The Role Of Testosterone In Anxiety
The sexually dimorphic behaviors related to anxiety can be influenced by both, organizational and activational effects of gonadal hormones. Organization of the neuronal circuits by testosterone and/or its metabolites predetermines the behavioral responses to the activational effects of sex hormones later in life. Besides the sensitive period of earlyprenatal and perinatal development , increasing amount of evidence supports the hypothesis that pubertal hormones organize the brain and determine a variety of adult behaviors during adolescence or outside of the classic critical periods of neurodevelopment . An overview of the results of some experiments investigating sex differences and the role of testosterone in anxiety-like behavior, with particular regard to the age of animals with hormone manipulation and analysis of the outcomes, is provided in Table Table11.
Testosterone Replacement Therapy May Help Reduce Symptoms Of Depression
While research is ongoing on the link between depression and testosterone, some studies suggest that TRT may help relieve depressive symptoms and boost mood if you have low testosterone levels.
One large study published in JAMA Psychiatry journal looked at 27 different randomized clinical trials looking at testosterones effects on depression. The study found that TRT may have a positive effect for those with low testosterone and depression.
The researchers found that testosterone replacement therapy had a moderate antidepressant effect compared to placebo and offered clinically significant reductions in depressive symptoms. Many people in the study noticed benefits. However, testosterone was most effective for middle-aged men with low testosterone in the study. Researchers also noted that TRT may be more effective for those experiencing less severe depression.
As research continues, this may open up a positive step for those with depression and low T. This may be especially helpful for men with already low testosterone levels, as many antidepressants can lower testosterone, sometimes as much as 30-80%. Many people experience sexual dysfunction as a side effect of traditional depression treatments, which is why the potential for testosterone to help with depression is so exciting in the healthcare community.
What Does Testosterone Do To The Brain
Testosterone has been linked to various mental performance advantages for men. According to numerous studies about mental health, men showed superior mental performance such as spatial abilities and mental rotation.
Testosterone influences the brain through organizational and activational effects. Although highly controversial, research shows that testosterone is responsible for some of the cognitive advantages of men.
The brain contains androgen receptors, which respond to free testosterone in the body. The interaction between testosterone and androgen receptors in the brain creates a chain reaction that also affects cognition along with libido and muscle growth.
Scientists have not been able to pinpoint the mechanism of action of how testosterone influences cognition and mood, but observational results clearly conclude that testosterone has a major role in improving cognition.
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Testosterone And Depression: What Is The Connection
There is a definite connection between testosterone levels, anxiety, and depression.
According to the Mayo Clinic, depression is defined as a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think, and behave and can lead to a variety of emotional and physical problems.
Current statistics from the Anxiety and Depression Association of America say that major depressive disorder affects an estimated 16.1 million adults annually in the United States alone.
The World Health Organization describes depression as the leading cause of ill health and disability worldwide.
There is a growing body of evidence that suggests a link between low testosterone and depression.
Testosterone is critical in many ways for physical wellbeing. Testosterone is necessary to build muscle, to burn fat, to keep your bones healthy, and to regulate and stimulate many other physical processes. Testosterone also plays a vital role in maintaining emotional health in men and women.
Specifically, current research has shown a definitive link between low levels of testosterone and increased depression and anxiety. A 2016 study published in the journal, Psychoneuroendocrinology found that in older men, low serum testosterone was associated with an 86% increased hazard of depression.
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Is It Low Testosterone Or Is It Depression
Just as there can be many causes for low testosterone itself, there are many causes of depression. However, we now know that low testosterone can certainly contribute to depressive symptoms, as well as anxiety, increased irritability, and other negative emotional states.
Because of this link, and perhaps in spite of it, the symptoms of depression and low testosterone can often overlap, prompting you to wonder, do I have low testosterone, or am I just depressed?
Symptoms that are common to both low T and depression include:
- trouble concentrating
While the symptoms of low testosterone and depression often go hand in hand, one way to tell one from the other is to look at any physical symptoms you may be going through in addition to your emotional symptoms.
If you, in addition to feeling the blues you also are experiencing weight gain, erectile dysfunction, or other sexual issues and loss of muscle, chances are your depressive symptoms are related to a testosterone imbalance.
If, on the other hand, you are feeling sad, anxious, or depressed without the physical symptoms of muscle loss and weight gain, chances are your depressive symptoms are not related to low testosterone.
Men and women with low testosterone are at a greater risk of developing depression and anxiety.
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Sex Differences In Anxiety
Anxiety is interconnected with behavioral and brain functions such as fear response. In clinical practice, anxiety is considered to be a consequence of overestimated response to threat in uncertain situations associated with prolonged hyper-vigilance and hyper-arousal . In neuropsychiatric studies, rodents are the most commonly used animal models . While in humans, anxiety might be assessed by self-report questionnaire, in rodents anxiety is evaluated based on temporary behavioral responses to various threatening stimuli. Therefore the translational value of such evaluation is disputable. On the other hand, animal experiments are crucial to elucidate causality behind observed associations. Although mice and rats may differ in some behavioral traits, the behavioral tests assessing anxiety in rodents are based on their common innate avoidance of certain conditions, such as bright illuminations or open space . Therefore the most of the anxiety tests are suitable for both, mice and rats . In anxiety assessment it should be also considered that anxiety is associated with other behavioral phenotypes, such as aggression and violence . These exhibit sex differences and positive correlations with testosterone concentration . Furthermore, anxiety-related behavior assessed in experimental rodents is often related to their cognitive performance, which might be affected by sex hormones and dependent on androgen signaling .
How Low Testosterone Causes Anxiety And Depression
Most men are already familiar with their biological clocks.
They know that sometime around middle agetypically ranging from their late thirties through their seventiestheyll experience a decline in their physical capabilities. Theyll gradually lose muscle tone and gain fat. Theyll likely lose some of their unbridled ambition. Though they may not want to admit it, they may even experience less zest for private time with their partners in the bedroom.
These are all expected, though not necessarily welcome changes that will occur as they age. Its all a result of their testosterone gently decreasing. It happens to all of us, but some of us end up with lower testosterone levels than others, in which case, other unwanted developments can occurlike erectile dysfunction.
However, what men may not expect from low testosterone due to age are mental health struggles in the form of mood swings, anxiety, and depression. There is a growing body of research that suggests men who have lower than normal testosterone levels and are entering middle age are at an increased risk for depression.
In case after case, low T coincides with these mental health illnessesbut the silver lining appears to be that treating hypogonadism may also have positive effects on depression as well.
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What Are The Top Symptoms Of Depression In Men
There are times when low testosterone symptoms are often confused with the signs of depression. However, although they share many of the same symptoms and low testosterone can lead to depression, the complications for the psychological disorder and the hormone imbalance can differ slightly.
For example, people who have depression may also experience headaches, back pain, or neck pain, in addition to other symptoms such as:
Consult with a physician if youre unsure about whether youre experiencing symptoms of depression or low testosterone. They can check your testosterone levels to determine if your depression is related to testosterone deficiency and help you find treatment to treat the source of your symptoms.
How Can Low Testosterone Cause Depression
We know that testosterone is a neuroactive steroid, meaning that it can influence mood, making it reasonable to assume that low testosterone can cause depression, moodiness, and anxiety. But, researchers hesitate to use the word cause and would rather say that low testosterone and depression are linked.
There are several reasons that low testosterone can influence depression. There are the known chemical effects of testosterone and how it interacts with other mood-causing hormones such as cortisol and neurotransmitters like serotonin and dopamine.
Beyond the biochemical influences of low testosterone on mood, the other known physical issues caused by low testosterone weight gain, loss of energy, loss of libido, and sexual dysfunction all can cause a man to feel low and depressed.
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When I Need A Doctor
If youre experiencing depression along with physical symptoms such as rapid weight gain and decreased sexual performance, then you may want to talk to a physician about testing you testosterone levels to determine whether or not youre suffering from low testosterone. A healthcare professional can provide the tests needed to check your testosterone levels and recommend several treatment options to help elevate your testosterone levels to normal parameters, which can help treat the physical symptoms of low testosterone that may be affecting your mental health. However, low testosterone can affect everyone differently, so although TRT can resolve the physical complications associated with Low T, there may still be psychological effects that will require other forms of treatment. Your physician may also recommend cognitive behavioral therapy to help you overcome your issues with mental health. By consulting with a physician, you can increase your chances of finding a solution to address your low testosterone and treat your depression.
Mental Health And Low Testosterone
While men do experience decreased levels of testosterone as they age, not all men end up with levels low enough to call a testosterone deficiency. Those who do, however, may find that their moods are affected. These symptoms may be easy to ignore, as they can come on gradually. Often, people attribute their depressed mood to the aging process or to everyday stress, not realizing that they may actually be facing a hormonal imbalance.
Testosterone actually has a direct effect on the brain, which contains testosterone receptors. When these receptors dont get the amount of hormonal input they need, the result can be mood swings, depression, irritability, and anxiety.
Some people call this andropause, seeing it as similar to female menopause. However, menopause comes on suddenly, with a quick, steep drop in female hormones. Men dont experience the same kind of sudden onset when testosterone level decrease. Instead, the loss comes on very gradually, which often makes it even harder to detect and pin down symptoms.
Any man who is experiencing depression, especially if it hasnt responded to appropriate medications, should be tested for low testosterone levels. The same is true for men experiencing unexplained mood changes, with an increase in stress and irritability. Take a look at some of the key mental health conditions that can result from low testosterone.
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Hormonal Ways To Relieve Social Anxiety
Although hormonal changes may be related to social anxiety, treatment with hormonal therapy is not currently a common recommendation. Instead, your best option is some form of traditional treatment for SAD as well as understanding and adapting to the role of hormones in your anxiety.
What is not helpful is self-medicating. Try to avoid temporary “fixes” like sugar, alcohol, smoking cigarettes, or other substances that give you a quick feel-good surge but don’t solve the long-term anxiety problem. Below are six tips to get you started.
Low T Is Tied To Osteoporosis
This disease causes your bones to thin and become weak over time. Its much more common in women, but it occurs in men, as well, and those with low T have higher odds of developing it since testosterone is a crucial building block of strong bones. Men with hypogonadism do have a higher risk of osteoporosis, which can lead to fractures, such as hip fractures and vertebral fractures, says Dr. Ghalib. But it can be missed very easily in all levels of care. She does have some good news, though: You can improve your bone density by 30% on testosterone replacement therapy.
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Who Does Low Testosterone Affect
Male hypogonadism is a medical condition that can affect people with testicles at any age from birth through adulthood.
Low testosterone is more likely to affect people who:
There are several possible causes of low testosterone. The two types of male hypogonadism are:
- Primary hypogonadism .
- Secondary hypogonadism .
Causes of primary and secondary hypogonadism are also divided into either congenital or acquired .
Causes of primary male hypogonadism
Primary hypogonadism happens when something is wrong with your testicles that doesnt allow them to make normal levels of testosterone.
Another name for primary hypogonadism is hypergonadotropic hypogonadism. In this type, your pituitary gland produces more luteinizing hormone and follicle-stimulating hormone in response to low testosterone levels. The high levels of these hormones would normally tell your testicles to produce more testosterone and sperm. However, if you have damaged or missing testicles, they cant respond to the increased levels of gonadotropins. As a result, your testicles make too little or no testosterone and sperm.
Sometimes in primary hypogonadism testosterone levels are within the normal range and gonadotropins are high. Your specialist will help you understand if you need treatment, even with normal testosterone levels.
Congenital conditions that affect your testicles and can lead to primary hypogonadism include:
Acquired conditions that affect your testicles and can lead to primary hypogonadism include:
What Makes The Optimale Testosterone Blood Test Effective
Rather than just testing for testosterone, our test determines five key biomarkers associated with testosterone and testicular function.
- Total Testosterone: It indicates the total amount of testosterone present in your blood. If you have symptoms such as a lack of libido or muscle loss due to low testosterone, you might see a decline in total testosterone numbers.
- Free Testosterone: It is the fraction of total testosterone available for your body to use. Having total testosterone in the normal range but low free testosterone indicates a problem. If you have low free testosterone, you will experience some of the symptoms discussed above.
- Sex Hormone Binding Globulin : It is a protein that binds to testosterone when it is present in the blood. When testosterone is attached to this protein, it is unavailable for the bodys cells to use. Consequently, the higher the amount of SHBG in your blood, the more testosterone will be sequestered away, and less of it will be available for your body to use.
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Does Smoking Or Drinking Alcohol Lower Testosterone
This one is a bit more nuanced. There are conflicting studies concerning the effect of smoking on testosterone levels. A 2021 study from Egypt demonstrated that serum testosterone levels among smokers were significantly lower compared with nonsmokers. This confirmed earlier studies revealing a significant decrease in total testosterone levels among smokers compared to non-smokers. While the exact mechanism is unknown, researchers have hypothesized that smoking lowers testosterone levels as a result of damaging Leydig cells in your testicles, which are responsible for testosterone production.
However, other studies have found higher testosterone levels among smokers. Researchers have developed several theories for this, one of which suggests that this increase may be related to smokers having increased levels of sex-hormone-binding globulin .
Even though the exact mechanism of elevated testosterone levels in smokers is not known, there is some concern that the temporary boost or false elevation in testosterone levels from smoking may actually be masking undiagnosed hypogonadism.
We do know that smoking often has a negative effect on erectile function because of damage to your blood vessels and the development of atherosclerosis . Smoking can also lead to damage to your heart and lungs.
Either directly or indirectly, smoking does affect sexual and overall general health, says Dr. Hakim.
What Causes Anxiety In Males
Your age, hormones, and how much stress you experience can all contribute, too. As a male, hormone levels are more relevant if youre older, while life stress can affect you regardless of age.
Allen says that in her practice, she has observed her male patients, have less emotionally supportive relationships and less language around expressing emotions than women. If youre finding it hard to deal with complex emotions, it could be related to anxiety.
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Is Testosterone Replacement Therapy For Anxiety Right For You
Whether you have tried anxiety treatment optionsto no avail or you are just getting started exploring the possibilities forhealing, a compassionate practitioner can help you to consider your next steps.If there is a chance you may have low testosterone, a hormone practitioner canwork with your psychiatrist to determine the most effective all-aroundtreatment plan.
Hormone tests are necessary to determine whether your testosterone levels are out of balance and may allow you to put related symptoms into context. If insufficient levels of testosterone are negatively affecting your psychiatric state, then its reasonable to expect that rebalancing the hormone levels will help restore your sense of emotional well-being. However, a comprehensive treatment plan is importanteven if your anxiety is entirely attributable to low testosterone, establishing healthy patterns of thought and behavior can require additional supports beyond TRT.