The Crucial Link Between Testosterone and Depression: Why It Matters for Both Men and Women

When treating patients who are struggling with depression, it can be critical to identify and address the root causes that are contributing to their symptoms. Some of the more common factors that can affect mood include nutrient deficiencies, psychosocial stressors, trauma, inflammation, gut dysbiosis, toxin exposure, and hormonal dysregulation. This approach often includes a comprehensive hormonal assessment to identify any hormone imbalances that may be contributing to a given patient’s depressive symptoms.

Even in the world of integrative psychiatry, cortisol and thyroid hormones tend to garner more attention for their effects on mental health. Testosterone is often just associated with muscle mass and sexual function, and tends to be somewhat dismissed. However, testosterone plays a significant role in mood regulation and mental well-being for both men and women.

Testosterone and Mental Health

Beyond its physiological effects on muscle, bone density, and body hair, testosterone exerts a profound influence on mental health given its status as a neuroactive steroid hormone. Testosterone’s effects on the brain cannot be understated; it has been shown to modulate levels of GABA and serotonin and it influences dopamine signaling (Khera, 2013) (Purves-Tyson et al., 2014). Additionally, testosterone is considered neuroprotective and has been shown to increase neurogenesis, the process of growing new neurons in the brain (Spritzer & Roy, 2020).

Testosterone plays an instrumental role in supporting energy levels, confidence, and mental clarity (Straftis & Gray, 2019). When testosterone levels decline, both physical and mental health can be significantly impacted. Research demonstrates that lower levels of testosterone are associated with depression in men (Khera, 2013).

Furthermore, testosterone therapy has been found to improve mood and overall well-being in men with low testosterone levels. In a meta-analysis published in JAMA Psychiatry, the authors concluded that testosterone therapy was effective in the treatment of depression not only in men with overt hypogonadism, but also in men with normal testosterone levels (Walther et al., 2018). Given its role in maintaining robust energy levels, supporting cognitive function, and contributing to healthy levels of motivation and drive, it isn’t a surprise that optimizing testosterone levels would lead to positive outcomes in men struggling with depression.

Testosterone Levels in Women

While the focus on testosterone’s role in mental health often centers on men, it’s essential to recognize its significance for women as well. Although women have much lower levels of testosterone compared to men, the hormone still plays a vital role in their overall health and well-being. As in their male counterparts, testosterone contributes to libido, muscle strength, bone density, and mood regulation in women.

However, inadequate testosterone levels in both pre and post-menopausal women is frequently overlooked. Symptoms such as fatigue, low libido, and mood disturbances are often attributed to other factors, leading to underdiagnosis and undertreatment of testosterone deficiency in women. In one study, lower salivary testosterone levels were associated with depressive symptoms in women (Giltay et al., 2012) .

Causes and Treatment for Low Testosterone

In order to address low testosterone, it can be important to investigate the reasons for lowered production. Various factors can contribute to low testosterone levels in men and women, including:

1. Nutritional deficiencies: Certain vitamins and minerals like zinc, magnesium and vitamin D are essential for hormone synthesis and addressing deficiencies through diet and supplementation can help optimize testosterone levels (Wrzosek et al., 2020).
2. Chronic stress: Prolonged stress can disrupt the endocrine system and lead to imbalances in hormone production, including testosterone (Xiong et al., 2023). Stress management techniques such as mindfulness, meditation, and psychotherapy can support healthy testosterone levels via modulation of the hypothalamic-pituitary-adrenal (HPA) axis.
3. Poor sleep quality: Sleep is crucial for hormone regulation, and inadequate sleep can disrupt testosterone production. Addressing sleep issues and improving sleep hygiene can support healthy testosterone levels. Undiagnosed sleep apnea is a common root cause for low testosterone in men (Kim & Cho, 2019).
4. Sedentary lifestyle: Regular exercise has been shown to increase testosterone levels in both men and women. Incorporating physical activity, especially resistance training like weightlifting, can help patients maintain optimal testosterone levels (Hayes et al., 2017).
5. Environmental toxins: Exposure to certain chemicals found in plastics, pesticides, and household products can disrupt hormone function, including testosterone production (Ullah et al., 2023). Minimizing exposure to these toxins can support overall hormonal health.
6. Blood sugar imbalance: High blood sugar levels and insulin resistance have been linked to low testosterone production (Tahara et al., 2010). Balancing blood sugar and insulin levels through diet, exercise, stress management and targeted supplementation can go a long way in optimizing testosterone levels.

Takeaway

As a hormone that influences brain function, testosterone plays a significant role in mental health for both men and women. Adequate levels of testosterone are essential for mood regulation, energy, cognitive function, and overall well-being. While the focus on testosterone’s impact in mental health often centers on men, it’s crucial to recognize its importance for women. For individuals who are struggling with low testosterone, identifying and addressing the causes of low testosterone can be just as important as considering testosterone replacement.