Even "Mid-low-T" Levels Make Men Depressed

Men referred for borderline testosterone levels may have high rates of depression and depressive [[{"type":"media","view_mode":"media_crop","fid":"39635","attributes":{"alt":"©IgorGolovniov/Shutterstock.com ","class":"media-image media-image-right","id":"media_crop_818233442881","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3980","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right; height: 150px; width: 200px;","title":"©IgorGolovniov/Shutterstock.com ","typeof":"foaf:Image"}}]]symptoms that are underrecognized, according to the results of a new study.

“In an era where more and more men are being tested for ‘Low T’ - or lower levels of testosterone - there is very little data about the men who have borderline low testosterone levels. We felt it important to explore the mental health of this population,” said lead author Michael S. Irwig, MD, associate professor of medicine and director of the Center for Andrology at the George Washington School of Medicine and Health Sciences in Washington, DC.

The number of testosterone prescriptions has grown exponentially over the past decade. Along with it has been a corresponding increase in direct-to-consumer marketing about the effects of "Low T" on decreased sexual function and low energy in middle-aged men.

The study included 200 adult men, mean age 48 years, who were referred for borderline total testosterone levels between 200 and 350 ng/dL. Doctors typically treat men for hypogonadism if they have symptoms of low testosterone and their testosterone levels are below 300 ng/dL.

The researchers gathered information on demographics, medical histories, medication use, signs and symptoms of hypogonadism, and assessments of depressive symptoms and/or a known diagnosis of depression or use of an antidepressant.

All of the study participants who were not diagnosed with depression or who were taking medications for the condition answered standardized test questions aimed at measuring mood.

The results show that more than half (56%) of the men had depression or depressive symptoms, which is significantly higher than rates seen in general populations. A recent survey of US adults found that 6% of those who are overweight or obese were depressed. One-quarter of the men used antidepressants.

Rates of depression were 62% for those in their 20s and 30s, 65% for those in their 40s, 51% for those in their 50s, and 45% for those who were age 60 and higher.

Notably, the men had high rates of overweight or obesity and physical inactivity. Common symptoms were erectile dysfunction, decreased libido, fewer morning erections, low energy, and sleep disturbances.

Sexual and nonspecific symptoms, such as fatigue, likely prompted measurements of testosterone in this selected population, the researchers pointed out.

They concluded that “clinicians should consider screening for depression/depressive symptoms and overweight and unhealthy lifestyle risk factors in men referred for tertiary care for potential hypogonadism.”

Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men, the researchers said.

The researchers published their results online on July 1, 2015 in the Journal of Sexual Medicine.

References:

Westley CJ, Amdur RL, Irwig MS. High rates of depression and depressive symptoms among men referred for borderline testosterone levels.  J Sex Med. 2015 Jun 30. doi: 10.1111/jsm.12937. [Epub ahead of print]