Effect of transdermal testosterone therapy on mood and cognitive symptoms in peri- and postmenopausal women: a pilot study

Arch Womens Ment Health. 2025 Jun;28(3):541-550. doi: 10.1007/s00737-024-01513-6. Epub 2024 Sep 16.

Abstract

Purpose: The purpose of this study was to assess the impact of testosterone therapy on mood and cognitive symptoms in perimenopausal and postmenopausal women.

Methods: A retrospective cohort study undertaken in a UK specialist menopause clinic. 510 women using hormone replacement therapy (HRT) with persistent low libido, cognitive and negative mood symptoms were treated with testosterone cream or gel for 4 months. A modified version of the Greene Climacteric Scale was used to measure self-reported symptom frequency and severity at baseline and 4 months after initiating treatment.

Results: All nine cognitive and mood symptoms significantly improved across the study period. Mood improved more than cognition (47% of women reported an improvement in mood vs. 39% reported an improvement in cognition; 34% vs. 22% decrease in mean symptom scores, respectively). Regarding libido, 52% of women reported an improvement; mean symptom score decreased by 33%.

Conclusion: Transdermal testosterone therapy for 4 months was associated with significant improvements in mood and cognition. Further research including randomised clinical trials are needed to establish the long-term efficacy and safety of testosterone for the treatment of menopausal cognitive and psychological symptoms.

Keywords: Cognition; Hormone replacement therapy; Menopause; Mental health; Mood; Testosterone.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Affect* / drug effects
  • Aged
  • Androgens* / administration & dosage
  • Cognition* / drug effects
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Libido / drug effects
  • Middle Aged
  • Mood Disorders* / drug therapy
  • Perimenopause* / drug effects
  • Perimenopause* / psychology
  • Pilot Projects
  • Postmenopause* / drug effects
  • Postmenopause* / psychology
  • Retrospective Studies
  • Testosterone* / administration & dosage
  • Testosterone* / therapeutic use
  • Treatment Outcome
  • United Kingdom

Substances

  • Testosterone
  • Androgens