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There is a definite link between low testosterone, mood, anxiety and depression.
It has been well documented in medical literature that low testosterone can cause or worsen anxiety and depression. Testosterone helps manage brain chemicals like serotonin and affects the body’s stress response. When levels drop, it can lead to low mood, nervousness, and constant fatigue.
The relationship between testosterone and depression and anxiety is a complex one, having to do with everything from the hormone’s impact on “feel good” brain chemicals, to the stress created by the physical symptoms of low-T.
Let’s take a closer look.
Your brain is not separate from your body. It is part of it. And your brain responds to hormones every day just as the rest of your body does. Hormones can influence mood in several ways. First, they affect brain signaling. Your brain uses natural chemicals to support calm, motivation, and a sense of reward. When hormones are out of balance, those signals can feel “turned down.” You may feel less upbeat, less driven, or more irritable.
Second, hormones shape sleep quality. Poor sleep can make anyone feel anxious, stressed, or emotionally sensitive. When hormones that support deep sleep decline, you may wake up tired, even after a full night in bed. Over time, this can impact mood and coping skills.
Third, hormones affect stress response. When your body is under stress, it can feel like you are always “on edge.” Some people describe this as being wired, jumpy, or easily overwhelmed. Hormone balance helps your nervous system feel steadier.
Finally, hormones influence physical confidence. When hormones drop, many people gain fat more easily, lose muscle, and feel weaker. That physical shift can affect self-image, energy, and social confidence. When your body feels better, your mood often lifts with it.
Age-related hormone decline tends to happen gradually. That is why it can be hard to notice at first. Many people adapt and push through until the symptoms become too loud to ignore.
In men, testosterone commonly declines with age. The symptoms of low testosterone are commonly linked to muscle, strength and sex drive, but it also supports confidence, energy, and mental stamina. When testosterone drops, some men describe feeling less motivated, less resilient, and more emotionally flat. They may also feel more irritable or impatient.
Also keep in mind, hormones do not work independently, and testosterone is not the only hormone that declines as we get older. Others that influence mood and depression do as well. In women, estrogen and progesterone shift during perimenopause and menopause. These changes can affect sleep, temperature control, and emotional steadiness. Many women report new anxiety, mood swings, and a shorter emotional “fuse” during this time. When sleep is disrupted by night sweats or hot flashes, mood and thinking often suffer even more.
Growth hormone levels also tend to decline with age. While people often think of growth hormone as a “body” hormone, it is also tied to energy, recovery, and overall well-being. When levels are lower, many people report more fatigue, less drive, and less “spark.” When energy and vitality return, mood and cognition often feel stronger too.
The key takeaway is simple: hormone decline can change how you feel and how you think. If you have been blaming personality, aging, or stress alone, it may be time to look deeper.
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.”
This study echoed earlier research, which has found a strong link between low testosterone, depression, anxiety, and other emotional issues in both men and women.
Medical professionals do not like to say that imbalances in testosterone are a definitive “cause” of depression, but there is little doubt that testosterone is one of many hormones that influence mood and feelings of depression and anxiety.
Low testosterone also leads to erectile dysfunction, low sex drive, and a lack of physical energy. These physical symptoms can lead to less enjoyment in life. That could lead to depression. But there could be something more to the link between low-T and depression.
Testosterone is necessary to produce serotonin and other important neurotransmitters. Neurotransmitters like serotonin are the brain’s “feel-good” chemicals that help to regulate mood and stave off depression. In fact, most antidepressants work by keeping levels of serotonin high.
Testosterone levels decline in both men and women as they age. Low testosterone could be the reason why depression and anxiety are more prevalent in people over 40, that it is in younger people.
Similar to depression, there is also evidence that your level of testosterone can and does influence feelings of fear and anxiety.
Studies have shown that low testosterone can increase feelings of anxiety and anxiety symptoms. What is even more interesting is that researchers have found that men who have been diagnosed with low testosterone and have complained of feelings of anxiety saw significant decreases in anxiety after being prescribed testosterone replacement therapy.
The researchers qualified their results by indicating that decreased anxiety could be influenced by other positive impacts of testosterone replacement, such as alleviating depression and improving sexual function. However, they also concluded that testosterone is “believed to impact anxiety levels independent of other factors.”
These kinds of results are not found only in men.
A 2016 study found an important connection between testosterone levels and anxiety in women. In this study, the researchers found that women with social anxiety disorder (SAD) experienced less “gaze avoidance and aversion to images of angry faces” – core indicators of the kind of social anxiety typical of SAD – when treated with testosterone. According to the researchers, these findings suggest that for patients with SAD, testosterone replacement therapy might help to alleviate social anxiety disorder symptoms and submissive behaviors.
This study is significant because we know that low testosterone is also a problem in older women. Women suffer age-related testosterone deficiency just as men do. However, unlike men, who lose testosterone gradually over time, women’s testosterone levels drop significantly when they reach menopause. We all know that depression, anxiety, and mood swings are major symptoms of menopause.
We used to think that the emotional distress most women experience during menopause was largely due to the lack of estrogen that occurs in the post-child-bearing years. However, current research seems to indicate that the depression and mood swings typical of menopause are more related to low levels of testosterone than estrogen.
Doctors do not like to speak of cures when it comes to testosterone and depression. But it is certainly an effective treatment for managing depression and anxiety, equally as good, and in some cases better than typical antidepressants such as SSRIs. In fact, studies have shown that in patients where “first-line” treatments for clinical depression such as SSRI have failed, testosterone replacement has worked.
There can be many causes of clinical depression. The link between low testosterone and depression is now well known. Does that mean that testosterone could replace antidepressants and/or other therapies in people with depression? Not for those who do not have other symptoms of low testosterone. However, for men and women who are over 45 and are experiencing the other symptoms of low testosterone, testosterone replacement therapy has been shown to boost mood and reduce anxiety, depression, and irritability.
In addition to anxiety and depression, other signs and symptoms of low testosterone include:
Stress does not increase testosterone. You might think that during a crisis, your “fight or flight” reaction is triggered by testosterone or causes a burst of testosterone to flow into your blood to deal with the emergency. This is a misconception. The hormone related to stress and your “fight or flight” reaction is cortisol. Cortisol is the “stress hormone,” it is cortisol that is released into your blood that causes the release of adrenaline and the higher heart rate that gives us the physical boost we need to escape or handle danger. Cortisol and testosterone are antagonists. High levels of cortisol in your blood actually lower your testosterone level. Therefore, men who are often under chronic stress are likely to experience low testosterone.
Depression is almost always associated with low testosterone levels. However, there have been incidences where too much testosterone has led to aggressive behavior in men and women – so-called “roid rage,” and as a consequence may cause depression.
But this is rather uncommon and usually occurs when people abuse testosterone and is rarely if ever, a side effect of normally prescribe testosterone replacement therapy.
Low testosterone is can also be a problem for women. Women suffer age-related testosterone deficiency just as men do. However, unlike men, who lose testosterone gradually over time, women’s testosterone levels drop significantly when they reach menopause. We all know that depression, anxiety, and mood swings are major symptoms of menopause.
We used to think that the emotional distress most women experience during menopause was largely due to the lack of estrogen that occurs in the post child-bearing years. However, current research seems to indicate that the depression and mood swings typical of menopause are more related to low levels of testosterone then of estrogen.
Depression is a complicated condition with many causes. And no two people suffering from a depressive disorder are exactly alike. Because depression is so complex, that is precisely why we cannot draw direct a “cause and effect” between depression and low testosterone but have to understand that they two are related. It would be great if we could say that testosterone improves feelings of depression and anxiety 100% of the time. But the truth us no drug or medical therapy can make that kind of a claim.
However, in our practice, if a person has low testosterone and depression, we have found that there is an excellent chance that their symptoms will improve over the course of a program of testosterone replacement therapy.
Many of our patients have reported a complete reversal or at least a significant improvement in their mood after treatment with testosterone therapy.
Also, testosterone tends to benefit many of the symptoms that can lead to mood changes. Supplemental testosterone helps improve sleep, energy, body composition, health, appearance, and more. These positive changes can benefit a person’s emotional state and his or her total outlook on life.
Numerous clinical trials have shown a definite link between testosterone, mood, depression, and anxiety.
A 2004 study on the incidence of depression in men with low testosterone found that men with low testosterone who were studied over a two-year period were four times more likely to be diagnosed with clinical depression. The head researcher on the projects, Molly M. Shores, MD, director of the Veterans Affairs Puget Sound Health Care System and the University of Washington in Seattle, said, “Older men would be particularly vulnerable to [the effects of low testosterone on depression] because serotonin receptors are already decreased from normal aging…Because depression is a major risk factor for suicide, and older men have the highest suicide rate of any age group in the United States, identifying conditions [such as low testosterone] that increase the risk of depressive illness could be an important opportunity for early intervention and treatment.”
But the most definitive study on testosterone and depression was published in 2019 in the journal JAMA Psychology.
The study was a meta-analysis or a “study of studies” that looked at testosterone and depression. According to the authors, their analysis was the “largest examination to date of the association of testosterone treatment with depressive symptoms in men.”
Specifically, the researchers aimed to “examine the association of testosterone treatment with the alleviation of depressive symptoms in men and to clarify moderating effects of testosterone status, depression status, age, treatment duration, and dosage.”
After analyzing relevant studies that had nearly 2000 participants, the researchers concluded, “Testosterone treatment appears to be effective and efficacious in reducing depressive symptoms in men, particularly when higher-dosage regimens were applied in carefully selected samples.”
Many men come to Nexel Medical thinking testosterone is only about building muscle and improving sex drive. In reality, testosterone can shape how you feel about life.
When testosterone is low, men often report:
When testosterone is restored appropriately, many men report feeling more positive, more confident, and more emotionally steady. Research also supports that testosterone treatment can be associated with improvement in depressive symptoms in men in many cases.
This is one reason TRT can feel life-changing for the right patient. It is not only physical. It can help men feel more engaged, more driven, and more like themselves again.
Cognitive complaints are common in men with low testosterone. Many describe:
TRT may support cognitive performance in men who have low testosterone and cognitive symptoms. In one placebo-controlled study, TRT was associated with improvements in depression scores, and cognitive scores improved in men who had cognitive impairment at baseline.
Even when the benefit is subtle, it can feel meaningful. If you are leading meetings, managing a business, or caring for family, better mental stamina and focus can change your day-to-day life.
Hormone therapy should never feel generic. Your brain, your mood, and your body deserve a plan built for you. At Nexel Medical Clinics nationwide, our approach is designed to support both performance and well-being:
We start with a complete evaluation. That means listening carefully to your symptoms, your lifestyle, and your goals and not rushing to a one-size-fits-all answer. Then, we build a targeted plan. Whether you need TRT, HGH therapy, HRT for women, or a combined approach, we tailor your therapy to your needs, not someone else’s.
We focus on the results that matter in real life. Better energy, better sleep, better mood, clearer thinking, more confidence, and improved quality of life. These are the outcomes patients come to us for, and these are the outcomes we plan for.
If you are struggling with anxiety, low mood, or brain fog and you suspect hormones may be part of the reason, Nexel Medical can help. Why not contact us today and see how we can build a hormone therapy plan that supports your emotional health and cognitive performance, along with your physical vitalit
It can. Low testosterone may be linked with changes in mood, motivation, energy, confidence, and mental focus. However, anxiety and depression can have many causes. A proper medical evaluation can help determine whether low testosterone may be one part of the problem.
TRT may help improve mood when low testosterone is contributing to emotional symptoms. Some men report feeling more motivated, more emotionally steady, and more like themselves as testosterone levels return to a healthier range. Results vary, and treatment should be based on confirmed testosterone deficiency.
It may. Men with low testosterone sometimes report trouble focusing, forgetfulness, or a general sense of mental fog. When those symptoms are related to a hormone deficiency, properly managed TRT may help improve mental clarity and concentration over time.
Some men notice changes in energy, motivation, or mood within the first several weeks, while other improvements may take longer. The response depends on hormone levels, overall health, sleep, stress, and other factors. Regular follow-up helps determine whether treatment is working as expected.
TRT is not a replacement for mental health treatment. Its role is to correct confirmed testosterone deficiency. If low testosterone is contributing to mood or emotional symptoms, TRT may help as part of a broader treatment plan. Men with ongoing anxiety or depression may still need care from a mental health professional.
Symptoms alone cannot confirm low testosterone. Mood changes, low motivation, fatigue, poor sleep, and difficulty concentrating can also occur with stress, thyroid problems, depression, anxiety, and other health conditions. Blood testing and a medical evaluation are needed to determine whether low testosterone is involved.
Not necessarily. Response to treatment is individual. Men whose emotional symptoms are strongly connected to low testosterone may notice meaningful improvement, while others may have additional causes that need attention. The goal of treatment is to restore healthy hormone levels and monitor how the patient responds over time.
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