Testosterone for Depression

Testosterone may be to be beneficial for depression in men who are low in testosterone and suffer from erectile difficulties. It has been found helpful in men who are depressed and HIV positive. AIDS disease sometimes markedly lowers testosterone. There is also one study showing testosterone may be of benefit for mood in women who have had their ovaries removed, but in these cases I would first try the much less expensive DHEA. Testosterone is available as a weekly injection or a daily patch by prescription only. High levels of testosterone illegally used by some weight lifters cause frequent rage reactions and even manic psychosis.

A prostate exam and PSA level should precede starting testosterone.  There is a concern that testosterone replacement therapy might increase the risk of prostate cancer.  A recent report details 20 men who developed prostate cancer within two years of starting testosterone.  The cases came from six urological practices (Gaylis, et al. UC San Diego, J Urology 8/05). 

Testosterone Sent Soaring by Attractive Female:  In a University of Chicago study, male students were paid to come in to have their saliva tested. Saliva tests showed the brief interaction with an attractive female assistant was enough to raise testosterone levels by as much as 30%. The more a man's hormone level shot up, the more attractive he later admitted to finding the research assistant. The research assistant herself was able to identify those men who found her attractive. The men who she judged to be doing the most to try to impress her proved to be those who registered the biggest jump in testosterone levels. However, little or no change was detected in the saliva of students who chatted with other men. James Roney, 11/03, Evolution and Human Behavior. (Ed: This is an interesting study.  One wonders when testosterone levels are being measured to decide whether a patient needs testosterone supplementation whether the attractiveness of the lab worker will cause a patient with low average testosterone have a briefly higher level reported.)

Maca Gelatin Increases Sex Desire in Men: 12 wk DB PC. Men aged 21-56 years received Maca in one of two doses: 1500 mg or 3000 mg or placebo. Self-perception on sexual desire, score for Hamilton test for depression, and Hamilton test for anxiety were measured at 4, 8 and 12 weeks of treatment. An improvement in sexual desire was observed at 8 wk with Maca. No effects on anx or depr. Lima,Peru, Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Gonzales GF, Cordova A, Vega K, Chung A, Villena A, Gonez C, Castillo S. Andrologia 2002 Dec;34(6):367-72

Low Testosterone Increased Arteriosclerosis, DHEA Trend: 1,032 nonsmoking men and women aged 55 yr and over. Aortic atherosclerosis by radiographic abdominal aorta. Relative to men with levels of total and bioavailable testosterone in the lowest tertile, men with levels of these hormones in the highest tertile had age-adjusted relative risks of 0.4. For women were 3.7 6) and 2.3. In men, testosterone also protected against progression of aortic atherosclerosis measured after 6.5 yr follow-up (P for trend = 0.02). In men, a protective effect of higher levels of DHEAS suggested. Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. Hak AE, Witteman JC, de Jong FH, Geerlings MI, Hofman A, Pols HA. J Clin Endocrinol Metab 2002 Aug;87(8):3632-9. With ageing, there is a decline in androgensl. There are implications for the health of ageing men as a result of hypogonadism. Overall, there seems to be an inverse relationship between body mass index and testosterone levels. Obesity seems to depress the production of testosterone. DHEA tends to decrease obesity in aging men. Impact of obesity on hypogonadism in the andropause. Tan RS, Pu SJ. Int J Androl 2002 Aug;25(4):195-201

No Effect on Blood Lipids: As compared with placebo, transdermal testosterone treatment of healthy elderly men for 3 years did not affect any of the lipid or apolipoprotein parameters that we measured. The effect of testosterone treatment on cardiovascular events was unclear, because the number of events was small. 108 men >65yo. Am J Med 2001 Sep;111(4):255-60

Testosterone No Benefit Depression in Small, Short Study: DB PC 30 men hypogonadal + MDD 6 wk. Testosterone enanthate 1 cc /wk. in 13. Clinical trial with depressed, hypogonadal men, antidepressant effects of testosterone replacement could not be differentiated from those of placebo. Testosterone replacement therapy for hypogonadal men with major depressive disorder: a randomized, placebo-controlled clinical trial. Seidman SN, Spatz E, Rizzo C, Roose SP. J Clin Psychiatry 2001 Jun;62(6):406-12

Testosterone Improves Memory in Older: 25 normal men 50-80yo, DB 100mg testosterone enanthate Qwk x 6. improvements in cognition were observed for spatial memory (recall of a walking route), spatial ability (block construction), and verbal memory (recall of a short story) in older men treated with testosterone compared with baseline and the placebo group. Testosterone supplementation improves spatial and verbal memory in healthy older men. Cherrier MM, Asthana S, Plymate S, Baker L, Matsumoto AM, Peskind E, Raskind MA, Brodkin K, Bremner W, Petrova A, LaTendresse S, Craft S. Neurology 2001 Jul 10;57(1):80-8

Testosterone + Letrazole Increase Boys Heights: DB 18 month study. Estrogen promote plate closure. Letrozole, used in advance breast CA, effectively inhibited oestrogen synthesis and delayed bone maturation. Progression of bone maturation was slower in the letrozole group than in the placebo group. In 18 months, bone age had advanced 1.1 (SD 0.8) years in the untreated group and 1.7 (0.9) years in the group treated with testosterone and placebo, but only 0.9 (0.6) years in the letrozole group (p=0.03 between the treatment groups). Predicted adult height did not change significantly in the untreated group and in the placebo group, whereas in the group treated with letrozole the increase was 5.1 (3.7) cm. U Helsinki, A specific aromatase inhibitor and potential increase in adult height in boys with delayed puberty: a randomised controlled trial. Wickman S, Sipila I, Ankarberg-Lindgren C, Norjavaara E, Dunkel L., Lancet 2001 Jun 2;357(9270):1743-8

Helps Stable Angina in Men: 46 men 12 wk DB PC 5mg/d via patch. Low-dose supplemental testosterone treatment in men with chronic stable angina reduces exercise-induced myocardial ischemia. Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina: A randomized, double-blind, placebo-controlled study. English KM, Steeds RP, Jones TH, Diver MJ, Channer KS. Circulation 2000 Oct 17;102(16):1906-11

Testosterone Helps Sex and Depression in Oopharectomized Women: DB PC 75 31-56yos. The ovaries provide approximately half the circulating testosterone in premenopausal women. All on estrogen 0.625/d. 300microg/d testosterone via patch was higher dose. At the higher dose the percentages of women who had sexual fantasies, masturbated, or engaged in sexual intercourse at least once a week increased two to three times from base line. The positive-well-being, depressed-mood, and composite scores of the Psychological General Well-Being Index also improved at the higher dose (P=0.04, P=0.03, and P=0.04, respectively, for the comparison with placebo), but the scores on the telephone-based diary did not increase significantly. CONCLUSIONS: In women who have undergone oophorectomy and hysterectomy, transdermal testosterone improves sexual function and psychological well-being. Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. Shifren JL, Braunstein GD, Simon JA, Casson PR, Buster JE, Redmond GP, Burki RE, Ginsburg ES, Rosen RC, Leiblum SR, Caramelli KE, Mazer NA.

Testosterone Improves Mood & Sex in Hypogonodal Men: T gel replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men with less skin irritation and discontinuation compared with the recommended dose of the permeation-enhanced T patch. 227 pt 6 months rx. UCLA, Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. Testosterone Gel Study Group. Wang C, Swedloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, Matsumoto AM, Weber T, Berman N. J Clin Endocrinol Metab 2000 Aug;85(8):2839-53

Testosterone Helped Elderly Men Muscle Mass in 3 Yr Study: DB PC 108 men>65yo 36 months, testosterone via patch. increasing the serum testosterone concentrations of normal men over 65 yr of age to the midnormal range for young men decreased fat mass (7#), principally in the arms and legs, and increased lean mass (4#), principally in the trunk, but did not increase the strength of knee extension and flexion. Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age. Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Lenrow DA, Holmes JH, Dlewati A, Santanna J, Rosen CJ, Strom BL., J Clin Endocrinol Metab 1999 Aug;84(8):2647-53. Also helps with bone density but only for elderly men in lower testosterone range.

Testosterone Can Increase PSA: DB 3 mo testosterone enanthate 100mg Qwk 13 men 57-75yo. Increase muscle mass, decrease cholesterol and LDL. Increase hemotocrit, but also some mild increase PSA. Suggests monitoring PSA. Effects of testosterone supplementation in the aging male. Tenover JS. U Wash, J Clin Endocrinol Metab 1992 Oct;75(4):1092-8

Testosterone in Elderly Helps Only Spacial Cognition: In a double-blind manner, verbal and visual memory, spatial cognition, motor speed, cognitive flexibility, and mood in a group of healthy older men who were supplemented for 3 months with testosterone were assessed. The increase in testosterone levels to 150% of baseline levels resulted in a significant enhancement of spatial cognition, but no change in any other cognitive domain was found. Testosterone influences spatial cognition in older men. Janowsky JS, Oviatt SK, Orwoll ES., Behav Neurosci 1994 Apr;108(2):325-32

Testosterone Increased Apnea: 17 healthy men over 60 years old three injections of testosterone or a placebo over three weeks. After an eight-week break, men who had had placebo received testosterone, and vice versa. The double-blind test conditions ensured that neither the subjects nor the researchers' behaviour would be influenced by knowing who was getting testosterone. While the men were on testosterone, they suffered 50 per cent more episodes of obstructed breathing, or apnoea, during each hour of sleep than when they were on the placebo (The Journal of Clinical Endocrinology and Metabolism 88: 3605, 8/03