Testosterone has spent decades being treated as a men’s problem. Men’s health brands sell it and men’s clinics prescribe it.

Women, meanwhile, have largely been told their fatigue, mood swings, and brain fog are just part of getting older, or maybe estrogen, or maybe anxiety, or maybe just life. But ultimately, deal with it.

A new study published in the Journal of Personalized Medicine by researchers at Brigham Young University pushes back on that. Hard.

What the Study Is

The study analyzed 332 women between ages 27 and 78 receiving individualized TRT through Joi + Blokes, a telehealth hormone optimization platform. Participants were assessed across eight symptom domains: energy and fatigue, memory, concentration, irritability, depression, anhedonia, sexual interest, and relationship satisfaction.

Eighty-four percent reported improved energy. Nearly 90% reported improved quality of life. Depression, irritability, and anhedonia all exceeded 65% improvement. When participants named their biggest area of benefit: energy first at 64%, mood second at 50%, sexual desire third at 41%.

Read that again. Those stats matter.

The clinical conversation around testosterone in women has been almost entirely anchored to libido. What this study suggests is that women themselves aren’t leading with sex drive when they describe what TRT changed. They’re talking about energy. Mood. Mental clarity. Feeling like themselves again.

Biomarker data from a 120-person subset adds weight. At 12 weeks, total testosterone rose 152%, free testosterone rose 217%, hemoglobin increased 5.5%, and triglycerides dropped 12.6%. All values stayed within normal clinical limits. The hemoglobin bump is worth noting specifically as better oxygen carrying capacity has downstream effects on daily energy and physical performance alike.

The dose range targeted, 25 to 50 ng/dL total testosterone, approximates the upper end of what a healthy premenopausal woman carries naturally. This is hormonal restoration, not enhancement.

Not All Roses. It’s Complicated

The limitations are real, and the authors don’t hide them.

It’s observational and retrospective, with no control group and no randomization. Symptom data came from a single post-treatment survey using a non-validated instrument. A larger sample size and a prospective design would have told a more definitive story.

Selection bias is baked in. Women who discontinued TRT; because it didn’t work, caused side effects, or got too expensive aren’t in this dataset. The progressive improvement across duration groups may partly reflect who stayed on therapy, not how well therapy worked over time.

Also, the platform funding the study also provides the treatment. Lead authors Dr. Ben Bikman and Dr. Paul Reynolds hold scientific advisory roles with Joi + Blokes. That’s disclosed, but it can’t be ignored. Doesn’t mean it is a negative, but a sidenote.

We spoke directly with Dr. Reynolds, co-author on the study and Professor of Cell Biology and Physiology at Brigham Young University about the funding concern directly.

“The data comes from routine clinical care at scale, which gives us real-world validity that tightly controlled trials often lack,” he said. “The flip side is that observational data cannot prove causation, and we said so plainly in the limitations.”

On what moves TRT toward standard of care: “The field needs multi-site randomized controlled trials with diverse populations and adequate follow-up — ideally 12 months or longer — long-term safety data on cardiovascular and breast outcomes, and independent replication outside of telehealth populations. Our paper establishes that, in a large real-world cohort, individualized low-dose TRT was associated with meaningful symptom improvement across eight domains. That is a useful signal for the field, not a regulatory endpoint.”

That’s the right framing and he’s open to having a conversation. This isn’t a green light. It’s a signal worth taking seriously that low-dose TRT can help women feel better.

The Relationship between Testosterone and Women

Testosterone in women declines progressively starting in the third decade of life. By the mid-40s, many women carry roughly half the testosterone they had in their 20s. The menopausal transition compounds this and the clinical framework has historically focused almost entirely on estrogen while testosterone declined quietly alongside it.

The cognitive findings here are telling. Memory and concentration didn’t show meaningful gains until four to six months in. It happened slower than energy and mood, which responded earlier. That delay is biologically coherent: testosterone’s effects on hippocampal neurogenesis and synaptic plasticity operate on longer timescales than the receptor-mediated pathways driving faster energy improvements.

Women who started TRT expecting across-the-board quick results and didn’t notice sharpness improvements immediately may simply need more time. Like a lot of things, patience is a virtue.

This isn’t only an athletic story, either. A woman working a demanding job, raising multiple kids, and running on fumes doesn’t need a 10K PR to care about her energy levels. The nearly 90% quality-of-life improvement reflects something broader and more universal than sport performance.

The Real Takeaway

TRT for men went from underground to mainstream over the last few years, driven by telehealth access, growing awareness of low testosterone as a legitimate health concern, and a wellness culture that treats hormonal optimization as proactive rather than reactive.

Women’s TRT is on a similar trajectory, just a few years behind. But with research like this, you’ll see it accelerate with a legitimate clinical uptick.

The 2019 Lancet meta-analysis of 36 RCTs in 8,480 women confirmed benefits in sexual function and triglyceride reduction. The Global Consensus Position Statement that same year endorsed testosterone for postmenopausal women with hypoactive sexual desire disorder.

What this new study adds is a broader symptom picture across eight domains and duration data suggesting benefit continues building past the 12-to-24-week windows most RCTs have used.

The science on women’s TRT is younger and thinner than the men’s literature. But it’s building and this study moves the line forward.

TRT and Athletes

For competitive athletes: governing bodies like World Athletics and USADA require a Therapeutic Use Exemption for any hormone therapy.

Dr. Reynolds was clear on this. “Our study examined everyday women presenting with symptoms of hormonal decline, not competitive athletes. Extending these findings to elite sport would be inappropriate.” He acknowledged the broader regulatory tension around women’s endocrine physiology but was direct: “I would be cautious about framing any self-directed hormone use as managing a deficit absent proper diagnostic workup and clinical oversight.”

Bloodwork first. Clinical oversight always. TUE process if you compete.

Should You Look Into TRT?

Low-dose TRT in women appears to do a lot more than boost libido. Energy, mood, cognitive function, and metabolic markers all moved in the right direction across a wide age range.

The methodology has real limits and a larger, independently funded, randomized trial would be far more definitive. But the authors don’t oversell it and that restraint makes the findings more credible.

TRT is no longer a men’s-only conversation. The science on the women’s side is younger, but it’s building. This study moves the line.

If you’re a woman in your late 30s or beyond dealing with persistent fatigue, mood disruption, or brain fog that doesn’t track with your lifestyle — yes, it’s worth a conversation with your physician about your hormone panel. Do bloodwork first, not self-diagnosis off a study or Google like us stupid men do.

If you compete in a sanctioned sport, do research or reach out to the organizers before starting anything. But if you’re competing and landing 50th in your Age Group, we say, do what makes you happiest.