Quick answer: Low testosterone is associated with symptoms that overlap with depression and anxiety, including fatigue, low mood, irritability, poor concentration, and reduced libido. The relationship runs in both directions and is not fully understood. Low testosterone is not a substitute diagnosis for a mental health condition, and testosterone therapy is not a treatment for depression outside of a diagnosed deficiency assessed by a physician.
If you are struggling with your mental health or having thoughts of harming yourself, you are not alone and support is available. Please reach out to a licensed healthcare provider or a local crisis line. In an emergency, contact your local emergency services.
What testosterone deficiency is
Testosterone is produced mainly in the testes and supports sperm production, libido, bone density, red blood cell production, muscle mass, fat distribution, and mood regulation. Levels decline naturally with age, but a marked or rapid decline can signal an underlying issue. Testosterone deficiency is considered a clinical diagnosis when levels fall below a defined threshold (commonly cited as total testosterone under 10 nmol/L) together with symptoms consistent with hypogonadism. Around a quarter of Canadian men aged 40 to 62 are estimated to have testosterone deficiency, and younger men increasingly present with symptoms as well [1].
Symptoms
Symptoms can include low libido, erectile difficulty, reduced or absent morning erections, fatigue, reduced muscle mass, weight gain, mood changes, poor concentration, sleep disturbance, and reduced bone density, among others.
Causes
Primary (testicular): genetic conditions (Klinefelter, Noonan), chemotherapy or radiotherapy, mumps infection, certain autoimmune conditions, some medications, and undescended testes.
Secondary (signalling): conditions affecting the hypothalamus or pituitary, including pituitary disorders, hyperprolactinemia, iron overload, obesity, aging, certain medications (including opioids and steroids), and nutritional deficiencies.
The overlap between low testosterone and depression
The symptoms of low testosterone overlap substantially with depression, which is part of why the hormonal cause is often missed.
| Low testosterone | Depression | |
|---|---|---|
| Overlapping symptoms | Fatigue, low mood, irritability, reduced libido, sleep problems, memory and concentration difficulty, anxiety | Fatigue, low mood, irritability, reduced libido, sleep problems, memory and concentration difficulty, anxiety |
| Features that differ | Low testosterone on testing, breast tissue changes, reduced muscle mass, hair thinning; suicidal thoughts less typical | Normal testosterone, no breast changes, weight change, headaches more common; suicidal thoughts more common |
Because these overlap, symptoms of low mood should be assessed by a clinician rather than self-attributed to hormones. Where mood symptoms are present, testosterone is one factor a clinician may consider, not a diagnosis in itself.
If any of this reflects thoughts of harming yourself, please reach out to a licensed provider or a local crisis line, support is available, and you don’t have to navigate this alone.
What the research shows
Testosterone and depression: Studies have found associations between testosterone levels and depressive symptoms in men, though findings are mixed and may depend on depression subtype [2]. In a large European study of men aged 40 to 79, lower testosterone was associated with a higher frequency of several symptoms, including low mood and fatigue [3].
Testosterone and anxiety: Population research, including the Tromsø Study of Norwegian men, has associated lower testosterone with higher anxiety symptom scores [4]. This suggests testosterone may play a role in emotional regulation, though association does not establish cause.
Testosterone therapy and mood: A systematic review and meta-analysis of 27 randomized placebo-controlled trials (1,890 men) found testosterone treatment was associated with a significant reduction in depressive symptoms, particularly at higher doses [5]. This suggests that in men with a diagnosed deficiency, treatment may also help mood symptoms. It does not mean testosterone therapy is a treatment for depression in men without a deficiency, and any such decision requires assessment by a licensed physician. Depression has effective, established treatments; testosterone is not a substitute for them.
Frequently asked questions
Can low testosterone cause depression? Low testosterone is associated with depressive symptoms, and the relationship appears bidirectional. It is not a replacement for a mental health assessment.
Should I try testosterone for low mood? Not on that basis alone. Low mood should be assessed by a clinician, who can determine whether testing or treatment of any kind is appropriate.
When to speak with a provider
If you are experiencing persistent low mood, fatigue, or related symptoms, speak with a licensed healthcare provider. They can assess what is contributing and whether any testing is appropriate for you.
Disclaimer
This article is for general information only and, like all content on Gambit’s Health Hub, is not a substitute for professional medical advice, diagnosis, or treatment. Mental health symptoms should be assessed by a qualified professional. For any health concern, consult a licensed physician.
This is a sensitive topic. If you are struggling, please reach out to a licensed provider or a local crisis line; in an emergency, contact emergency services.
References
- Grober ED, et al. A practical guide to diagnosis, management and treatment of testosterone deficiency for Canadian physicians. Canadian Urological Association Journal. 2010;4(4):287–288.
- Määttänen I, Gluschkoff K, Komulainen K, Airaksinen J, Savelieva K, García-Velázquez R, Jokela M. Testosterone and specific symptoms of depression: evidence from NHANES 2011-2016. Comprehensive Psychoneuroendocrinology. 2021;6:100044. doi:10.1016/j.cpnec.2021.100044. PMID: 35757365.
- Wu FC, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. New England Journal of Medicine. 2010;363(2):123–135.
- Berglund LH, Prytz HS, Perski A, Svartberg J. Testosterone levels and psychological health status in men from a general population: the Tromsø study. Aging Male. 2011;14(1):37–41. doi:10.3109/13685538.2010.522276. PMID: 20923289.
- Walther A, Breidenstein J, Miller R. Association of testosterone treatment with alleviation of depressive symptoms in men: a systematic review and meta-analysis. JAMA Psychiatry. 2019;76(1):31–40. PMID: 30427999.
