Testosterone does not increase during menopause. Total testosterone levels stay relatively stable through the menopausal transition and then decline gradually with age. What does change dramatically is the ratio between testosterone and estrogen. As estrogen drops sharply, testosterone becomes the more dominant sex hormone in your body, creating what researchers call a state of “relative androgen excess.” This shift explains why many women notice androgen-related symptoms even though their testosterone isn’t actually rising.
What Actually Happens to Testosterone Levels
When researchers compare women at different stages of the menopausal transition (using standardized staging criteria), testosterone levels don’t vary significantly between premenopausal, perimenopausal, and postmenopausal women of the same age. A large cross-sectional study published in eBioMedicine found that testosterone did not change based on menopausal stage when comparing women aged 48 to 53.
What does affect testosterone is simply getting older. Median levels drop from about 0.56 nmol/L in women aged 40 to 44 down to 0.42 nmol/L by ages 55 to 59. That’s a gradual decline, not a cliff. And the range is wide at every age: some women in their 60s have testosterone levels as high as women in their early 40s. For reference, typical adult testosterone in women falls between 15 and 70 ng/dL, and there is no established “deficiency” threshold for women the way there is for men.
So the decline in testosterone is driven by aging itself, not by menopause specifically. This is an important distinction, because it means menopause doesn’t trigger a sudden testosterone crash the way it does with estrogen.
Why It Can Feel Like Testosterone Is Higher
During the menopausal transition, estrogen levels fall by roughly 80 to 90 percent. Testosterone barely budges. The result is that androgen hormones, which were previously balanced out by high estrogen, now occupy a much larger share of your hormonal landscape. This relative androgen excess is a well-documented phenomenon linked to metabolic changes during midlife, including shifts in body composition and cardiovascular risk markers.
There’s also a second mechanism at play. A protein called SHBG (sex hormone-binding globulin) acts like a sponge in your bloodstream, binding to testosterone and making it inactive. Premenopausal women have higher SHBG levels because estrogen stimulates the liver to produce more of it. After menopause, as estrogen falls, SHBG production drops too. Lower SHBG means more of your existing testosterone circulates in its free, active form. The correlation is strong: SHBG and free testosterone move in opposite directions. So even without any increase in total testosterone, you can end up with more biologically active testosterone reaching your tissues.
Symptoms of Relative Androgen Excess
This hormonal rebalancing explains a set of changes many women notice around and after menopause. The most common signs of androgen dominance include new or worsening facial hair growth (particularly on the chin and upper lip), thinning hair on the scalp, and adult acne. These are the same symptoms seen in younger women with conditions like PCOS, where androgens are elevated relative to other hormones.
For most postmenopausal women, these changes are mild to moderate and develop gradually. Coarse hair in a few new places or slightly oilier skin are typical. Rapid or severe changes, like significant voice deepening, pronounced muscle bulk, or clitoral enlargement, are not a normal part of menopause and suggest something else is going on, such as an androgen-producing ovarian or adrenal growth.
Where Testosterone Comes From After Menopause
Before menopause, your ovaries and adrenal glands both contribute to testosterone production. After menopause, the ovaries don’t shut down androgen production entirely. Research measuring hormone levels directly in the ovarian veins of postmenopausal women found testosterone concentrations 24 times higher in ovarian blood than in the general circulation. The postmenopausal ovary produces an estimated 50 micrograms of testosterone per day (combined from both ovaries).
Women who have had both ovaries surgically removed show a 42 percent drop in testosterone compared to postmenopausal women with intact ovaries. That’s a significant contribution, which is why surgical menopause often produces more pronounced symptoms of low testosterone (fatigue, low libido, reduced sense of well-being) than natural menopause does.
The adrenal glands also play a major role. They produce DHEA, a precursor hormone that your body converts into testosterone and estrogen locally inside individual cells in tissues like skin, fat, and muscle. This process, sometimes called intracrinology, means testosterone can be made and used right where it’s needed without ever showing up in a blood test. It’s one reason blood levels of testosterone don’t always tell the full story of what’s happening in your body.
The Bottom Line on Testosterone and Menopause
Testosterone does not rise during menopause. It declines slowly with age, independent of menopausal stage. But because estrogen plummets and SHBG drops alongside it, the testosterone you do have becomes proportionally more influential and more biologically available. This relative shift is real, produces noticeable symptoms, and is a normal part of the hormonal reorganization that happens during midlife. If you’re experiencing gradual changes like new facial hair or scalp thinning, this hormonal rebalancing is the most likely explanation.