testosterone

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What’s the connection between low testosterone and depression?

By Joe Young | Medically reviewed by Lauren Sien
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You may associate testosterone with fiery tackles at five-a-side and drunk men peacocking in bars, but the hormone affects us beneath the surface too. Probably more than you think. 

Whilst there could be various reasons you feel down, angry, or anxious, testosterone is rarely considered as the cause. That needs to change. It can have an impact on mental health and could be impacting you more than you realise. 

Let’s explore the link. 

Testosterone and depression

Depression and low testosterone share a lot of the same symptoms, such as fatigue, loss of interest in activities, changes in appetite, irritability, and decreased sex drive.

Because of this, it’s common for men with low testosterone to be misdiagnosed as having depression alone. So if you’re experiencing these symptoms, it’s worth taking a blood test to see what’s really going on under the hood. Blood tests can give you interesting - even surprising - insights into what's going on in your body.

A study analysed 278 men (aged 45 or older) with normal or low testosterone levels and no prior history of depression. After a 2-year period, they found a 21% incidence of depression in men with low levels, compared with a 7% rate in those with normal levels. 

Several further studies have reported a direct link between lower testosterone levels and a higher risk of depression in men. Testosterone plays a role in regulating mood and emotions, and its decline can lead to irritability, anxiety, and feelings of hopelessness.

Why is low testosterone linked to depression?

Some of the symptoms of low testosterone can trigger a chain reaction of symptoms that contributes to a downward spiral.

It can zap your energy levels and motivation, leaving you feeling lethargic and fatigued. You might find yourself becoming more sedentary and less inclined to move. Physical activity is fuel for your mind and body and is essential to your health. When the motivation to exercise dwindles, it can create a vicious cycle. A lack of physical activity can lead to a further decrease in testosterone, compounding the problem.

Lower levels of the hormone can also cause muscle loss and increased body fat. This can sometimes lead to a loss of confidence in your physical appearance.

Last but certainly not least - it can cause sexual dysfunction. A loss of libido and erectile dysfunction can be debilitating. Rates of depression in men with erectile dysfunction are reported to be as high as 56%. 

But thankfully, there’s something you can do about it.

Will testosterone replacement therapy (TRT) help with depression?

The good news is that there’s plenty of science behind TRT improving testosterone levels, which can contribute to the improvement of symptoms of depression in those with low testosterone levels. In one study, researchers looked at the impact of TRT on 51 men. They found significant decreases in anger, irritability, sadness, tiredness, and nervousness, and showed improvement in energy levels, friendliness, and sense of overall wellbeing.

Another study of 790 men 65 years or older found similar results. They had their levels increased to a mid-normal range for men 19 to 40 years of age. They reported better mood and lower severity of depressive symptoms than those who received the placebo. They also saw increased sexual activity and erectile function - a great natural mood booster. 

And that’s not all. A systematic review and meta-analysis of 27 randomised placebo-controlled clinical trials involving a total of 1890 men found that testosterone treatment was associated with a significant reduction of depressive symptoms.

The numan take

Depression can be a debilitating condition. Hence, getting to the root cause of your low mood is an important step to take on the road to feeling more like yourself again. Whilst Low testosterone may not be the reason for everyone it could be worth checking blood tests, as these can provide invaluable insights into your body's signals. If low testosterone is a contributing factor, there are ways to help you feel like you again.

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