Hormones rule our bodies—but the buzz around perimenopause and testosterone therapy is spinning out of control. Let’s cut through the noise. Perimenopause usually kicks in around 46 or 47 years old. But here’s the catch: hormone levels swing wildly during this phase. Estrogen, progesterone, luteinizing hormone, and follicle-stimulating hormone roller-coaster before settling down after menopause.
Because these hormones fluctuate so much, no blood test can pin down perimenopause. That means doctors can’t rely on a single hormone measure to confirm it. This rollercoaster makes hormone replacement therapy, or HRT, a tricky subject. HRT was tested and approved for menopausal women, not for those still in perimenopause.
HRT and Perimenopause: Not the Cure-All
HRT can help with menopausal symptoms. It also prevents osteoporosis and helps maintain muscle strength. But in perimenopausal women, HRT can cause abnormal bleeding. This risk complicates its use during that phase. Meanwhile, supplements marketed for menopause symptoms don’t have solid proof they work. Their effectiveness is limited or nonexistent.
The symptoms people blame on hormone changes—like fatigue, brain fog, aches, pains, and digestive trouble—don’t line up neatly with hormone shifts. These symptoms don’t track closely with menopause’s hormone changes. So, blaming hormones for all these woes misses the mark.
The Testosterone Craze: Sales Soar Despite Questions
Testosterone therapy has exploded in popularity, but the story isn’t simple. Testosterone was first approved in the 1950s to treat hypogonadism. That’s when men don’t produce enough testosterone naturally. Testosterone levels drop naturally with age. This can affect sexual function, mood, and bone density.
In the early 2010s, drugmakers spent millions advertising testosterone products on TV. They promised relief from “low T” symptoms. By 2013, testosterone drugs raked in over $2 billion annually, even though the FDA hadn’t approved them for most claims made in ads.
In 2015, the FDA pushed drugmakers to clarify that testosterone drugs weren’t approved for routine aging problems. They slapped on a boxed warning about possible heart risks. But last year, in 2025, the FDA removed that safety warning. That change came after a 2023 study tracked 5,000 men with heart disease history. Half used testosterone gel, half a placebo. After two years, heart attack and stroke rates were the same in both groups.
Still, testosterone therapy mostly helps sexual symptoms in men. NIH studies on nearly 800 older men showed improvements in erectile dysfunction and libido. But fatigue, memory, and overall well-being barely improved. Plus, men wanting kids should avoid testosterone. It blocks the body’s own hormone production and harms fertility.
Guidelines urge caution for men with prostate cancer or at risk for it. The FDA proposed new language advising men with spreading prostate cancer to avoid testosterone. Online testosterone supplements are not FDA-approved and likely ineffective. In 2022, only 1 in 7 online prescribing companies asked basic screening questions, like intentions about fatherhood.
Military and Women’s Health: Screening Controversies and Tech Gaps
The Pentagon announced a new policy to screen active-duty service members aged 30 and older for low testosterone. Defense Secretary Pete Hegseth revealed this on Tuesday. Experts criticize this move. Standard medical practice only screens men showing clear symptoms of hypogonadism. Critics say this policy lacks scientific backing.
Women have testosterone levels about 10 times lower than men. Yet women in the military perform equally well despite those lower levels. “That should tell you everything you need to know about testosterone levels and performance,” noted a military health expert. Testosterone therapy is not FDA-approved for women. It can cause severe health risks like blood clots, strokes, and heart attacks.
Testosterone levels vary hour to hour, day to day, week to week, and season to season depending on stress and exertion. This variability makes screening tricky. It also challenges claims linking testosterone to broad symptoms like fatigue or brain fog.
Meanwhile, women’s health technology remains surprisingly underserved in places like Hong Kong. Only 39 percent of women there receive regular cervical cancer screenings. Femtech experts highlight this gap as a critical area for innovation and attention.
What’s Next in Hormone Health?
The hype around hormone treatments is booming. But the science tells a different story. Perimenopause symptoms and hormone levels are complex and don’t fit neat tests or treatments. Testosterone therapy works for some men but is overprescribed and poorly regulated online. It’s risky for women and not proven for broad symptoms.
Military screening policies need solid science backing before expanding. Women’s health tech demands innovation and better access worldwide. Understanding hormone health requires nuance, not hype. The future calls for smarter, safer approaches that respect complexity. Watch this space—it’s just getting started.
Based on
- There’s a lot of hype around perimenopause. Don’t buy it. — technologyreview.com
- Trump officials want to make testosterone drugs easier to prescribe. Is that a good idea? | PBS News — pbs.org
- Trump officials want to make testosterone drugs easier to prescribe. Is that a good idea? | The Independent — independent.co.uk
- The Pentagon’s plans to screen military members for testosterone lacks scientific backing, medical experts warn | The Independent — independent.co.uk
- How are Hong Kong start-ups closing the ‘glaring gap’ in women’s health technology? | South China Morning Post — scmp.com
