Women have been posing as men online to buy testosterone because they cannot access prescriptions on the NHS, a doctor has warned.

Speaking to the BBC, Dr Michelle Olver, a consultant in sexual and reproductive health working in Wales said there had been a “very sharp increase” in testosterone referrals to the NHS for post-menopausal women but that access was variable.

In her clinic, she reported seeing women with up to 12 times the safe level of the hormone because they had bought it online.

Patients were accessing testosterone from online pharmacies because it had not been available to them on the NHS but needed proper counselling and monitoring, she said.

NICE guidance on menopause recommends considering testosterone supplementation for people with low sexual desire associated with menopause if HRT alone is not effective.

But there has been growing demand from women after high profile discussions of its use with some claiming it helps with energy levels and cognition not just libido.

A study is being done in Wales to determine if adding testosterone to standard HRT can reduce menopausal symptoms beyond its effect on sexual function.

Some GPs are reluctant to prescribe off licence medications or rely on colleagues who specialise in women’s health to deal with testosterone requests, clinicians told the BBC. High doses can lead to side effects that can be permanent.

Androfeme, a low-dose testosterone cream developed specifically for post-menopausal women was approved by the Medicines and Healthcare Regulatory Agency in 2025.

But availability on the NHS will depend on NICE approval – a process that has been agreed but for which there’s no date set.

In response to the concerns raised about women accessing high doses through online prescribers the Welsh government said: ‘All health boards are expected to adhere to the NICE guidelines on identification and management of menopause including providing individualised care when prescribing HRT.

‘We are aware this may include some practitioners prescribing testosterone for some women.

‘We expect all health boards to conform to any recommendation made by NICE in relation to prescribing testosterone when its guidance is published.’

A spokesperson for the British Menopause Society said testosterone can be beneficial for some women experiencing persistent low sexual desire associated with menopause, where other contributing factors have been considered and addressed.

‘Current guidance recommends that testosterone is considered alongside HRT for this indication, with appropriate assessment, prescribing and monitoring by a healthcare professional.’

They added there was ongoing interest in whether testosterone may have benefits for other symptoms sometimes experienced during menopause, such as fatigue, brain fog or low mood but ‘evidence currently available does not provide sufficient support for the routine use of testosterone’ for these.

Last year the Government announced that millions of women will be asked about the menopause as part of NHS Health Checks at GP practices

The specific questions that will be included in the NHS Health Checks – offered to eligible adults aged 40-74 every five years – are being developed with experts.

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Women posing as men to access testosterone treatment for menopause online