Testosterone replacement therapy improves mood in hypogonadal men--a clinical research center study.

Abstract

The effect of testosterone (T) replacement on changes in mood was studied for 60 days in 51 hypogonadal men. All patients were withdrawn from their prior T replacement for at least 6 weeks before enrollment. Of these patients, 18 received T enanthate 200 mg im every 20 days, 16 received sublingual T cyclodextrin (SLT) at a dose of 2.5 mg three times daily, and 17 received SLT at a dose of 5.0 mg three times daily. The total treatment period was 60 days. The patients were asked to respond to a questionnaire on 7 consecutive days before the start of treatment and on 7 consecutive days before their visits to the clinic on days 21, 41, and 60 of treatment. The following mood parameters were assessed using a 7-point Likert rating scale: angry, alert, irritable, full of pep (energy), sad/blue, tired, friendly, nervous, and well/good. When compared with the baseline period, T replacement led to significant decreases in anger (P = 0.0045), irritability (P = 0.0009), sadness (P = 0.0033), tiredness (P = 0.0035), and nervousness (P = 0.0291), and significant improvement in energy level (P = 0.0020), friendliness (P = 0.0072), and sense of well-being (P = 0.024) in all subjects as a group. Analyses of the area under the curve (AUC) of baseline serum T levels before T replacement showed significant positive correlations between serum T (AUC) and friendliness (r = 0.29, P < 0.05) and sense of well-being (r = 0.27, P < 0.05), and significant negative correlations with nervousness (r = -0.27, P < 0.05), irritability (r = -0.29, P < 0.05) and tiredness (r = -0.28, P < 0.05). Similar correlations were found between serum dihydrotestosterone (DHT) and some of the mood parameters. After T replacement in the hypogonadal men, these correlations between AUC of serum T levels and the positive and negative mood scores disappeared. These results were corroborated in a subsequent study in which 30 hypogonadal men were supplemented with SLT 5 mg three times daily for 6 months. The patients were less nervous (P = 0.0025) and more alert (P = 0.0004), friendly (P = 0.042), and energetic (P = 0.0001) during the 6-month treatment period compared with baseline. We conclude that T replacement therapy in hypogonadal men improved their positive mood parameters, such as energy, well/good feelings, and friendliness and decreased negative mood parameters including anger, nervousness, and irritability, and direct correlations between serum T and DHT with mood scores were only observed in the baseline period when serum androgen levels were below the normal range. The latter observation suggests that once a minimally adequate serum T/DHT level was achieved by T replacement therapy, further increases in serum T/DHT levels did not further contribute to the improvement in mood variables.

Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy

“…Also, testosterone deficiency may decrease cerebral perfusion in the brain regions involved in memory, reasoning, judgment, and emotions [10], leading to a deterioration in mental and overall wellbeing [11,12]. Studies in elderly subjects and non-cancer patients have reported a clear association between testosterone levels and depressive symptoms [13]: lower testosterone levels in older men have been associated with more depressive symptoms [14,15], which seem to disappear with testosterone hormone treatment [16,17]. Besides contributing to the onset of depressive disorders, decreased testosterone blood levels can cause breast tenderness and loss of penile length or volume.…”

Durability of the Effects of Testosterone and Growth Hormone Supplementation in Older Community Dwelling Men: The HORMA Trial.

“…The effects of testosterone supplementation on QOL have been inconsistent in previous trials 24, 25 whereas rhGH has been reported to improve mood, cognition and other components of QOL in GH-deficient adults 26,27 . We found no significant changes in GDS or SF-12 PCS, but changes in PASE were correlated with changes in testosterone during treatment.…”

Androgens and male aging: current evidence of safety and efficacy

“…Testosterone administered to nondepressed eugonadal men at physiological doses, did not result in significant effects on mood [101,102]. In hypogonadal men, testosterone replacement was associated with improved mood and well-being, and reduced fatigue and irritability [103][104][105]. Randomized controlled trials of testosterone therapy in men without or with underlying chronic illness using a variety of testosterone formulations, report equivocal improvements in QoL measures, including general well-being and fatigue [106,107].…”