"She's 57, on testosterone, and building companies with AI."

There is a number I want to tell you. Not because it’s shocking — though it is — but because once you hear it, you’ll never hear “I guess I’m just less motivated than I used to be” the same way again.

By age 40, women have lost approximately 50% of their testosterone.

Not by menopause. Not by 50. By 40.

Before the hot flashes. Before the missed periods. Before anyone hands you a pamphlet or sends you to an endocrinologist. The hormone that runs ambition, creative fire, goal-directed behavior, and the deep animal desire to build things is already at half capacity — and almost no one will tell you this is happening.

I know. Because nobody told me.

What we call “aging” might be a deficiency.

You know the feeling I’m talking about. Not depression, exactly. Not burnout in the way that word gets used at work. Something subtler and harder to name. The flatness. The sense that you’re operating at 80% of yourself. The project you used to be excited about that now feels like it has a ceiling. The business idea you had in your 30s that you just… didn’t pursue, and when you try to remember why, all you can find is something like “I didn’t have the energy.”

I have watched brilliant women in their 40s and 50s describe this to me as if it’s an obvious truth about aging:

“I’m just less driven than I used to be.” “I don’t start things the way I once did.” “I think I’ve become more of a settler.”

And I want to reach through time and tell them: what if you haven’t changed? What if a measurable, correctable hormone deficiency changed the chemistry of ambition — and medicine decided it wasn’t worth addressing because there’s no FDA-approved product to sell you?

Here’s what the neuroscience shows, briefly: testosterone acts on dopamine systems in the brain. Dopamine is the neurotransmitter of wanting — not of pleasure exactly, but of the motivated pursuit of pleasure. The drive to initiate. The reward signal for doing hard things. What researchers call “goal-directed behavior.” When testosterone declines, the dopamine signal weakens. The technical term for the loss of that motivational drive is anhedonia — the inability to feel the pull toward things you used to care about. It shows up not as sadness, but as flatness. As a quieter, more manageable version of yourself that you mistake for maturity.

It isn’t maturity. In a lot of cases, it’s a deficiency. And here’s something medicine almost never explains: you can be on an antidepressant — I’ve been on one for 30 years — and still have textbook testosterone-deficiency anhedonia. SSRIs and SNRIs address serotonin pathways. Testosterone-deficiency anhedonia runs through dopamine. Those are different systems. An antidepressant that’s working perfectly for depression won’t touch the flat, motivationless quality that comes from low testosterone, because it isn’t designed to.

What came back.

I’m 57. I founded adoption.com in 1995 — built it from scratch, ran orphanages in Ethiopia, Kenya, and Haiti, adopted seven kids, pioneered internet communities for families before most people had email. I know what it feels like to have the vroom vroom. I also know what it feels like when it goes quiet.

For a long time I thought the quieter version was just who I’d become. Older. More realistic. Less likely to bet on something crazy. I told myself that was wisdom.

Then I got on testosterone — injectable testosterone enanthate, dosed for women, not the men’s protocol — and I got 20 years back.

I don’t say that lightly. I mean it specifically:

The drive to complete things came back. Not just to start them — to finish them. To follow a thread all the way to the end without losing the thread.

The excitement to wake up in the morning. The actual physical pull toward the work I’d laid out the night before.

The creativity of starting businesses again. The appetite to bet on myself. The “what if I just tried this” that I thought I’d outgrown.

The willingness to do hard things voluntarily. To go to the gym not because I should but because I want to feel strong. To take on a project that scares me a little because the fear is interesting rather than paralyzing.

The enjoyment of the gym specifically has surprised me more than almost anything else. I used to white-knuckle workouts. Now I want them. That’s not discipline. That’s dopamine.

My injection is every two weeks. I know when it’s been too long because the flatness starts creeping back in at the edges. Not dramatically — I don’t crash. But there’s a warmth that dims, a hum that goes quieter. And when I get the injection, it comes back within 48 hours like a tide coming in. I’m not exaggerating to make a point. This is just what it actually feels like.

The pharmacokinetics explain it exactly. Testosterone enanthate has a half-life of approximately 4.5 days — which means on a two-week injection schedule, by day 9 you’re already below half your peak dose, and by day 14 you’re close to zero. Women’s target range is roughly 20–70 ng/dL; the injection creates a rollercoaster from well above that down to near nothing. The flatness at the edges isn’t psychological. It’s measurable. It’s the predictable consequence of a dosing schedule designed for men’s physiology — where the target range is 300–1,000 ng/dL and peak swings matter far less — applied without adjustment to women.

My partner, Bob, would tell you he notices when it’s been too long between injections. The version of me on testosterone is the version he fell for.

Nobody told me this was available. I had to find it myself, which is its own indictment of how medicine handles women’s hormones. But that’s a separate article.

Now add AI.

Here is where I want to go somewhere that I don’t think anyone else is talking about yet.

The world is in the middle of the most dramatic individual productivity transformation in human history. AI tools are compressing work that used to take teams into work one motivated person can do. Agentic AI — systems that can run parallel tasks autonomously while you think — is multiplying output in real time. Voice interfaces are eliminating the keyboard barrier entirely: I dictated the concept for this very newsletter to my AI executive assistant, out loud, while doing something else entirely.

But here’s the thing about this transformation: it rewards the energized, the curious, and the willing-to-try.

The woman running on 50% testosterone looks at tools like Claude Code or Wispr AI and doesn’t have the dopaminergic drive to adopt them. It feels like friction. It feels like one more thing to learn when she’s already tired. The “what if I just tried this” signal is too quiet. She closes the tab.

The woman with restored testosterone — with actual motivation, actual creative fire, actual willingness to do hard things — is the one who picks up the AI multiplier and runs.

I am that woman right now, and I want to tell you what it looks like from the inside.

I’m 57. I split my time between Boulder, Colorado (my primary base now) and Ajijic, Mexico — which, practically speaking, means testosterone is easy to access: over the counter at any Mexican pharmacy, no prescription required. I’m building multiple newsletters simultaneously — SmartStrongAlive, NotTooOldForAI, a menopause content localization project for OB/GYNs in Mexico. I’m running research pipelines that would take a team of writers. I’m orchestrating AI agents that work in parallel while I sleep. I dictate to my AI assistant using Wispr AI — a voice-to-text tool that lets me speak my thoughts rather than type them — and those thoughts become articles, research briefs, project plans. I wake up in the morning with ideas I want to act on and the energy to act on them.

The testosterone is not incidental to this. It is foundational. The AI is the force multiplier. But a force multiplier applied to 50% is still 50%. Restore the baseline and then apply the multiplier — that’s when something extraordinary becomes possible.

The world I can imagine from here.

If women over 40 across the developed world were routinely told the truth — that testosterone is declining before they even notice, that the decline has specific cognitive and motivational consequences, that restoration is possible and legal and increasingly well-evidenced — what would change?

I think about the 45-year-old who had a business idea and didn’t pursue it. Not because the idea wasn’t good. Because she couldn’t summon the fire. The “vroom vroom” was gone and she didn’t know it was gone because of a hormone.

I think about the 52-year-old who stepped back from her career and told everyone it was burnout. Maybe it was. But what if mixed in with the burnout was a measurable deficiency that nobody screened her for because there’s no approved pharmaceutical product incentivizing anyone to screen her?

I think about the 58-year-old who stopped learning new things — stopped being curious in the hungry, acquisitive way she used to be — because the curiosity just… flattened. And she grieved it quietly and assumed it was age.

Now add the AI tools. Give those women their biological engine back. Hand them the force multiplier. And then get out of the way.

Women who have both the restored drive AND the AI tools could build things the world has never seen. Not because the AI does the work — it doesn’t, not really, not the part that matters. But because the AI removes the friction between the idea and the output. And when you have the hormonal engine running at full capacity, you have an endless supply of ideas.

This is not utopian. It’s basic. Give women the information, give them the option, get out of the way.

Why this isn’t happening — and what you can do today.

Here is the short, unflinching version of why you probably don’t know any of this:

There are zero FDA-approved testosterone products for women. Not because the evidence doesn’t exist — it does — but because the regulatory and commercial pipeline for women’s hormones has been broken since the Women’s Health Initiative scared everyone away from hormone research in 2002. (That’s a separate article too, and I’ve written it.)

The result is that women are using off-label products, compounded formulations, and men’s products in micro-doses — all of which work, but all of which require finding a provider who actually knows what they’re doing, which is its own obstacle.

What you can do:

Find a menopause specialist. Not just an OB/GYN. A doctor who has done specific training in hormones and menopause — the Menopause Society (formerly NAMS) has a provider finder at menopause.org.

Ask for the right labs. Total testosterone is not enough. Ask for:

Total testosterone
Free testosterone by equilibrium dialysis (the gold standard method — not calculated free T, not by analog assay)
SHBG — Sex Hormone-Binding Globulin, the protein that binds testosterone and makes it unavailable. High SHBG (common in women on oral contraceptives or oral estrogen) can tank your free testosterone even if your total looks okay.

Have the conversation explicitly. Say: “I want to discuss testosterone restoration for motivation, energy, and cognitive drive — not just libido.” Because if you don’t name it, they’ll assume you’re there about sex, and they’ll give you a libido-focused answer that undersells what’s actually available to you.

The vroom vroom is not gone. It was never supposed to leave.

Here is what I want you to hear, if you’re 45 or 52 or 57 and you’ve been quietly grieving a version of yourself that you thought was just youth:

The ambition you had in your 30s was not youth. It was testosterone. The drive to start things, to bet on yourself, to do hard things voluntarily and enjoy the doing — that was a hormone. And hormones are testable, and in many cases they are correctable.

The version of you that would have started the business, taken the risk, learned the new thing, stayed up late working on something you cared about — she didn’t grow out of it. She didn’t mature past it. A measurable deficiency quieted her. And she can come back.

I know because she came back for me. At 57, I am building more, creating more, and frankly having more fun than I was at 47. The testosterone is why. The AI tools are why. But mostly the testosterone — because without the engine, the tools are just sitting in the driveway.

Go get your labs. Find a doctor who will actually run them. Have the conversation.

And then come back and tell me what you built.

Annette Thompson is 57, the founder of adoption.com, and a menopause advocate writing about evidence-based women’s health.

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