Does balanced testosterone actually make women feel calm and focused?

What did @hrtandme5 actually say?

Here is the honest answer: the video transcript contains no spoken health claims. The audio is song lyrics, specifically lines like "you're a tears of a poison" and "I'm a dead child to you." The only actual claim in this content is the caption: "Balanced testosterone feels calm, focused, and confident, not chaotic."

That caption is doing real work. It implies that testosterone optimization in women produces specific psychological and emotional effects, namely calm, focus, and confidence, and that low or imbalanced testosterone produces the opposite. That is a meaningful clinical claim, even if it arrived via a 15-word caption on a music video. We are going to treat it seriously because a lot of women in perimenopause are making real medical decisions based on exactly this kind of content.

Does the science back this up?

Partially, and with important caveats. The research on testosterone and mood in women is real but messier than a TikTok caption can capture.

A 2019 systematic review by Davis et al. in The Lancet Diabetes and Endocrinology found that testosterone therapy in postmenopausal women improved sexual well-being, but evidence for mood, energy, and cognitive outcomes was far less consistent. A 2021 randomized controlled trial by Islam et al. in JAMA Internal Medicine found that testosterone gel improved sexual function scores but did not show statistically significant improvements in mood or general well-being compared to placebo at 6 months.

Animal models and some observational data do suggest androgenic activity influences dopaminergic tone and can affect motivation and emotional regulation. But translating that into "balanced testosterone feels calm and confident" is a larger leap than the current evidence supports cleanly.

What did they get wrong (or right)?

They got the directional intuition partially right and the framing mostly wrong.

There is a real clinical observation, not just anecdote, that women with symptomatic androgen insufficiency sometimes report fatigue, low motivation, and emotional flatness. Restoring testosterone to physiological ranges can, for some women, improve those symptoms. That part is defensible. The problem is the caption presents this as a predictable, universal outcome. "Balanced testosterone feels calm, focused, and confident" sounds like a guaranteed result, not a possible one for a subset of patients.

That framing is misleading for a few reasons. First, there is no established reference range for "optimal" testosterone in women the way there is for men. Second, supraphysiological doses, which some pellet and compounding protocols deliver, can cause anxiety, acne, hair loss, and irritability. The caption implies more is better or that balance is easy to achieve. Neither is straightforward.

• No established female testosterone "optimal" range exists in major endocrine guidelines
• Excess testosterone in women can cause mood instability, not resolve it
• Individual response varies considerably based on androgen receptor sensitivity

What should you actually know?

If you are a perimenopausal woman wondering about testosterone, here is what the evidence actually supports as of 2024.

Testosterone therapy has the strongest evidence base for hypoactive sexual desire disorder in postmenopausal women. The global consensus position statement by Goldstat et al. and updated by the International Menopause Society acknowledges benefit there, while explicitly noting insufficient evidence for cognitive or mood outcomes as primary indications. That does not mean mood benefits never happen. It means we cannot reliably predict them or dose to achieve them.

Delivery method also matters enormously. Pellets, which are popular in the wellness-adjacent HRT space, are not FDA-approved for women and can produce testosterone levels two to three times the upper limit of the female physiological range. Compounded testosterone products vary in absorption and consistency. These are not minor footnotes.

If a provider is promising you that testosterone will make you feel "calm, focused, and confident," ask them to show you the trial data supporting that specific outcome. A good clinician will tell you it is possible, not guaranteed.