Her hormones changed. She asked for help. The answer was no.
She's 39. She's waking at 3am, foggy and anxious in a way she doesn't recognise. She's seen the posts about perimenopause, so she asks her GP about hormone therapy. The answer is no.
At 55, her hot flushes are under control, but her desire has disappeared and it's distressing her. This time the evidence suggests testosterone could help. But in many countries, a testosterone product made for women is hard to get.
Two recent news stories show both sides of this. Sometimes the no is backed by evidence. Sometimes the evidence says yes, and getting help is still hard. Either way, women are left without the answers they came for, and both stories come back to the same root cause: women's hormonal health has never been studied the way it should have been.
When the answer is no
Australian doctors say more women in their late 30s and early 40s are asking for menopausal hormone therapy (MHT, the newer name for HRT). They're describing night-time waking, anxiety, trouble concentrating and brain fog, and they believe perimenopause is the cause.
"We've had a real influx of much younger women coming in, even from their 30s and early 40s, saying, 'I think I've got perimenopause and I want to talk to you about MHT'," said Melbourne GP Dr Magdalena Simonis.
The doctors' reasons for saying no are grounded in evidence. Experts say there's no reliable evidence MHT helps with anything beyond hot flushes, night sweats and vaginal dryness, or symptoms that stem from them. "A large government-led investigation in the United States asking what symptoms MHT treats find the answer is hot flushes, night sweats and vaginal dryness. That's it," said Professor Martha Hickey, head of menopause services at the Royal Women's Hospital.
There are also risks. Professor Susan Davis, head of Monash University's Women's Health Research Program, says there's "no safety data" on giving hormones to women with regular cycles. "We have no idea what adding more hormones to their body does to their risks of cancer," she said.
Hickey says that when she tells patients she doesn't have medication for brain fog or rage without hot flushes or night sweats, it "doesn't go down very well when they've seen all that other stuff on social media".
But a no isn't an answer. The symptoms are still real, and she still needs to know what's causing them. In women this young, without changes to their period or hot flushes, experts say the cause is more often life stress or another health condition. Fatigue, for example, is often put down to perimenopause when it's actually iron deficiency.
Sarah White, CEO of Jean Hailes for Women's Health, says many symptoms put down to perimenopause may come from "the midlife collision", when more pressure at work collides with more responsibility at home. Women are carrying a huge load, she says, and "we can't address those structural issues by simply sticking a gel on our arms".
When the evidence says yes
Testosterone is usually thought of as a male hormone, but women make it too, in the ovaries and adrenal glands. Levels are about 10 to 15 times lower than in men, but it still acts on the bones, muscles, heart, blood vessels and brain. It declines gradually from well before menopause.
For one use, the evidence is strong. A 2019 meta-analysis of 36 randomised trials found carefully dosed testosterone can improve sexual desire and satisfaction in some postmenopausal women. International guidelines recognise it as an evidence-based treatment for hypoactive sexual desire disorder (HSDD), persistent low desire that causes distress.
Yet products made for women have been slow to arrive:
Australia registered Androfeme, a testosterone cream for women, in 2020.
The UK authorised it in July 2025, but it's not yet routinely available on the NHS.
The US still has no approved testosterone product for women. The FDA held a public workshop on the gap in September 2026.
So women improvise. In the UK, some have reportedly posed as men to get testosterone gel. The usual workaround is men's gel, with a small portion of a sachet measured out by eye. For a hormone needed in such tiny amounts, that's imprecise, and too much can cause side effects like acne and extra facial or body hair.
Demand keeps climbing anyway. NHS testosterone prescriptions to women in England rose roughly tenfold between 2015 and 2022, while long-term safety data for women is still limited.
The same failure, twice
At 39, she's refused a hormone the evidence doesn't support. At 55, she struggles to get one it does. Both times she's left without the answers she came for, and the gaps underneath are the same.
We don't know enough about testosterone in women. Beyond low desire, high-quality trial evidence is largely missing. Female levels are so low that routine blood tests have historically struggled to measure them reliably, so even "normal" is hard to define. Long-term safety data is limited, especially for heart disease, stroke and breast cancer, because trials have been short and often excluded women at higher risk. A UK study of 510 women found those on testosterone gel for four months reported better mood, cognitive symptoms and libido. Interesting, but it can't prove the testosterone caused it.
We don't know enough about hormones in perimenopause. The landmark Women's Health Initiative study found combined HRT led to an extra eight cases of breast cancer per 10,000 women per year (averaged over five years). But it only enrolled postmenopausal women aged 50 to 79. There's no equivalent safety data for younger women still having regular cycles.
That vacuum is where online menopause content thrives. Hickey says claims spread because there isn't enough research for experts to refute them. "If this was breast cancer, for example, and there was a load of people on social media saying, 'Do this, don't do that, don't do the other', the cancer specialist would be straight in there saying, 'No, that's wrong. Here's the evidence that you should be doing this'. But we're not actually in that position," she said.
What needs to change
Women shouldn't have to pose as men to get a treatment, or turn to social media because research hasn't kept up. Closing these gaps means:
Licensed, female-specific testosterone products, so women aren't guessing doses from men's gel, and so testosterone in women can be studied with real rigour.
Trials that include women at every stage, including perimenopause and women at higher risk, with long enough follow-up to answer safety questions.
Care that matches the stage of life. "And if it is perimenopause, you should be on a program appropriate for perimenopause, not a program of hormone therapy that's appropriate for a postmenopausal woman whose ovaries have completely stopped working," Davis said.
What you can do now
Track your cycle alongside your symptoms. Changes to your period, hot flushes and night sweats are the signs that point to perimenopause. Without them, it's worth looking at other causes.
Ask what's been ruled out. If you're told hormones aren't right for you, ask what else could be behind your symptoms and how it can be checked.
Check where advice comes from. A viral clip isn't the same as a clinical guideline. Your GP or specialist can talk through what's right for you.
We built Ovum because women deserve better than guesswork. Designed by a female doctor, Ovum brings your cycle, symptoms, test results and health history together, so you can walk into every appointment with the full picture. And every woman who opts in to share her data anonymously helps build the research that women's health has gone without for far too long.
Whatever her age, she deserves more than a no.
Sources
"Women are turning to testosterone – but what does the science actually say?", The Conversation (open question: add the author's name)
Euan Black, "Why women in their late 30s demand HRT – and why doctors say no", The Australian Financial Review, 5 November 2026
Take control of your health, download Ovum now.
Download Ovum now.
She's 39. She's waking at 3am, foggy and anxious in a way she doesn't recognise. She's seen the posts about perimenopause, so she asks her GP about hormone therapy. The answer is no.
At 55, her hot flushes are under control, but her desire has disappeared and it's distressing her. This time the evidence suggests testosterone could help. But in many countries, a testosterone product made for women is hard to get.
Two recent news stories show both sides of this. Sometimes the no is backed by evidence. Sometimes the evidence says yes, and getting help is still hard. Either way, women are left without the answers they came for, and both stories come back to the same root cause: women's hormonal health has never been studied the way it should have been.
When the answer is no
Australian doctors say more women in their late 30s and early 40s are asking for menopausal hormone therapy (MHT, the newer name for HRT). They're describing night-time waking, anxiety, trouble concentrating and brain fog, and they believe perimenopause is the cause.
"We've had a real influx of much younger women coming in, even from their 30s and early 40s, saying, 'I think I've got perimenopause and I want to talk to you about MHT'," said Melbourne GP Dr Magdalena Simonis.
The doctors' reasons for saying no are grounded in evidence. Experts say there's no reliable evidence MHT helps with anything beyond hot flushes, night sweats and vaginal dryness, or symptoms that stem from them. "A large government-led investigation in the United States asking what symptoms MHT treats find the answer is hot flushes, night sweats and vaginal dryness. That's it," said Professor Martha Hickey, head of menopause services at the Royal Women's Hospital.
There are also risks. Professor Susan Davis, head of Monash University's Women's Health Research Program, says there's "no safety data" on giving hormones to women with regular cycles. "We have no idea what adding more hormones to their body does to their risks of cancer," she said.
Hickey says that when she tells patients she doesn't have medication for brain fog or rage without hot flushes or night sweats, it "doesn't go down very well when they've seen all that other stuff on social media".
But a no isn't an answer. The symptoms are still real, and she still needs to know what's causing them. In women this young, without changes to their period or hot flushes, experts say the cause is more often life stress or another health condition. Fatigue, for example, is often put down to perimenopause when it's actually iron deficiency.
Sarah White, CEO of Jean Hailes for Women's Health, says many symptoms put down to perimenopause may come from "the midlife collision", when more pressure at work collides with more responsibility at home. Women are carrying a huge load, she says, and "we can't address those structural issues by simply sticking a gel on our arms".
When the evidence says yes
Testosterone is usually thought of as a male hormone, but women make it too, in the ovaries and adrenal glands. Levels are about 10 to 15 times lower than in men, but it still acts on the bones, muscles, heart, blood vessels and brain. It declines gradually from well before menopause.
For one use, the evidence is strong. A 2019 meta-analysis of 36 randomised trials found carefully dosed testosterone can improve sexual desire and satisfaction in some postmenopausal women. International guidelines recognise it as an evidence-based treatment for hypoactive sexual desire disorder (HSDD), persistent low desire that causes distress.
Yet products made for women have been slow to arrive:
Australia registered Androfeme, a testosterone cream for women, in 2020.
The UK authorised it in July 2025, but it's not yet routinely available on the NHS.
The US still has no approved testosterone product for women. The FDA held a public workshop on the gap in September 2026.
So women improvise. In the UK, some have reportedly posed as men to get testosterone gel. The usual workaround is men's gel, with a small portion of a sachet measured out by eye. For a hormone needed in such tiny amounts, that's imprecise, and too much can cause side effects like acne and extra facial or body hair.
Demand keeps climbing anyway. NHS testosterone prescriptions to women in England rose roughly tenfold between 2015 and 2022, while long-term safety data for women is still limited.
The same failure, twice
At 39, she's refused a hormone the evidence doesn't support. At 55, she struggles to get one it does. Both times she's left without the answers she came for, and the gaps underneath are the same.
We don't know enough about testosterone in women. Beyond low desire, high-quality trial evidence is largely missing. Female levels are so low that routine blood tests have historically struggled to measure them reliably, so even "normal" is hard to define. Long-term safety data is limited, especially for heart disease, stroke and breast cancer, because trials have been short and often excluded women at higher risk. A UK study of 510 women found those on testosterone gel for four months reported better mood, cognitive symptoms and libido. Interesting, but it can't prove the testosterone caused it.
We don't know enough about hormones in perimenopause. The landmark Women's Health Initiative study found combined HRT led to an extra eight cases of breast cancer per 10,000 women per year (averaged over five years). But it only enrolled postmenopausal women aged 50 to 79. There's no equivalent safety data for younger women still having regular cycles.
That vacuum is where online menopause content thrives. Hickey says claims spread because there isn't enough research for experts to refute them. "If this was breast cancer, for example, and there was a load of people on social media saying, 'Do this, don't do that, don't do the other', the cancer specialist would be straight in there saying, 'No, that's wrong. Here's the evidence that you should be doing this'. But we're not actually in that position," she said.
What needs to change
Women shouldn't have to pose as men to get a treatment, or turn to social media because research hasn't kept up. Closing these gaps means:
Licensed, female-specific testosterone products, so women aren't guessing doses from men's gel, and so testosterone in women can be studied with real rigour.
Trials that include women at every stage, including perimenopause and women at higher risk, with long enough follow-up to answer safety questions.
Care that matches the stage of life. "And if it is perimenopause, you should be on a program appropriate for perimenopause, not a program of hormone therapy that's appropriate for a postmenopausal woman whose ovaries have completely stopped working," Davis said.
What you can do now
Track your cycle alongside your symptoms. Changes to your period, hot flushes and night sweats are the signs that point to perimenopause. Without them, it's worth looking at other causes.
Ask what's been ruled out. If you're told hormones aren't right for you, ask what else could be behind your symptoms and how it can be checked.
Check where advice comes from. A viral clip isn't the same as a clinical guideline. Your GP or specialist can talk through what's right for you.
We built Ovum because women deserve better than guesswork. Designed by a female doctor, Ovum brings your cycle, symptoms, test results and health history together, so you can walk into every appointment with the full picture. And every woman who opts in to share her data anonymously helps build the research that women's health has gone without for far too long.
Whatever her age, she deserves more than a no.
Sources
"Women are turning to testosterone – but what does the science actually say?", The Conversation (open question: add the author's name)
Euan Black, "Why women in their late 30s demand HRT – and why doctors say no", The Australian Financial Review, 5 November 2026
She's 39. She's waking at 3am, foggy and anxious in a way she doesn't recognise. She's seen the posts about perimenopause, so she asks her GP about hormone therapy. The answer is no.
At 55, her hot flushes are under control, but her desire has disappeared and it's distressing her. This time the evidence suggests testosterone could help. But in many countries, a testosterone product made for women is hard to get.
Two recent news stories show both sides of this. Sometimes the no is backed by evidence. Sometimes the evidence says yes, and getting help is still hard. Either way, women are left without the answers they came for, and both stories come back to the same root cause: women's hormonal health has never been studied the way it should have been.
When the answer is no
Australian doctors say more women in their late 30s and early 40s are asking for menopausal hormone therapy (MHT, the newer name for HRT). They're describing night-time waking, anxiety, trouble concentrating and brain fog, and they believe perimenopause is the cause.
"We've had a real influx of much younger women coming in, even from their 30s and early 40s, saying, 'I think I've got perimenopause and I want to talk to you about MHT'," said Melbourne GP Dr Magdalena Simonis.
The doctors' reasons for saying no are grounded in evidence. Experts say there's no reliable evidence MHT helps with anything beyond hot flushes, night sweats and vaginal dryness, or symptoms that stem from them. "A large government-led investigation in the United States asking what symptoms MHT treats find the answer is hot flushes, night sweats and vaginal dryness. That's it," said Professor Martha Hickey, head of menopause services at the Royal Women's Hospital.
There are also risks. Professor Susan Davis, head of Monash University's Women's Health Research Program, says there's "no safety data" on giving hormones to women with regular cycles. "We have no idea what adding more hormones to their body does to their risks of cancer," she said.
Hickey says that when she tells patients she doesn't have medication for brain fog or rage without hot flushes or night sweats, it "doesn't go down very well when they've seen all that other stuff on social media".
But a no isn't an answer. The symptoms are still real, and she still needs to know what's causing them. In women this young, without changes to their period or hot flushes, experts say the cause is more often life stress or another health condition. Fatigue, for example, is often put down to perimenopause when it's actually iron deficiency.
Sarah White, CEO of Jean Hailes for Women's Health, says many symptoms put down to perimenopause may come from "the midlife collision", when more pressure at work collides with more responsibility at home. Women are carrying a huge load, she says, and "we can't address those structural issues by simply sticking a gel on our arms".
When the evidence says yes
Testosterone is usually thought of as a male hormone, but women make it too, in the ovaries and adrenal glands. Levels are about 10 to 15 times lower than in men, but it still acts on the bones, muscles, heart, blood vessels and brain. It declines gradually from well before menopause.
For one use, the evidence is strong. A 2019 meta-analysis of 36 randomised trials found carefully dosed testosterone can improve sexual desire and satisfaction in some postmenopausal women. International guidelines recognise it as an evidence-based treatment for hypoactive sexual desire disorder (HSDD), persistent low desire that causes distress.
Yet products made for women have been slow to arrive:
Australia registered Androfeme, a testosterone cream for women, in 2020.
The UK authorised it in July 2025, but it's not yet routinely available on the NHS.
The US still has no approved testosterone product for women. The FDA held a public workshop on the gap in September 2026.
So women improvise. In the UK, some have reportedly posed as men to get testosterone gel. The usual workaround is men's gel, with a small portion of a sachet measured out by eye. For a hormone needed in such tiny amounts, that's imprecise, and too much can cause side effects like acne and extra facial or body hair.
Demand keeps climbing anyway. NHS testosterone prescriptions to women in England rose roughly tenfold between 2015 and 2022, while long-term safety data for women is still limited.
The same failure, twice
At 39, she's refused a hormone the evidence doesn't support. At 55, she struggles to get one it does. Both times she's left without the answers she came for, and the gaps underneath are the same.
We don't know enough about testosterone in women. Beyond low desire, high-quality trial evidence is largely missing. Female levels are so low that routine blood tests have historically struggled to measure them reliably, so even "normal" is hard to define. Long-term safety data is limited, especially for heart disease, stroke and breast cancer, because trials have been short and often excluded women at higher risk. A UK study of 510 women found those on testosterone gel for four months reported better mood, cognitive symptoms and libido. Interesting, but it can't prove the testosterone caused it.
We don't know enough about hormones in perimenopause. The landmark Women's Health Initiative study found combined HRT led to an extra eight cases of breast cancer per 10,000 women per year (averaged over five years). But it only enrolled postmenopausal women aged 50 to 79. There's no equivalent safety data for younger women still having regular cycles.
That vacuum is where online menopause content thrives. Hickey says claims spread because there isn't enough research for experts to refute them. "If this was breast cancer, for example, and there was a load of people on social media saying, 'Do this, don't do that, don't do the other', the cancer specialist would be straight in there saying, 'No, that's wrong. Here's the evidence that you should be doing this'. But we're not actually in that position," she said.
What needs to change
Women shouldn't have to pose as men to get a treatment, or turn to social media because research hasn't kept up. Closing these gaps means:
Licensed, female-specific testosterone products, so women aren't guessing doses from men's gel, and so testosterone in women can be studied with real rigour.
Trials that include women at every stage, including perimenopause and women at higher risk, with long enough follow-up to answer safety questions.
Care that matches the stage of life. "And if it is perimenopause, you should be on a program appropriate for perimenopause, not a program of hormone therapy that's appropriate for a postmenopausal woman whose ovaries have completely stopped working," Davis said.
What you can do now
Track your cycle alongside your symptoms. Changes to your period, hot flushes and night sweats are the signs that point to perimenopause. Without them, it's worth looking at other causes.
Ask what's been ruled out. If you're told hormones aren't right for you, ask what else could be behind your symptoms and how it can be checked.
Check where advice comes from. A viral clip isn't the same as a clinical guideline. Your GP or specialist can talk through what's right for you.
We built Ovum because women deserve better than guesswork. Designed by a female doctor, Ovum brings your cycle, symptoms, test results and health history together, so you can walk into every appointment with the full picture. And every woman who opts in to share her data anonymously helps build the research that women's health has gone without for far too long.
Whatever her age, she deserves more than a no.
Sources
"Women are turning to testosterone – but what does the science actually say?", The Conversation (open question: add the author's name)
Euan Black, "Why women in their late 30s demand HRT – and why doctors say no", The Australian Financial Review, 5 November 2026
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