Losing Muscle After 40? Sermorelin vs Testosterone for Women

You want back the muscle you have lost since your 40s, and no trial has compared sermorelin and testosterone head to head in women. Sermorelin is a compounded peptide that prompts your own pituitary to release growth hormone. In a 16-week trial of 10 women and 9 men aged 55 to 71, a sermorelin-type peptide thickened women's skin but raised lean mass only in the men. Testosterone has no product made for women at female doses in the US, according to the Endocrine Society guideline. It raised lean mass by 1.8 kg only at the highest injected dose in a 24-week trial of 71 women, and the 2019 Global Consensus found no significant muscle gain at normal female doses.

Is sermorelin or testosterone better for building muscle in women?

Neither drug has shown a muscle gain in women at a dose the guidelines support, and no trial has compared them. Choose by what else you want. Testosterone fits if low desire after menopause is part of it. Sermorelin fits if you want to raise your own growth hormone without taking a sex hormone.

What women share

We read 52 low-libido threads in r/Menopause, r/Perimenopause and r/TwoXChromosomes from October 2025 to October 2026. 18 of 52 mentioned testosterone. These were threads about desire, not muscle.

Why is it harder to regain muscle after 40?

Your growth hormone system winds down with age. The researchers behind the sermorelin-type peptide trial say that weakening may be behind the changes in body composition and metabolism that come with getting older.

Testosterone falls with age too, and the authors of the 24-week testosterone trial note that this drop in older women has been linked to frailty. They also point to the SWAN study of midlife women, which found more physical limitation after surgical menopause than after natural menopause.

Growth hormone shots themselves caused side effects that limited their use in older adults, which is why researchers tested the releasing-hormone route that sermorelin uses.

Sermorelin aims at the first drop and testosterone at the second, so the choice depends on which hormone story fits you. See all our options for body goals.

What does the research show for each?

Sermorelin-type peptide. In a single-blind trial of 10 women and 9 men aged 55 to 71, everyone self-injected saline nightly for 4 weeks, then the peptide nightly for 16 weeks. In women, overnight growth hormone rose and IGF-1 went up within 2 weeks. IGF-1 stayed up for 12 weeks, then drifted back toward baseline by week 16.

In that trial, skin got thicker in both women and men. Lean mass, well-being and libido improved in the men only, and sleep did not change in either group. For more on how sermorelin relates to body changes, read our guide to sermorelin for muscle and fat loss.

Testosterone injections. A placebo-controlled trial enrolled 71 menopausal women with low testosterone who had had a hysterectomy (some also had their ovaries removed). All were on estrogen through the skin, and they took one of four weekly testosterone doses or placebo for 24 weeks. Only the highest dose beat placebo: 1.8 kg more lean mass, 27 watts more chest-press power and 57 watts more loaded stair-climb power. Fat mass did not change, and walking speed and unloaded stair climbing did not improve.

The 2019 Global Consensus does not recommend injections. It groups them with pellets as products that push testosterone above the normal premenopausal range. In the trial's highest-dose group, average blood testosterone was 210 ng/dl, against 19 ng/dl on placebo.

The Endocrine Society guideline says testosterone raises lean mass and may lower fat in women, but less than in men. It recommends against general testosterone use for metabolic health, bone health or general well-being.

What are the side effects of each?

Ask your clinical team what to watch for.

How much does each cost?

Sermorelin runs $125 to $175 a month at Elara, depending on plan length. Women's testosterone cream starts at $60 a month plus a membership at Hone. Every price below was checked October 2026 on the seller's own page.

Prices checked October 2026

For more sellers, see our guides to sermorelin providers and testosterone options for women.

Hot or Nothing is one more option. Our clinical team can prescribe sermorelin if it fits your goal.

You want back the muscle you have lost. Take the quiz to start your plan, so your clinical team can see whether sermorelin fits that goal and your health history.