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A large retrospective study is raising red flags about testosterone therapy in postmenopausal women, finding an 8-fold higher risk of cardiovascular disease compared to untreated women. The findings, presented at The Menopause Society's 2026 annual meeting, are considered hypothesis-generating — but experts say the signal is too consistent to ignore. This comes as testosterone prescriptions for women have nearly tripled in recent years, despite no FDA-approved female-specific product existing in the US.
A retrospective cohort study using the TriNetX U.S. Collaborative Network has found that postmenopausal women on testosterone therapy face a significantly elevated risk of cardiovascular disease (CVD) compared to untreated counterparts. Presented at The Menopause Society's 2026 annual meeting, the study matched 3,164 women in each group and tracked composite CVD outcomes — including coronary artery disease, cerebrovascular disease, and heart failure — across multiple follow-up windows.
Researchers and outside experts are urging caution but not alarm. The study's observational design, potential for residual confounding, and lack of data on testosterone dose or formulation mean results shouldn't be taken as proof of causation. Still, the consistency of the signal across multiple analyses has prompted calls for prospective validation. A separate survey also found that women on testosterone most often cite improved energy and mood — not sexual desire — as top benefits, highlighting a gap between patient experience and current evidence-based guidelines, which only endorse testosterone for hypoactive sexual desire disorder (HSDD) in postmenopausal women.
By the Numbers:
Why it matters: With testosterone use among menopausal women surging and no FDA-approved female-specific product on the market, this cardiovascular safety signal adds urgency to calls for rigorous prospective trials and careful, individualized prescribing — especially given that heart disease remains the leading cause of death in women.
