Androgens / Testosterone

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 Question mark: This treatment has not been properly researched. It is not possible to say whether they are useful or not.

What is it?

Androgens are a type of hormone. The most well-known androgen is testosterone, which is produced naturally by the body. Testosterone is involved in the development of male sex characteristics and is important for men’s health and wellbeing. Women also produce testosterone, but in much smaller amounts.

How does it work?

Some research has suggested there could be a link between low testosterone levels and depression in men. It is thought that increasing testosterone levels may lead to an improvement in mood for men with low levels of testosterone. Testosterone can be given in many forms, such as tablets, gels, injections and skin patches. 

Is it effective?

There have been a number of studies in which men with low mood were treated with testosterone Three reviews of these kind of studies found that testosterone may be helpful in improving depression symptoms, particularly for men who had low levels of testosterone to begin with. However, not all of the participants in these studies had clinical depression. More research is needed to better understand if testosterone could be an effective treatment for clinical depression in men.

One study has looked at using testosterone injections to treat women with depression who had not responded well to other treatments. Two thirds of the women experienced a reduction in their depression symptoms after treatment. However, the study only included nine women and there was no control condition to compare to.

Are there any disadvantages?

Testosterone treatments are generally well tolerated by men, however some studies have found that large doses of testosterone were linked to cardiovascular side effects, and more research is needed to determine the long-term impacts of testosterone treatments. Side effects of testosterone for women can include oily skin, acne, and increased body hair.

Testosterone may have negative interactions with other medications or supplements. It is important that testosterone is only taken under the supervision of a health care professional. High doses may have harmful side effects.

Where do you get it?

Testosterone can be prescribed by a doctor.

Recommendation

Testosterone might help to improve mood in men who have low levels of testosterone, however more research is needed to better understand if it could be an effective treatment for clinical depression. It is not recommended as a treatment for depression.

Key references

  • Amanatkar HR, Chibnall JT, Seo B-W, Manepalli JN, Grossberg GT. Impact of exogenous testosterone on mood: a systematic review and meta-analysis of randomized placebo-controlled trials. Ann Clin Psychiatry. 2014; 26(1): 19-32.
  • Elliott J, Kelly SE, Millar AC, Peterson J, Chen L, Johnston A, et al. Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis. BMJ open. 2017; 7(11): e015284.
  • Miller KK, Perlis RH, Papakostas GI, Mischoulon D, Losifescu DV, Brick DJ, et al. Low-dose transdermal testosterone augmentation therapy improves depression severity in women. CNS spectrums. 2009; 14(12): 688-94.
  • Orengo CA, Fullerton L, Kunik ME. Safety and efficacy of testosterone gel 1% augmentation in depressed men with partial response to antidepressant therapy. Journal of geriatric psychiatry and neurology. 2005; 18(1): 20-4.
  • Pope HG, Jr., Amiaz R, Brennan BP, Orr G, Weiser M, Kelly JF, et al. Parallel-group placebo-controlled trial of testosterone gel in men with major depressive disorder displaying an incomplete response to standard antidepressant treatment. Journal of clinical psychopharmacology. 2010;30(2):126-34.
  • Pope HG, Jr., Cohane GH, Kanayama G, Siegel AJ, Hudson JI. Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial. The American journal of psychiatry. 2003; 160(1): 105-11.
  • Seidman SN, Miyazaki M, Roose SP. Intramuscular testosterone supplementation to selective serotonin reuptake inhibitor in treatment-resistant depressed men: randomized placebo-controlled clinical trial. Journal of clinical psychopharmacology. 2005; 25(6): 584-8.
  • Seidman SN, Roose SP. The sexual effects of testosterone replacement in depressed men: randomized, placebo-controlled clinical trial. Journal of sex & marital therapy. 2006; 32(3): 267-73.
  • Walther A, Breidenstein J, Miller R. Association of testosterone treatment with alleviation of depressive symptoms in men: a systematic review and meta-analysis. JAMA psychiatry. 2019; 76(1): 31-40.

Last reviewed and updated: 1 November 2019