Testosterone Treatment of Depressive Disorders in Men Too Much Smoke, Not Enough High-Quality Evidence

madman

Super Moderator
In summary, this meta-analysis suggests that among non-depressed hypogonadal men, testosterone replacement may enhance mood. Overall, some epidemiologic evidence and a limited amount of clinical trials’ evidence suggests that a late-life–onset DD may be associated with late-onset hypogonadism; randomized trials of the efficacy of testosterone replacement as a specific antidepressant therapy in such men are warranted. A large placebo-controlled, randomized, doubleblind, multicenter study of topical testosterone replacement therapy in 6000 symptomatic hypogonadal men at increased risk for cardiovascular disease is currently being conducted in the United States (the TRAVERSE trial). One substudy of the TRAVERSE trial will determine the efficacy of testosterone replacement therapy in inducing remission of depression in middle-aged and older hypogonadal men with late-onset DD. Until then, the clinicians should follow the Endocrine Society guideline for testosterone replacement therapy of androgen-deficient men ; the available data do not support the use of testosterone treatment, especially in supraphysiologic doses, for the treatment of depressive disorders in men.
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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