Two new 2026 studies involving more than 600 women are adding to the conversation about testosterone and women's health.

When most people hear the word testosterone, they tend to think about men's health.

But women produce testosterone too, and it plays an important role throughout a woman's life.

As women move through their 40s and 50s, hormone levels can change significantly. Estrogen and progesterone are often the focus of conversations around perimenopause and menopause, while testosterone receives considerably less attention.

That may be changing.

Two studies published in 2026 looked at a combined 611 women receiving testosterone therapy in real world clinical settings. Both reported improvements across multiple areas of health and well being.

One finding was particularly interesting: energy and fatigue were among the areas showing the greatest reported improvement.

For women who have noticed that they simply do not have the same energy, motivation, focus or sense of vitality they once did, this research raises an important question:

Could testosterone be one piece of the puzzle?

Testosterone in Women: More Than Libido

Testosterone is often discussed in women's health primarily in connection with sexual desire.

And sexual health is certainly one area where testosterone can matter.

But testosterone has effects throughout the body. It is involved in maintaining muscle and bone, supporting sexual function and contributing to overall physiological health.

During the reproductive years, women produce testosterone primarily through the ovaries and adrenal glands. Testosterone levels generally decline with age, although the pattern is different from the relatively rapid changes seen with estrogen during menopause.

That gradual change can make it difficult to determine whether testosterone is contributing to symptoms.

A woman may not think, "My testosterone is changing."

Instead, she may notice:

"Why am I exhausted all the time?"

"Why don't I have the same motivation I used to?"

"Why is it harder to concentrate?"

"Why has my libido changed?"

"Why don't I feel like myself anymore?"

These symptoms can have many causes, which is why looking at hormones in the context of the whole person is important.

What Did the First 2026 Study Find?

A study published in the Journal of Personalized Medicine evaluated 332 women between the ages of 27 and 78 who were receiving individualized testosterone replacement therapy in routine clinical care.

The researchers looked at changes in symptoms and quality of life reported by the women.

The results were notable.

84.3% reported improvement in energy and fatigue.

Energy and fatigue were also the symptoms most frequently selected by participants as one of their greatest areas of improvement, with 64.2% identifying this category.

Other reported improvements included:

70.8% improvement in depression

69.0% improvement in irritability

67.5% improvement in anhedonia, or reduced ability to experience pleasure

66.9% improvement in sexual interest

57.8% improvement in concentration

54.5% improvement in memory

Overall, 89.7% of participants reported some degree of improvement in quality of life.

Those numbers are interesting because they show that the women in this clinical population were reporting changes across multiple areas of daily life, not simply sexual function.

However, there is an important distinction.

This was a retrospective observational study. It was not a randomized controlled clinical trial, so the findings cannot establish that testosterone itself caused every improvement.

Still, the results provide useful real world data and support the need for further research.

The Second Study Looked at Perimenopause and Menopause

The second 2026 study, published in the Journal of Sexual Medicine, looked at 279 perimenopausal and menopausal women who were already using standard hormone replacement therapy.

Researchers evaluated 24 symptoms before and after the addition of transdermal testosterone.

After an average follow up period of approximately three months, 15 of the 24 symptoms showed statistically significant improvement.

The symptoms evaluated covered several different areas, including:

Energy and fatigue

Mood and emotional symptoms

Cognitive symptoms

Musculoskeletal symptoms

Genitourinary symptoms

Endocrine and hormonal symptoms

The study also reported improvements in symptoms such as vaginal dryness, hot flashes and libido.

Again, the significance here is not that testosterone should automatically be added to hormone therapy.

It is that researchers are continuing to investigate how testosterone may affect a much broader range of symptoms in women going through hormonal changes.

Why Are Women Talking About Energy?

Energy is one of those symptoms that can be difficult to quantify but incredibly easy to notice.

A woman may still be functioning at work, taking care of her family and doing everything she normally does, but feel like everything requires considerably more effort.

She may stop exercising because she is exhausted.

She may struggle to stay focused through the afternoon.

She may sleep but still wake up feeling tired.

She may feel less motivated to do the things she used to enjoy.

And sometimes, these changes happen alongside other symptoms associated with perimenopause or menopause.

That is why the finding that energy and fatigue were the most frequently improved symptom category in the 332 woman study is particularly interesting.

It suggests an area that deserves more investigation.

But Low Energy Does Not Automatically Mean Low Testosterone

This is an important part of the conversation.

There is no single hormone responsible for how energetic a woman feels.

Fatigue can be associated with many different factors, including:

Sleep quality

Stress

Thyroid function

Iron status

Nutritional deficiencies

Blood sugar regulation

Medications

Depression or anxiety

Changes in estrogen and progesterone

Changes in testosterone

Metabolic health

Lifestyle and activity levels

This is why simply looking at a testosterone level without considering symptoms, health history and other factors may not provide the complete picture.

At Hawaii Natural Medicine, hormone optimization is approached as part of a larger health picture.

What Does Hormone Optimization Actually Mean?

Hormone optimization is not simply about making a laboratory number higher.

It is about understanding how hormonal changes may be affecting an individual woman and determining whether hormone therapy is appropriate.

Two women can have similar laboratory results and completely different symptoms.

One may feel well.

Another may be experiencing significant changes in energy, libido, mood or overall quality of life.

That is why individualized care matters.

Dr. Jené Ferrante, one of the leading practitioner in hormone optimization at Hawaii Natural Medicine, takes an integrative approach to evaluating hormone health.

The goal is to look beyond a single symptom and consider the bigger picture.

What changed?

When did it change?

What other symptoms are present?

What does the woman's overall health look like?

Are there other factors that could be contributing?

And if hormones are part of the picture, what options may be appropriate?

What About Testosterone and Libido?

Libido remains an important part of the testosterone conversation.

For some women, declining sexual desire is one of the first changes they notice during perimenopause or menopause.

But libido is complicated.

Hormones can influence sexual desire, but so can sleep, stress, relationships, medications, pain, vaginal health, mood and many other factors.

This is another reason why testosterone should not be viewed as a one size fits all solution.

The 2026 research is interesting precisely because the reported improvements extended beyond sexual desire.

Women were reporting changes in energy, mood, cognition and other aspects of quality of life as well.

What About Mood and Brain Function?

The 2026 Journal of Personalized Medicine study also reported improvements in several symptoms related to mood and cognitive function.

Participants reported improvements in depression, irritability, concentration and memory.

These findings are worth paying attention to, but they should also be interpreted carefully.

Testosterone is not a treatment for every form of depression, memory problem or cognitive difficulty.

There are many potential explanations for changes in mood and cognition during midlife, including sleep disruption, stress, changing estrogen levels and other health factors.

The research simply adds another area for scientists to investigate.

What Does the Research Say About Quality of Life?

Perhaps the most interesting part of the first study is that the researchers looked beyond individual symptoms.

They also examined quality of life.

Nearly 90% of participants reported some improvement in quality of life.

That matters because women rarely experience hormonal changes as one isolated symptom.

It is usually a combination.

Less energy.

Poorer sleep.

Changes in libido.

Mood changes.

Difficulty concentrating.

Changes in body composition.

Reduced motivation.

When several of these occur together, the overall effect can be significant.

Improving one area may influence how a woman experiences the rest of her life.

Is Testosterone Therapy Safe?

This is where it is important to separate promising research from definitive conclusions.

The 2026 studies provide encouraging real world evidence, but they do not establish that testosterone therapy is appropriate or safe for every woman.

The first study was retrospective and observational.

The second study was also based on outcomes observed in women receiving treatment in clinical practice.

Neither study replaces the need for larger randomized controlled trials and longer term research.

Questions remain around appropriate dosing, patient selection, long term safety and which women are most likely to benefit.

That is an important part of responsible hormone care.

The FDA Question

There is another reason the current research is generating interest.

There are limited FDA approved testosterone options specifically designed for women in the United States.

The 2026 Journal of Sexual Medicine paper discusses the regulatory limitations surrounding testosterone therapy for women and the lack of an FDA approved formulation specifically designed for women for broader uses.

That leaves an interesting gap.

We have women experiencing symptoms.

We have clinicians treating women in real world settings.

We have emerging research showing potentially meaningful improvements.

And we still need more high quality research and appropriately designed treatment options specifically for women.

Ultimately, women deserve better data and treatment options developed with women's physiology in mind.

What Should Women Take Away From the New Research?

The takeaway is not that every woman with fatigue needs testosterone.

It is also not that testosterone is the answer to every symptom associated with menopause.

The more useful takeaway is that women's testosterone health deserves more attention.

The two 2026 studies add real world evidence involving 611 women and report improvements in areas that extend beyond sexual health.

Energy and fatigue stood out in particular.

That gives researchers more questions to investigate and gives women another reason to have informed conversations about their hormones.

If you are experiencing changes in energy, libido, mood, concentration, muscle strength or overall well being, it may be worth looking at the bigger hormonal picture rather than assuming these changes are simply something you have to live with.

Exploring Hormone Optimization

At Hawaii Natural Medicine, Dr. Jené Ferrante provides individualized hormone optimization care for women looking for a more comprehensive approach to their health.

Your symptoms are personal, your hormone patterns are personal and your treatment should be individualized as well.

If you are experiencing changes in energy, mood, libido, focus or overall vitality, schedule an appointment with Dr. Jené Ferrante to explore your hormone health and available options.

References

Hernandez BS, Boyne AM, Fleming B, et al. Improvement in multiple organ systems following testosterone replacement therapy in women previously on standard hormone replacement therapy. The Journal of Sexual Medicine. 2026;23(9):qdag116.
https://doi.org/10.1093/jsxmed/qdag116

Elggren CW, Iverson CH, Morris MD, et al. Testosterone Replacement Therapy in Women Is Associated with Improved Symptom Burden and Favorable Biomarker Changes: A Retrospective Observational Study. Journal of Personalized Medicine. 2026;16(5):231.
https://doi.org/10.3390/jpm16050231

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