Study: 87% Drop in Visceral Fat With Testosterone and Exercise

By VirentaNews Staff — May 11, 2026

Why do older women rapidly accumulate dangerous belly fat after a hip fracture—and can it be stopped? As people age, fat doesn’t just increase—it shifts deep into the abdomen, embedding around vital organs as visceral fat, a known driver of heart disease, diabetes, and metabolic syndrome. This redistribution is especially pronounced in women after major health events like fractures. Now, researchers are asking whether this harmful process can be interrupted. A groundbreaking study focusing on elderly women recovering from hip surgery suggests a surprising answer: a simple testosterone gel, combined with standard rehabilitation, may block the surge of internal fat that typically follows such injuries.

How Does Aging Redistribute Fat in Women?

The answer lies in shifting hormones and declining physical activity. As women age, especially after menopause, levels of sex hormones like estrogen and testosterone drop significantly. While estrogen loss is widely known, the decline in testosterone—a hormone present in both sexes but critical for muscle maintenance and metabolism in women—has been underappreciated. Researchers at the University of California, San Francisco, and the University of Copenhagen discovered that this hormonal shift, combined with enforced immobility after hip fractures, creates a perfect storm for visceral fat accumulation. In a controlled trial, postmenopausal women who received a placebo during recovery gained an average of 12% more visceral fat over 6 months. But those who used a daily testosterone gel while undergoing physical therapy saw no such increase—and in some cases, a reduction.

What Evidence Supports Testosterone’s Role in Fat Control?

The study, published in The Lancet Healthy Longevity, followed 70 women over 65 who had undergone surgery for hip fractures. Half received a 1% testosterone gel applied daily; the other half used a placebo. All participants engaged in standard post-surgical rehabilitation. After 24 weeks, MRI scans revealed that the control group gained 11.8% more visceral adipose tissue, while the testosterone group showed a 2.1% decrease—a relative reduction of over 87%. Muscle mass also improved significantly in the treatment group, suggesting testosterone helped preserve lean tissue during recovery. “This is the first clinical evidence that replacing a single hormone can counteract one of the most harmful metabolic consequences of aging and immobility,” said Dr. Emily Syres, lead endocrinologist on the trial.

Are There Risks or Skeptics of Hormone Therapy in Older Women?

Despite the promising results, some experts urge caution. Hormone therapies in older populations have a complex history, particularly after the Women’s Health Initiative raised alarms about estrogen and cardiovascular risk. While testosterone is not associated with the same clotting concerns, questions remain about long-term safety, especially regarding liver function, mood changes, and potential androgenic effects like acne or hair growth. Dr. Linda Ng, a geriatrician at Johns Hopkins who was not involved in the study, noted, “We need larger trials with diverse populations before this becomes standard care. Also, we don’t yet know if the fat reduction translates into fewer heart attacks or diabetes cases down the line.” Additionally, the study excluded women with certain cancers or cardiovascular conditions, limiting generalizability. Critics also point out that the benefits may stem more from improved mobility due to increased muscle strength rather than direct fat metabolism changes.

What Are the Real-World Implications for Aging and Recovery?

For millions of older adults—especially women—hip fractures are a turning point. Nearly 300,000 U.S. adults over 65 are hospitalized annually for hip injuries, and many never regain full independence. The aftermath often includes rapid muscle loss, weight gain, and increased frailty. If confirmed in larger studies, testosterone gel could become a routine part of rehabilitation, helping patients maintain metabolic health during a critical window. Nursing homes and rehab centers might one day include hormone assessment in recovery protocols. Beyond fractures, the findings may apply to other periods of enforced bed rest, such as post-stroke recovery or intensive care stays. Preventing visceral fat buildup could extend healthspan, reduce chronic disease burden, and lower healthcare costs over time.

What This Means For You

If you or a loved one is facing recovery from a major injury or surgery, hormonal health may be more relevant than previously thought. While testosterone therapy isn’t yet standard for women, this study highlights the importance of preserving muscle and metabolic balance during rehabilitation. Discussing hormone levels with a doctor, especially after significant physical stress, could become a routine part of care. Simple interventions, supported by strong evidence, may one day prevent the slow decline that too often follows acute illness in older age.

Still, key questions remain: Could earlier intervention—before a fracture—prevent muscle loss and fat gain in at-risk seniors? And might similar benefits be seen in men, who also experience declining testosterone with age? Future research will need to explore dosage, delivery methods, and long-term outcomes to determine whether this approach can be scaled safely across diverse populations.

Source: ScienceDaily