant cognitive gains compared to placebos. While UK prescriptions have risen amid social media claims, clinical guidelines support testosterone only for low libido, prompting calls for more research like Cardiff University's ongoing trial.
Findings of the University College London review
- ▪A University College London meta-analysis of three randomized controlled trials involving 244 post-menopausal women with an average age of 57 found no statistically significant cognitive improvements from taking testosterone compared to a placebo.
- ▪Participants in the reviewed clinical trials were administered testosterone or placebo treatments over periods ranging between four and 26 weeks.
- ▪A University College London review published in Reproduction and Fertility examined five studies across Australia, Canada, the U.S., and Sweden to evaluate whether testosterone treatment improves memory and thinking in menopausal women.
Study limitations and future research needs
- ▪A ongoing Cardiff University trial involving 400 women, concluding in 2029, is investigating whether adding testosterone to standard hormone replacement therapy improves cognition, energy levels, motivation, and exercise.
- ▪The authors noted that existing clinical trials had small sample sizes and lacked data on perimenopausal women, highlighting the need for further research into testosterone's impact on brain health.
- ▪Study lead authors Dr. Alexandra Faulkner and Professor Aimee Spector emphasized that the review results indicate a lack of sufficient evidence rather than proof that testosterone has no effect on cognitive function.
Unregulated demand and off-label testosterone use
- ▪Some women in the United Kingdom have posed as men to purchase testosterone from online pharmacies, with menopause specialist Dr. Michelle Olver reporting patients with up to 12 times safe hormone levels.
- ▪Prescriptions for testosterone have increased across NHS and private clinics in the United Kingdom, reflecting growing interest in its role for menopausal symptom management.
- ▪Social media platforms contain widespread unverified claims that testosterone improves memory and brain fog, encouraging women to seek off-label prescriptions during menopause.
Prescribing testosterone for low libido
- ▪The NHS website states that menopausal women can obtain testosterone gel or cream on prescription from a menopause specialist to help improve low libido.
- ▪Current clinical guidance from the British Menopause Society, the International Menopause Society, and the NHS supports testosterone therapy for menopausal women only to treat low libido.
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