Three days ago, Biohack reported that testosterone prescriptions for women rose nearly 60% while large trials on wider menopause benefits are still missing. Now one of those hoped-for benefits has been put to a test. A new review of the research found that testosterone did not clearly improve memory or thinking in women around and after menopause1.
The review was published in the journal Reproduction and Fertility and was reported by the health news site News-Medical, according to UA.NEWS1. Biohack did not have the full paper, so this article relies on that coverage.
What the review looked at
The researchers did a systematic review, which means they searched for every available study on a question and assessed them together. They found five studies of women aged 41 to 65 that asked whether testosterone affects thinking and memory during and after menopause1.
The studies measured three kinds of mental skills1:
- Executive function: planning, focusing and switching between tasks.
- Verbal learning and memory: learning and recalling words.
- Visuospatial learning and memory: learning and recalling shapes, images and locations.
Women in the studies received either testosterone or a placebo (a dummy treatment), given daily, weekly or monthly depending on the study. Treatment lasted between 4 and 26 weeks1. The data came from Australia, Canada, the United States and Sweden1.
For the meta-analysis, the step where results are combined mathematically, the authors used three randomized controlled trials, where women are assigned by chance to testosterone or placebo. Together these three trials included 244 women1.
What it found
When the three trials were pooled, there was no statistically significant difference in thinking-test scores between the women on testosterone and the women on placebo1. “Statistically significant” means a difference large and consistent enough that it is unlikely to be due to chance. In plain terms, the women given testosterone did not do clearly better on memory and thinking tests than those given a dummy treatment.
The review targets a common complaint. So-called brain fog around menopause can include trouble recalling words and numbers, difficulty concentrating, forgetfulness and misplacing things1. A New Zealand menopause clinic’s guide, citing earlier research, says more than 60% of women report memory complaints during perimenopause, the years of changing hormones before periods stop2. The same guide says testosterone “likely” plays a role in menopause-related brain fog2. That is the kind of idea the new review set out to check against trial data.
What it does not show
The authors were careful about what their result means. They stressed that it does not prove testosterone has no effect on thinking. Instead, it shows the available evidence is not enough for firm conclusions1.
Several limits stand out:
- Few, small studies. The researchers noted that the number of studies and the number of women in them were limited1. With only 244 women in the pooled analysis, a small real effect could be missed.
- Short treatment. The longest study lasted 26 weeks, about six months1. The review cannot say what happens with years of use.
- Mixed designs. The studies gave testosterone on different schedules and measured different skills1, which makes combining them harder.
- Tests versus daily life. The studies measured performance on thinking tests1. The coverage does not say whether women’s own sense of brain fog in daily life was also measured.
The review also does not address safety. Biohack’s earlier article noted that heart and breast cancer safety of testosterone in women remains unclear; this review was about thinking and memory only.
Who is behind it
The coverage available to Biohack does not name the review’s authors, their institutions or who funded the work1. It also does not report any ties to companies that make testosterone products. Readers should treat these as unknowns until the full paper can be checked.
The source describing brain fog as common and linked to falling hormones comes from a menopause clinic that offers hormone therapy, which is worth keeping in mind when weighing its claims2.
How it fits the field
Current guidance already draws a line around testosterone. According to the coverage, the British Menopause Society and the International Menopause Society support using testosterone to treat low sex drive, while its effects on thinking and memory remain insufficiently studied1. The new review does not change that picture. It adds that the small amount of trial data on thinking does not show a clear benefit.
Hormones and the menopausal brain have been tested before, with estrogen rather than testosterone. In the KEEPS-Cog trial, published in 2015, 693 recently postmenopausal women in the US were randomly assigned to estrogen pills plus progesterone, estrogen skin patches plus progesterone, or placebo pills and patches3. Over four years, the researchers found no beneficial effect of treatment on thinking or on symptoms of clinical depression3. Women on the estrogen pills did show improvements in some mood symptoms compared with placebo3.
That trial had its own limits. Most women in it were white, well educated and at low risk of heart disease, and because the hormones eased menopause symptoms, women could often tell whether they were on the real treatment3. Still, it is a larger and longer test than the testosterone trials in the new review, and it pointed the same way for thinking skills.
Interest in testosterone for women has grown fast even so. The earlier Biohack article in this thread described a rise of nearly 60% in prescriptions from 2024 to 2025, mostly to women aged 45 to 65, with claims of wider menopause benefits resting on emerging evidence. The new review speaks directly to one of those wider claims.
What to watch next
The authors said future studies should help better establish whether there is a link between testosterone therapy, memory and changes in thinking during menopause1. Key things to look for:
- Larger trials, with hundreds of women or more, so a small effect would not be missed.
- Longer treatment periods than six months.
- Studies that measure both test scores and women’s own day-to-day experience of brain fog.
- Any update from menopause societies on testosterone beyond low sex drive.
- Publication details of the review itself, including its authors and funding.
For now, the measured result is narrow: in three small, short trials, testosterone did not clearly beat a dummy treatment on memory and thinking tests. What it would do over longer periods, or in larger groups of women, has not been measured.
