The Low Testosterone and Anti Depressant Connection

If you are a man (or women for that matter) and your testosterone is suboptimal and/or hypogonadal, You can experience low energy, lethargy, and depression like symptoms. Since 2009, Ive had numerous male clients who have reported feeling “down in the dumps”, and told me their energy just sucks.  They’ve gotten slower, weaker, and their attitude is negative. Often times, their spouses tell them to see a psychiatrist but I tell them to get their hormones checked. What almost always ends up happening? Their testosterone is low (or in some cases, non existent). Few doctors ever make the connections between these things, but the reality is that suboptimal testosterone dramatically impacts cognitive health and well being.

Your hormones=Your mental health 

(Originally published on Mental Health Daily) Many people that take antidepressants, specifically SSRI’s (selective-serotonin re-uptake inhibitors), find out that they have abnormally low testosterone. So what does this all mean? Did the initial low testosterone lead the individual to become depressed and go on an antidepressant? Or did the treatment with an antidepressant actually slowly reduce the individual’s natural ability to produce testosterone? It really is a “chicken vs. egg” type argument in regards to whether low T caused depression or an antidepressant caused low T. Unfortunately there is no clear-cut scientific answer as to whether the antidepressant you took caused your testosterone to be lowered. Most doctors and “experts” will tell you that it isn’t likely or “impossible” that these psychiatric drugs could have caused low T. With that said, new research comes out all the time finding new things about antidepressants (SSRI’s) – they really aren’t well understood. Many antidepressants medications are now linked to development of diabetes, birth defects, etc. Although there are no formal studies to link antidepressants with low testosterone, many people taking these drugs are convinced that they are the root cause.   There is really only one very small-scale study that found a link between antidepressant-induced sexual dysfunction and “low serum free testosterone.”

Do antidepressants (SSRI’s) lower testosterone levels?

The only real way to determine whether your antidepressant lowered your level of testosterone is to test yourself. Go get your testosterone levels checked before you start antidepressant treatment, and after awhile, get them checked again to see if they change. If your testosterone levels dropped after you had been on an antidepressant for awhile, it is likely that the drug you were on is a culprit for inducing lower testosterone. Based on the information that I’ve gathered from individuals that have tested their T levels before and during treatment, there seems to be no direct evidence supporting the idea that antidepressants lower testosterone. They can cause sexual dysfunction and inability to orgasm – but this does not mean that they necessarily lower testosterone as well. Is there a correlation between low testosterone, depression, and taking antidepressants? Yes. However it is important to keep in mind that correlation does not equal causation. Just because someone is depressed with low testosterone doesn’t mean that the antidepressants are the root cause of lowering the testosterone. It could have been that the lower testosterone was what caused the person to feel depressed in the first place. The low T could have also merely been a coincidence among those who are depressed – after all, having low T is a pretty common issue.

Factors: Antidepressants, Testosterone, Depression

There is really no conclusive evidence as to whether antidepressants are causing a person’s testosterone levels to drop. A couple of important factors to analyze include “antidepressants vs. testosterone” and “depression vs. testosterone.” Antidepressants and Testosterone: Many people taking antidepressants experience low testosterone. Similarly, many people with low testosterone are taking antidepressants. These two factors could also occur independently. In other words a person may develop low testosterone while on an antidepressant without the antidepressant being the cause. Depression and Testosterone: Many people may be experiencing depression as a result of low testosterone. Similarly many people may be experiencing low testosterone as a result of depression. Additionally, these two factors could be totally unrelated and independent of each other. In other words the depression could have nothing to do with low T and vice versa.

1. Depression and sex drive – Many people with depression tend to have lower than average sex drives. It is the depression that is thought to lead to disinterest in pleasurable activities like sex. People may be in such a depressed, low level of arousal, that they don’t feel like having sex. Therefore in this case, it could be that the depression and not testosterone is causing reduced sexual interest.
2. Testosterone and sex drive – It is well known that healthy testosterone levels are linked with a healthy sex drive. Men that have low T tend to have less fuel for sex, erectile dysfunction, and other performance issues. If your testosterone level were to be lowered, the natural result would be a reduced sex drive. This reduced sex drive could be linked to depression – therefore testosterone could play a role.
3. Low testosterone causing depression? – Individuals with lower than average levels of testosterone could be experiencing depressive symptoms as a result of their low T. Studies have found that among men with abnormally low levels of T, testosterone therapy helped reduce symptoms of depression. For this reason it is important to rule out all causes of depression (including low T) before you get on an antidepressant.
4. Antidepressants and low testosterone – It is well documented that antidepressants can affect hormones. Therefore some hypothesize that hormonal changes can influence our sex drive. It is not known whether antidepressants are the culprit behind lowering levels of testosterone. Many people that have taken SSRI’s believe that the drugs they took lowered their testosterone.

Testosterone has antidepressant effects in men

On average, men tend to naturally experience lower levels of testosterone by the time they reach age 50. By age 60 it is estimated that 1 in 5 men have problems with their testosterone. In cases where men experienced a reduction in their level of testosterone and simultaneously became depressed, increasing testosterone levels can be therapeutic. Testosterone not only plays a role in sexual arousal, but it also influences aggression, cognition, and emotional tone. In older men, testosterone therapy may prove to yield antidepressant effects. Most medical research demonstrates that testosterone can have positive effects on mood. It seems as though testosterone treatment tends to be most beneficial for males who are experiencing depression as a result of testosterone decline. Once again I’ll reiterate the fact that unless you checked your testosterone before taking an antidepressant and during or after, there’s no way to conclude that the antidepressant “caused” your testosterone to drop. Always get it checked before you go on any type of medication so that you have proof as to whether the T drop is a problem stemming from the antidepressant that you took. As I will continue to recommend to all men, read Jay’s book The Definitive TRT MANual to fully educate yourself to the fullest extent about Testosterone.