Men with low levels of the male hormone testosterone are more than four times as likely to become depressed as other men. It has been found that testosterone-deficient men have a condition known as hypogonadism, which is also characterised by a decrease in muscle strength, loss of bone mass, fatigue, and declining interest in sex. Since testosterone levels tend to peak early in life and decrease as men age, the rate of hypogonadism is highest in older men, reaching 30 percent among men older than 55. Researchers from the University of Washington in Seattle, USA, followed 278 men, more than 45 years old, for two years noting who developed depression. A total of 23 men were diagnosed with hypogonadism. Roughly 20 percent of the men with testosterone deficiency developed depression during the study period, compared with only 7 percent of men with normal hormone levels. There are many possible reasons why testosterone deficiency may be linked to depression. The symptoms of hypogonadism - such as fatigue, muscle loss and decreased libido - could trigger a low mood, while changes in hormone levels themselves may also cause depression. The findings suggest that giving testosterone to men who are depressed and have low levels of the hormone could improve their mood. However, the results of past studies suggest that the solution may not be so simple. Previous research has shown that testosterone helps correct depression in HIV-positive men who are also hypogonadal, and adding the hormone to antidepressant therapy may improve mood better than drugs alone. However, the only study to examine whether testosterone helps treat depression in older, hypogonadal men found that the hormone worked no better than an inactive drug. Further research is needed to investigate the role of testosterone in depression, as well as the risks and benefits of testosterone therapy in older men.

Archives of General Psychiatry ,
January 2004