Previous research provided evidence that testosterone treatment is effective in reducing depressive symptoms in hypogonadal men aged 30, 43, or middle aged up to 60 years. Since clinical conditions cannot be prevented in all men while maintaining apparent good health, testosterone replacement therapy may offer an opportunity to overcome undesirable psychological, sexual, cognitive and physical deficiencies caused by age-related hormonal changes. Study results suggest that testosterone treatment may improve depressive mood in older men who have low levels of physiologically active bioavailable testosterone. Since low levels are correlated with age and increased depression, between 123 and 125 bioactive metabolites of testosterone (serum dihydrotestosterone and estradiol) were not associated with the risk of depression, 126 It may be beneficial in the long term to focus on psychoeducation about these age-related hormonal alterations at the population level to help men and teach treatment options., 118 Depression is a common disorder affecting millions of people around the world with an increased incidence in women than in men, especially in adolescents and adults than in children.
Its pathophysiology is complex and is due to many overlapping factors, including chemical, morphological, inflammatory, genetic, environmental and endocrine processes. There are several classes of drugs that can be used to treat depression, and SSRIs are considered the first-line drug class because of their relatively lower side effect profile. Due to individual variations, many patients do not respond to treatment, so it is necessary to increase it with a combination of medications or with psychotherapy. Many novel treatments are currently being investigated and have shown promising results.
One of these treatments includes testosterone therapy because of the widespread effects that testosterone has throughout the body. Studies suggest that testosterone treatment could improve depressive mood in older men who have low levels of physiologically active bioavailable testosterone, as lower levels have been shown to be correlated with age and a greater onset of depressive symptoms. Testosterone therapy can help overcome undesirable psychological, sexual, cognitive and physical problems caused by age-related hormonal changes. However, as an androgenic steroid, testosterone has a considerable profile of side effects associated with cardiovascular, musculoskeletal, neuropsychiatric, hepatic, and reproductive complications. In addition, it is unknown if the symptoms of depression are caused by testosterone deficiency in men or if testosterone treatment is effective in treating men with depressive symptoms and disorders.
More research is needed to determine the reason for the possible antidepressant action of testosterone administration and to justify its clinical use. In the 1940s, experiments demonstrated that major depression can be alleviated by injecting testosterone into men with low levels of that hormone. The treatment was never successful because the injections are painful and effective antidepressant drugs began to be marketed. However, more recently, testosterone patches and gels appeared. In June 2000, the U.S.
Food and Drug Administration approved a new form of gel to treat muscle loss, decreased sexual desire, lack of energy, and other symptoms of so-called hypogonadism or hypoactivity of the testicles. For many years, medical professionals have been arguing whether testosterone treatment can actually reduce depressive symptoms in men. This meta-analysis also showed promising results in terms of improving depressive symptoms in eugonadal or elderly men by administering higher doses of testosterone. Hypogonadal men who take testosterone supplements for one or two years are not at increased risk of contracting the disease.
They also demonstrated that the route by which testosterone is administered can influence its effectiveness. Medical and social science research differ in views on the relationship between testosterone levels and mood symptoms. Genetic markers of androgen receptor (AR) function, such as the duration of CAG repetition, can influence testosterone levels and depressive symptoms in middle-aged men. Another study concluded that subtypes of atypical depression showed dramatically reduced testosterone levels.
compared to those of patients with melancholic depression in men. We included men 18 years of age or older who used testosterone or not, depending on their reported use, insurance claim, or prescription use of testosterone documented in the electronic medical record. By stratifying testosterone below average and above average, it was concluded that the relationship between men with below-average testosterone levels and depression is inversely and directly related to those with above average testosterone levels. Some of the significant reductions in depressive symptoms were observed only in subgroups of the samples, depending on different factors such as age, testosterone levels, comorbidities, etc.
