Writer: Amy Harris, MS, RN, CNM
Understanding the connection between your mental health and your hormonal health may help you discover what treatment option is best for you. Hormones, such as testosterone, are chemical messengers that keep your body functioning and maintain a healthy mind.
Can low testosterone cause depression? People can feel depressed for many different reasons, including life and social factors, as well as physical changes in their brains and hormones. [1] Both males and females experience changes in their testosterone levels throughout their lives. Changes in hormone levels throughout the lifespan can impact mood and mental health.
Hormones Like Testosterone Can Influence Mood
Testosterone belongs to a group of hormones called androgens. Both people with testicles and those with ovaries have testosterone. Male testicles produce more testosterone, and males usually have testosterone levels 15-20 times higher than people with ovaries. [2]
You can test your testosterone levels (T levels) with a blood test that measures the amount of testosterone in your bloodstream, either with a healthcare provider or at home using the Everlywell Testosterone Test. It is best to test first thing in the morning when testosterone levels are at their highest. [3]
There are ranges of testosterone levels that are healthy for men and women. When levels are too high or too low, people can start noticing symptoms, feel unwell, and even develop serious health conditions. There are many different causes of unhealthy levels of testosterone in men and women. Healthcare providers may recommend testing your testosterone levels if you develop symptoms to help rule out serious health conditions.
Symptoms Can Be the Same for Depression and Low Testosterone
Low testosterone levels can make you feel [4]:
- Extremely tired
- Down or out of sorts
- Weak, low in energy, or unmotivated
- Irritable
- Anxious
- Like you want to spend less time with other people (social withdrawal)
- Uninterested in having sex or being intimate
Many of these symptoms overlap with depression symptoms. Symptoms of depression in women may be similar to or different from those in men. Some of the more commonly reported symptoms of depression in both men and women are [1]:
- A persistent sad, anxious, or "empty" mood
- Feelings of hopelessness
- Feelings of irritability, frustration‚ or restlessness
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
People with depression may also have physical symptoms such as [1]:
- Difficulty sleeping
- Changes in appetite or unplanned weight changes
- Fatigue, lack of energy, or feeling slowed down
- Physical aches or pains, headaches, cramps, or digestive problems
- Problems with sexual desire and performance
Is There a Link Between Testosterone and Depression?
Yes, there may be a link between testosterone and depression. Researchers and healthcare providers report an association between mood changes, people feeling depressed, and those who have low testosterone levels when tested. However, there is no conclusive evidence to show that having low testosterone levels (in either men or women) causes depression. [5-7]
Researchers have suggested several ways in which testosterone might influence mood and be related to depression. The first is that testosterone may act to reduce inflammation. Scientists have found higher levels of inflammatory markers in both people diagnosed with depression and healthy people who report symptoms of anxiety and depression. [6]
Additionally, testosterone may influence brain function by activating pathways between brain cells. Research tells us that there are receptors for testosterone in specific areas of the brain, including the limbic system. [9] The limbic system controls emotions, mood, behaviors, and motivation. Testosterone is a neurosteroid, a type of hormone that impacts brain function, including mood and stress response.
Studies show that it may influence emotional processing, memory, and perception. [9] High or low testosterone levels might impact the way your brain reacts to stressful life events, for example. Both genders report feeling more irritable or quick to anger when testosterone levels are too high. [4] Researchers suggest that unhealthy levels of testosterone could increase your risk of depression or the severity of your symptoms. [6]
People With Depression and Low T Levels Can Feel Better With Testosterone Treatment
The link between testosterone and depression is strengthened by evidence that people with symptoms of depression who have low testosterone feel less depressed when treated with testosterone. There are many effective treatment options for replenishing testosterone levels to the normal range. Sometimes called testosterone replacement therapy, or TRT, synthetic (made from chemicals) testosterone can be prescribed in a pill, patch, shot, gel, or pellet form. If your healthcare provider diagnoses you as having low testosterone levels, you may be able to take additional testosterone as a medication to replace what you are missing.
Some research studies looking at testosterone replacement reported that men receiving testosterone therapy reported lower levels of depressive symptoms. [5] They also report improved motivation, concentration, sleep, and libido, with less anger and irritability. [7]
The U.S. Food and Drug Administration (FDA) has not approved the use of testosterone for the treatment of depression in either men or women. The FDA has approved the use of testosterone in men with symptoms of low testosterone and low testosterone levels, diagnosed as hypogonadism. [8]
There is currently no FDA-approved testosterone medication for women in the U.S. Healthcare providers sometimes prescribe low doses of testosterone products for women off-label, meaning not as approved by the FDA. In women, testosterone is important for the normal functioning of the ovaries, bone health, and sexual function. [9]
Aging, Low Testosterone Levels, and Depression
Even if you have normal testosterone levels, they naturally fall in both men and women over time. In men, testosterone levels are usually at their highest around age 30 and then fall gradually by about 1% per year. [11] In women, testosterone levels also fall gradually beginning in the late teens or twenties. As a result of going through menopause, when the ovaries stop working and no longer produce testosterone, older women who no longer have their periods have much lower testosterone levels. [10]
Both men and women may be more likely to feel stressed or depressed by some of the accompanying symptoms of low testosterone and aging. Older men with lower testosterone levels have higher rates of depression and problems with appetite. [4-5]
While there are fewer studies of depression and testosterone in women, those studies do show that women may feel depressed when they have either high or low testosterone levels. [5]. Women sometimes have surgery to remove their ovaries to treat ovarian cancer, lower their risk of cancer, or treat other gynecological conditions. This surgery causes a sharp decline in testosterone almost overnight. Research shows that these women post-surgery have more depression and more severe symptoms of depression. [9]
In both men and women, low testosterone levels also cause changes in sexual desire and function. These changes may be emotionally upsetting and cause stress in intimate relationships, increasing people's risk for depression. [10] Both men who are depressed and men with low testosterone levels may have trouble getting or maintaining an erection. [4] Researchers have shown that using a combination treatment with transdermal estradiol (another sex hormone given through the skin with a patch) and testosterone gel returned women's testosterone levels to the normal range. Women who received this combined hormonal therapy reported improvements in sexual satisfaction, well-being, and mood. [10]
How to Take Care of Your Mental and Hormonal Health
Besides aging, mood changes can also be caused by other factors related to testosterone or overall hormonal health, such as [4]:
- Stress
- Lack of sleep
- Changes in your diet
- Increasing or decreasing your physical activity
Having regular health check-ups, ideally once a year, is part of staying physically and mentally healthy. You can talk with a healthcare provider, either in person or from the comfort of your home, with an Everlywell virtual care visit about how lifestyle factors, other medical conditions, or aging may be affecting both your mood and hormones.
Want to check your hormone levels or get a comprehensive view of your health? Consider these Everlywell options:
- Explore overall well-being with the Everlywell 360 Full Body Test.
- Check your testosterone levels specifically with the Everlywell Testosterone Test.
- Men can get a broader view of key health markers with the Everlywell Men's Health Test.
Depression in general can have many different causes and symptoms. This means there can also be more than one way to treat it. [1] For some people, testosterone may be part of a successful treatment plan, especially if testing shows that they have low testosterone levels.
If you have signs or symptoms of depression that do not go away or are impacting your quality of life, talk to a healthcare provider. Sometimes people who are depressed have thoughts of harming themselves and of suicide. If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.