Low testosterone levels appears to be associated with an increased likelihood of depression in men, according to a US study published in the “Journal of Sexual Medicine”. Men referred to a specialist for borderline testosterone levels had much higher rates of depression and depressive symptoms than those of the general population.
For the study, the researchers at the George Washington University in Washington, DC, analysed data from 200 men aged 20 to 77 (48 years average age) who were referred for borderline total testosterone levels between 200 and 350 ng/dL. Information gathered included demographics, medical histories, medication use, signs and symptoms of hypogonadism, and assessments of depressive symptoms and/or a known diagnosis of depression or use of an antidepressant.
Depression and/or depressive symptoms were present in 56% of the subjects. This rate was significantly higher than rates of 6–23% (PHQ-9 scores ≥10) seen in general populations. Antidepressant use was 25%. The population was notable for high rates of overweight/obesity and physical inactivity. Common symptoms were erectile dysfunction, decreased libido, fewer AM erections, low energy, and sleep disturbances.
The authors concluded that clinicians should consider screening for depression and depressive symptoms, overweight and unhealthy lifestyle factors in men with borderline low testosterone levels.
Results
While sexual and nonspecific symptoms (i.e., fatigue) likely prompted measurements of testosterone in this selected population, clinicians should recognize the high rates of depression and depressive symptoms in men referred for borderline testosterone levels. Clinicians should consider screening for depression/depressive symptoms and overweight and unhealthy lifestyle risk factors in men referred for tertiary care for potential hypogonadism.
Westley, C. J., Amdur, R. L. and Irwig, M. S. (2015), High Rates of Depression and Depressive Symptoms among Men Referred for Borderline Testosterone Levels. Journal of Sexual Medicine. doi: 10.1111/jsm.12937