Could Testosterone Help Women Build Stronger Bones After Menopause? A New Study Offers an Unexpected Clue

When most people hear the word testosterone, they think of men.

Muscle development. Physical strength. Male reproductive hormones.

But testosterone is not exclusively a male hormone.

Women's bodies produce it naturally, too.

And scientists are increasingly interested in whether this often-overlooked hormone might play a more important role in women's health than previously understood.

One area attracting particular attention is bone strength after menopause.

For decades, estrogen has been central to discussions about protecting women's bones as they age. When estrogen levels fall during menopause, bone loss can accelerate, increasing the risk of osteoporosis and fractures.

Estrogen-based hormone therapy can help reduce that risk.

But a small study presented at The Menopause Society's 2026 Annual Meeting suggests that combining estrogen with testosterone might produce additional improvements in bone density, particularly in the lower spine.

Researchers at the Keck School of Medicine of the University of Southern California examined data from 51 postmenopausal women who had received both hormone regimens at different stages.

Their findings were intriguing.

During treatment with estrogen alone, participants did not experience statistically significant increases in bone-density scores at the locations examined.

After testosterone was added, however, the researchers observed a statistically significant improvement in lumbar-spine bone-density scores.

Measurements at the hip and femoral neck remained broadly stable.

The findings suggest that testosterone could interact with estrogen to influence the inner structure of vertebral bone.

But there is an essential distinction.

This study does not establish that estrogen is ineffective for bone health, nor does it prove that adding testosterone prevents osteoporosis or fractures.

The research was small, retrospective, and lacked a separate randomized comparison group.

And testosterone is not currently an established treatment for preventing postmenopausal bone loss.

Still, the findings open an interesting question about how women's hormones interact with the skeleton—and whether future treatments could take better advantage of that relationship.

Why Women Lose Bone Faster After Menopause

Bones may appear solid and unchanging, but they are living tissues undergoing continuous renewal.

Throughout life, specialized cells remove older bone while other cells form new bone.

This process is called bone remodeling.

Two types of cells are especially important:

• Osteoclasts break down and remove existing bone tissue.
• Osteoblasts produce new bone material.

When these processes are balanced, the skeleton maintains its structure.

But when bone breakdown outpaces formation, bone mass declines.

The Role of Estrogen

Estrogen helps regulate bone remodeling and limits excessive bone breakdown.

During menopause, ovarian estrogen production falls substantially.

This hormonal change can increase bone resorption, meaning the body removes bone faster than it replaces it.

Over time, the resulting loss of mineral content and structural integrity can weaken bones.

The Menopause Society notes that women may lose approximately 10%–20% of their bone density during the first five to seven years following menopause, although individual experiences vary considerably.

Osteopenia Versus Osteoporosis

Bone loss exists along a spectrum.

Osteopenia means bone mineral density is lower than expected in a healthy young adult but has not crossed the conventional diagnostic threshold for osteoporosis.

Osteoporosis involves more substantial skeletal fragility and an increased risk of fractures.

These conditions are often identified through bone-density testing.

One particularly concerning feature is that osteoporosis frequently develops without obvious symptoms.

A person may not realize their bones have weakened until a fracture occurs.

That is why identifying risk and preserving bone strength are important parts of postmenopausal healthcare.

What the USC Researchers Actually Did

The investigation was led by Sona Davis and colleagues at USC.

It was not a new randomized clinical trial in which researchers assigned women to estrogen or estrogen-plus-testosterone treatment.

Instead, the team analyzed existing clinical data from women who had received hormone therapy and undergone bone-density scans.

The women had measurements obtained at baseline and during subsequent treatment periods.

Researchers compared findings during estrogen-only treatment with those recorded during combined estrogen-and-testosterone therapy.

Measuring Bone Density With DEXA

Bone mineral density was evaluated using dual-energy X-ray absorptiometry, commonly called DEXA or DXA.

The technique uses low-dose X-rays to estimate bone mineral density in areas such as the spine and hip.

Researchers focused on three skeletal locations:

1. The lumbar spine, representing the lower back.
2. The femoral neck, the narrow region near the top of the thigh bone.
3. The total hip.

These locations matter because they are clinically relevant to osteoporosis-related fractures.

The analysis also considered T-scores, which compare a person's bone-density measurement with a young-adult reference population.

What Researchers Found Before Testosterone Was Added

During estrogen-only therapy, the study did not detect statistically significant improvements in T-scores at the spine, femoral neck, or total hip.

That result may sound disappointing.

But there is an important qualification.

Maintaining bone density can itself be a meaningful treatment outcome after menopause.

If untreated bone loss would otherwise have occurred, a stable measurement may reflect a beneficial effect.

Because this study did not include an untreated randomized comparison group, it cannot establish what would have happened to the same women without estrogen.

The lack of a significant increase therefore does not establish that estrogen failed to protect their bones.

What Changed With Combined Hormone Therapy?

After participants received estrogen together with testosterone, the researchers observed a statistically significant increase in lumbar-spine T-scores.

The conference findings reported a difference of approximately 0.52 T-score units compared with estrogen therapy alone and approximately 0.45 units relative to baseline.

The femoral neck and total hip measurements remained comparatively stable.

These findings were interpreted as preliminary evidence that testosterone might enhance the skeletal effects of estrogen at the spine.

But the study did not establish that the combination reduced fracture rates or improved every aspect of bone strength.

Estrogen Alone vs. Estrogen Plus Testosterone

Results summarize the small USC observational study and established clinical guidance. The comparison cannot establish that testosterone caused the observed difference. The Menopause Society+1

The Special Vulnerability of Trabecular Bone

The lumbar vertebrae contain substantial amounts of trabecular, or spongy, bone.

This internal structure provides strength while allowing the skeleton to remain relatively lightweight.

Trabecular bone also has a large surface area involved in remodeling.

As a result, it can respond differently to hormonal changes than regions containing higher proportions of cortical bone.

The USC researchers proposed that testosterone might work alongside estrogen to influence this metabolically active internal bone network.

However, the study measured bone density rather than directly observing new trabecular bone formation.

It therefore cannot confirm precisely how testosterone produced the observed association.

Does Testosterone Build New Bone?

That remains an open question.

Testosterone and its metabolites can interact with biological pathways involved in bone maintenance.

Some testosterone is converted into estrogen through an enzyme called aromatase.

And androgen receptors are present in several tissues involved in skeletal physiology.

These mechanisms provide plausible explanations for potential effects on bone.

But identifying a biologically plausible mechanism does not establish that a particular hormone regimen will produce clinically meaningful benefits.

Researchers still need controlled trials to determine whether testosterone genuinely adds benefits beyond estrogen, and whether those benefits outweigh potential risks.

Women Produce Testosterone Naturally, Too

Testosterone is commonly described as the male sex hormone, but the biology is more complicated.

Women produce testosterone through the ovaries and adrenal glands, as well as through the conversion of other hormonal precursors in peripheral tissues.

Although circulating concentrations are generally much lower than in men, testosterone participates in normal female physiology.

It can influence sexual function and interacts with several metabolic pathways.

However, its role should not be oversimplified.

Low testosterone is not a universal explanation for fatigue, decreased muscle mass, low mood, or bone loss in postmenopausal women.

And measuring a testosterone level alone does not necessarily identify who would benefit from treatment.

Why Hormone Balance Matters More Than a Single Number

Hormones interact through complicated feedback systems.

Estrogen, testosterone, progesterone, thyroid hormones, parathyroid hormone, and vitamin D-related pathways can all influence physiological functions.

Bone health also depends on nutrition, genetics, physical activity, medications, and age.

For this reason, treating an isolated laboratory number without considering symptoms and medical history may not be appropriate.

The USC findings are best understood as a reason to investigate hormonal interactions—not as evidence that all women need higher testosterone levels after menopause.

What Makes This Study Promising—and Why It Still Isn't Proof

The findings deserve attention because they raise a clinically relevant possibility.

If future research confirms that adding carefully regulated testosterone can improve skeletal outcomes, clinicians might eventually have another option for selected patients.

But several limitations prevent the 2026 study from establishing that conclusion.

Only 51 Women Were Included

A sample of 51 participants is relatively small for evaluating the benefits and risks of hormone therapy.

Small studies can identify interesting signals, but their estimates may be unstable.

A statistically significant finding does not automatically mean the effect will be equally strong in a larger population.

There Was No Randomized Control Group

Participants were not randomly assigned to different treatment strategies.

Without randomization, differences in patient characteristics, treatment decisions, or other factors could influence results.

This makes it difficult to isolate the effect of testosterone itself.

The Treatment Periods Occurred at Different Times

The women received estrogen alone before transitioning to combined therapy.

That sequence creates potential complications.

Age, duration since menopause, changes in health, and other treatments may influence bone measurements over time.

The study cannot fully separate these effects from the change in hormone regimen.

Bone Density Is Not the Same as Fracture Prevention

A higher bone-density measurement is potentially encouraging.

But the most important clinical outcomes include preventing fractures and preserving mobility and independence.

This study did not demonstrate that testosterone reduced fractures.

Larger and longer studies would be needed to establish whether the observed changes translate into better real-world outcomes.

Long-Term Safety Remains Uncertain

The benefits of a proposed therapy must be considered alongside its risks.

Because testosterone treatment is not routinely recommended for postmenopausal bone health, questions remain about long-term adverse effects, appropriate dosing, and which individuals—if any—might benefit.

The Menopause Society itself emphasized the need for more research rather than recommending immediate changes to clinical practice.

What Current Medical Guidelines Say About Testosterone for Women

This is where the new findings need to be placed in context.

A major international consensus statement, endorsed by several professional medical organizations, concluded that the strongest evidence-based indication for systemic testosterone therapy in women is the treatment of hypoactive sexual desire disorder in selected postmenopausal women after appropriate clinical assessment.

The statement did not support prescribing testosterone to improve bone density.

It specifically noted that existing studies had not demonstrated a clear bone-density benefit at the spine, hip, or femoral neck after 12 months of treatment.

It also emphasized the lack of adequate long-term safety evidence.

The 2026 USC findings may challenge researchers to revisit some of those conclusions.

But a single small observational analysis does not supersede evidence-based clinical guidelines.

Could Testosterone Cause Side Effects?

Potential adverse effects depend on the formulation, dose, duration, and resulting hormone concentrations.

Reported concerns include acne, increased facial or body hair, and changes in androgen-related symptoms.

Higher-than-physiological testosterone exposure may raise additional risks.

Long-term cardiovascular and breast-health outcomes remain areas of uncertainty.

In fact, a separate study highlighted by The Menopause Society during the same 2026 meeting reported an association between testosterone use and higher cardiovascular disease risk among postmenopausal women.

That finding was also observational and does not by itself prove causation.

But it underscores why emerging evidence of potential skeletal benefit must be evaluated alongside potential harms.

Women should not begin testosterone therapy or increase hormone doses on their own to improve bone density.

How Women Can Protect Their Bones After Menopause Today

While testosterone remains experimental for this purpose, several established approaches can help protect bone health.

These are especially important because osteoporosis can progress silently.

Weight-Bearing and Resistance Exercise

Activities that place appropriate loads on the skeleton can help maintain bone and muscle strength.

Walking, stair climbing, and supervised resistance training are common examples.

The appropriate exercise program depends on overall health, fracture risk, and mobility.

Someone with established osteoporosis or previous vertebral fractures may require individualized exercise guidance.

Adequate Calcium and Vitamin D

Calcium is essential for bone mineralization.

Vitamin D supports calcium absorption and other processes relevant to skeletal health.

The amount required depends on age, diet, health conditions, and sometimes laboratory findings.

More is not automatically better.

High-dose supplements should be used only when medically appropriate, because excess intake can also cause harm.

Bone-Density Screening

DEXA scans can identify low bone density and help assess fracture risk.

Screening is generally recommended for women aged 65 or older, with earlier assessment for younger postmenopausal women who have relevant risk factors.

Individual recommendations vary by country and clinical circumstances.

Proven Osteoporosis Treatments

For women at sufficiently high fracture risk, medications such as bisphosphonates and other osteoporosis treatments have evidence supporting fracture-risk reduction.

Menopausal hormone therapy can also help prevent bone loss and reduce fractures in appropriately selected patients.

Treatment decisions depend on age, time since menopause, symptoms, medical history, and overall benefits and risks.

The availability of established options is particularly important when discussing experimental approaches such as testosterone.

Frequently Asked Questions

Does estrogen really fail to strengthen bones after menopause?

No. Estrogen has established benefits for reducing menopausal bone loss and fracture risk in appropriately selected women. The 2026 study simply found no statistically significant increase in bone-density scores during its estrogen-only observation period. Stability may itself be beneficial.

Can testosterone increase bone density in women?

A small 2026 observational study reported improved lumbar-spine T-scores when testosterone was added to estrogen. However, this does not establish causation or demonstrate that testosterone prevents fractures. Larger randomized trials are needed.

Why did testosterone appear to help the spine more than the hip?

The researchers suggested that combined hormone therapy might have particular effects on trabecular bone, which is abundant in the vertebrae. The mechanism remains hypothetical and was not directly confirmed by the study.

Is testosterone approved to treat osteoporosis in women?

No. Testosterone is not an established or approved treatment specifically for postmenopausal osteoporosis. Clinical guidelines do not currently recommend routine testosterone treatment to improve bone density.

Is estrogen and testosterone combination therapy safe?

The long-term safety of testosterone therapy in women remains incompletely understood. Possible effects depend on dose and formulation, and potential cardiovascular and other risks require careful evaluation. Treatment should be considered only with qualified medical supervision for an appropriate indication.

What is the most effective way to prevent postmenopausal bone loss?

The best strategy depends on individual fracture risk. Established measures include resistance and weight-bearing exercise, adequate calcium and vitamin D, appropriate screening, and proven medical treatments when indicated.

A New Chapter in Understanding Women's Bone Health

For decades, the relationship between menopause and bone loss has been explained largely through estrogen.

And for good reason.

The fall in estrogen during menopause is a major contributor to accelerated skeletal deterioration.

Hormone therapy can reduce bone loss and help prevent fractures in selected patients.

But the human hormonal system is more complicated than the effects of one hormone alone.

Women naturally produce testosterone, and researchers are beginning to investigate whether its interaction with estrogen may influence bone strength in ways that are not yet fully understood.

The USC study offers an intriguing early signal.

Among 51 postmenopausal women, the addition of testosterone was associated with improved lumbar-spine bone-density scores after a period of estrogen-only treatment.

That is worth studying.

But it is not enough to change treatment recommendations.

The study was small, retrospective, and lacked randomization.

It did not establish that testosterone caused the improvement.

It did not demonstrate fewer fractures.

And it could not resolve questions about long-term safety.

What it does provide is an opportunity for better research.

Future trials may help scientists understand whether testosterone offers a meaningful additional benefit, which women might respond, and whether any advantage could be achieved safely.

Until then, the most effective approach remains grounded in established bone-health measures and individualized medical care.

The real breakthrough is not proof that women need more testosterone. It is the recognition that bone health after menopause may involve hormonal interactions that scientists have not yet fully explored.

And that is a question worth answering carefully.

Scientific Sources and Further Reading

• The Menopause Society — Combined Estrogen and Testosterone Therapy Increases Lumbar Spine Bone Mineral Density. Official October 20, 2026, press release describing the USC study and its preliminary findings.
• HealthDay — Estrogen and Testosterone Therapy May Aid Bone Mineral Density. October 29, 2026, reporting with additional study data and T-score comparisons.
• Global Consensus Position Statement on Testosterone Therapy for Women. International clinical guidance on evidence-supported indications, musculoskeletal outcomes, and safety limitations.
• The Menopause Society — Testosterone Therapy May Increase Cardiovascular Risk. Separate 2026 research highlighting possible cardiovascular safety concerns.
• NIAMS — Osteoporosis. U.S. National Institutes of Health information on bone loss, risk factors, and prevention.
• USPSTF — Osteoporosis Screening Recommendations. Evidence-based recommendations for bone-density screening and fracture-risk assessment.