Risks Associated with Testosterone Therapy in Postmenopausal Women

Research indicates that postmenopausal women using testosterone therapy might have a higher risk of cardiovascular issues, including heart attack and stroke. This study, presented at the 2026 annual meeting of The Menopause Society in San Diego, focused on over 6,000 women aged 45 and older. The comparison involved women who underwent testosterone therapy and those who did not, excluding those with a history of cardiovascular disease.

The findings showed that 3.8% of the women receiving testosterone experienced a first-time cardiovascular event, whereas only 0.5% of the untreated group faced similar issues. These events encompassed heart attacks, strokes, heart failure, and other cardiovascular problems.

Testosterone, a hormone produced by the ovaries and adrenal glands, influences sexual desire, muscle and bone health, mood, and cognition. Cleveland Clinic notes its effects, while Anna Cabeca, a board-certified OB-GYN and menopause expert from Dallas, emphasizes the importance of understanding the difference between treated and untreated groups. Despite not participating in the study, Cabeca highlighted the significance of the findings.

“The difference between 3.8% and 0.5% is certainly significant enough to warrant attention, but we need to be careful about what these numbers actually tell us,” said Cabeca.

This equates to around 38 cardiovascular incidents per 1,000 women receiving testosterone therapy, compared to five per 1,000 untreated women. For women considering this therapy, Cabeca advises doctors to assess the patient’s comprehensive health profile, including heart history, blood pressure, cholesterol, metabolic health, medications, and familial background.

Testosterone’s connection to sexual health should not be ignored, particularly concerning libido and intimacy issues during and post-menopause, Cabeca noted. Its potential to enhance sexual satisfaction must be balanced against the risks.

In appropriate cases, experts recommend careful dosing and monitoring of symptoms and lab results. The study’s observational nature limits its ability to prove causation, as it analyzed existing testosterone users and their outcomes.

The researchers and Cabeca acknowledged that other health factors like age, blood pressure, diabetes, and cholesterol might influence heart risk differently between the two groups. She stressed the need for further investigation into these findings.