@tamsenfadal's menopause testosterone claims, fact-checked

What did @tamsenfadal actually say?

Fadal describes starting testosterone with initial hesitation, joking she worried about "growing hair on my chest." She then says she noticed a meaningful difference and, most specifically, that she "found my libido again" after it had been "MIA for a little while." That is essentially the entire medical claim here: testosterone restored her sex drive during what appears to be a menopause-related hormone shift.

To be clear, she is not presenting herself as a clinician. This is personal testimony shared in a conversational format. But with 1.3 million views, personal testimony functions like a health recommendation, whether she intends it to or not. So it deserves a serious look at whether the underlying biology actually supports what she experienced.

Does the science back this up?

Yes, more than most people realize. Low libido, formally called hypoactive sexual desire disorder (HSDD), is one of the best-supported indications for testosterone therapy in postmenopausal women. This is not fringe medicine.

A 2019 global consensus statement published in Climacteric (Testosterone for Women: The Clinical Practice Guideline of The Endocrine Society, Islam et al.) concluded that testosterone improves sexual function in postmenopausal women, with the strongest evidence coming from randomized controlled trials using physiologic doses. A Cochrane review (Achilli et al., 2017, Climacteric) analyzed 36 trials and found testosterone significantly improved sexual desire, arousal, and satisfaction compared to placebo or estrogen alone. The evidence for libido specifically is genuinely solid. Fadal's reported experience is consistent with what the clinical literature shows.

What did they get wrong (or right)?

Fadal got the core experience right. Testosterone decline during perimenopause and menopause is real, and its effect on libido is documented. Ovarian testosterone production drops significantly during the menopausal transition, and this correlates with reduced sexual desire in many women (Davis et al., 2019, Nature Reviews Endocrinology).

Where this video falls short is not inaccuracy but incompleteness. The "hair on my chest" joke reflects a common fear, and while she dismisses it personally, the video does not tell viewers that androgenic side effects, including unwanted hair growth, acne, and voice changes, are real and dose-dependent. They are manageable with proper monitoring, but they are not nothing. A viewer walking away from this might think testosterone is a consequence-free libido fix. It is not.

She also does not mention that testosterone is not FDA-approved for use in women in the United States, meaning any prescription is off-label. That is a material fact for anyone considering this therapy.

What should you actually know?

If you are a woman in perimenopause or menopause experiencing low libido, testosterone therapy is a legitimate clinical option with real evidence behind it. But the path to it matters.

• Baseline and follow-up blood testing is necessary. You need to know where your levels actually are before starting, and monitor them after.
• Off-label does not mean unsafe. It means the FDA approval process, which is expensive and typically drug-company driven, has not been completed for this population. The evidence base still exists.
• Androgenic side effects are real but typically occur at supraphysiologic doses. Staying within physiologic female ranges is what responsible prescribing looks like.
• Testosterone is usually considered alongside, not instead of, a broader hormone evaluation that may include estrogen and progesterone. Libido is rarely driven by a single hormone in isolation.
• This conversation should happen with a clinician who actually specializes in menopause medicine, not a general practitioner who may be unfamiliar with the evidence base for women's testosterone therapy.

Fadal's experience is plausible and well-supported by the literature. But a 30-second personal testimonial is not a treatment plan.