Can Low Testosterone Cause Depression?

When it comes to men’s health, hormonal imbalances are often overlooked, especially when it comes to emotional well-being. Testosterone is widely known for its influence on physical characteristics and reproductive function—but its impact goes far beyond that. One increasingly researched question is: can low testosterone cause depression?

Understanding the relationship between testosterone levels and mental health is crucial. If you’ve ever asked yourself whether your mood changes or energy dips could be hormonal, this is for you.

Can Low Testosterone Cause Depression? 

For those asking, does low testosterone cause depression, scientific studies suggest a strong link between hormonal imbalance and mental health. Testosterone has direct effects on brain chemistry, particularly the neurotransmitters serotonin and dopamine—both of which play major roles in mood regulation. When testosterone levels drop, these chemical pathways may be disrupted, increasing the risk of depression.

Numerous men suffering from signs of low testosterone also report symptoms consistent with major depressive disorder. While correlation doesn’t always equal causation, the biological mechanisms behind the connection are becoming increasingly clear.

So, does low testosterone cause depression? Yes, and in many cases, treating the hormone deficiency can alleviate depressive symptoms significantly.

Can Depression Cause Low Testosterone? 

Interestingly, the relationship between testosterone and depression is bidirectional. Just as low testosterone can contribute to depression, depression can cause low testosterone.

For those asking, can depression cause low testosterone? Here’s how:

• Stress and cortisol: Chronic stress elevates cortisol levels, which suppress testosterone production.

• Lack of motivation: Depression may reduce physical activity and increase poor dietary choices—both of which negatively affect hormone levels.

• Disrupted sleep: Depression often interferes with sleep quality, which is critical for testosterone production.

• Inflammation: Depression can increase systemic inflammation, impairing hormonal balance.

Therefore, can depression cause low testosterone? Absolutely. This two-way relationship makes it critical for healthcare providers to assess both mental health and hormonal function when addressing either condition.

What is Testosterone?

Testosterone is widely known as the primary male sex hormone, but its influence extends far beyond sexual health. While it’s most abundant in men—produced primarily in the testicles—it also plays a vital role in the female body and is produced in smaller amounts by the adrenal glands in both sexes.

This powerful hormone is central to many aspects of physical, emotional, and psychological health. From muscle growth and energy levels to mood regulation and cognitive function, testosterone helps maintain many systems within the body.

What is the Role of Testosterone?

Healthy testosterone levels are essential for optimal function throughout the body. Here are the key functions of this hormone:

• Development of male reproductive tissues: Testosterone is responsible for the growth of the penis, testes, and prostate during puberty.

• Regulation of libido and sexual performance: It fuels sexual desire and contributes to erectile function and sperm production.

• Promotion of muscle mass and strength: Testosterone supports muscle protein synthesis, helping build lean muscle mass and maintain strength.

• Support of red blood cell production: The hormone stimulates bone marrow to produce red blood cells, promoting oxygen delivery throughout the body.

• Mood regulation and cognitive function: Testosterone affects neurotransmitters in the brain, influencing emotional stability, memory, and concentration.

Given the hormone’s wide-reaching impact, it’s not surprising that a significant drop in testosterone—known as hypogonadism or “low T”—can lead to a range of health issues. One of the most concerning is its potential link to mental health disorders, especially depression. This raises the question: can low testosterone cause depression?

Natural Decline and Hormonal Imbalance

For men, testosterone levels naturally decrease with age, typically starting in a man’s late 30s and continuing gradually over time. While this decline is expected, some men experience a steeper or earlier drop than others.

Lifestyle factors such as chronic stress, poor diet, obesity, and lack of physical activity can accelerate this hormonal decline. When testosterone levels fall below the healthy range (generally considered under 300 ng/dL), the result is often a cascade of low testosterone symptoms—both physical and emotional.

Low Testosterone Symptoms

When most people hear about low testosterone, their minds often jump straight to sexual dysfunction. While it’s true that testosterone plays a vital role in libido and sexual health, the hormone does much more than regulate desire. In fact, the signs of low testosterone are vast, affecting everything from physical stamina to mental well-being.

Physical Symptoms of Low Testosterone

A hormonal imbalance doesn’t just manifest in how you feel emotionally—it can significantly affect your body. Men with low testosterone often notice gradual but impactful changes in their physical health, strength, and appearance.

• Reduced Muscle Mass and Strength: Testosterone is a key player in muscle protein synthesis. When levels drop, maintaining or building muscle becomes more difficult—even with regular exercise.

• Increased Body Fat, Especially Around the Belly: Men with low T frequently experience an increase in abdominal fat. This is particularly concerning, as belly fat contributes to a vicious cycle of hormone imbalance and inflammation.

• Decreased Bone Density: Low testosterone reduces the stimulation needed to maintain bone density, increasing the risk of fractures or osteoporosis, particularly in older men.

• Hair Thinning or Hair Loss: Testosterone supports healthy hair growth. A drop in levels may accelerate balding or result in overall thinning across the body.

• Erectile Dysfunction (ED): While ED can stem from a variety of causes, low testosterone reduces nitric oxide production, a compound essential for erections.

• Low Libido (Reduced Sexual Desire): A noticeable dip in sexual interest is one of the hallmark signs of low testosterone, but it rarely occurs in isolation.

These physical issues, especially when they cluster together, are not just frustrating—they may also contribute to feelings of low self-esteem and emotional distress. That’s where the mental health component comes in.

Psychological and Emotional Symptoms of Low Testosterone

While physical signs may be easier to detect, the emotional and psychological consequences of low testosterone symptoms are just as important—and often more disruptive to daily life. Testosterone plays a crucial role in brain chemistry, mood regulation, and motivation. When levels decline, men may experience subtle or severe changes in how they think and feel.

• Persistent Fatigue and Low Energy: A lack of testosterone can make even simple tasks feel exhausting. Men often report a chronic sense of tiredness that doesn’t improve with rest.

• Difficulty Concentrating (“Brain Fog”): Testosterone influences cognitive clarity and focus. Reduced levels may cause forgetfulness, mental sluggishness, or trouble concentrating at work.

• Irritability and Mood Swings: Men with low T may feel emotionally unstable or more reactive than usual. Mood changes can range from mild irritability to uncharacteristic outbursts.

• Feelings of Sadness, Emptiness, or Hopelessness: Depression-like symptoms are common in men with low testosterone. Many report a lingering emotional numbness or a diminished sense of purpose.

• Loss of Motivation and Interest in Activities: A decline in testosterone often leads to anhedonia—the loss of pleasure in things that once brought joy, whether it’s hobbies, work, or relationships.

These emotional symptoms strongly resemble those of clinical depression, making it understandable why many ask: does low testosterone cause depression, or are depressive symptoms driving testosterone down?

Understanding Depression and Its Symptoms

Depression is not simply a temporary feeling of sadness or a low day—it’s a serious mental health disorder that can disrupt every aspect of life. From how you think and feel to how you sleep, work, and relate to others, depression can have wide-ranging and sometimes debilitating effects.

In the United States, over 6 million men experience depression annually. Unfortunately, many go undiagnosed due to stigma, cultural expectations, or the tendency to downplay emotional struggles. Some men may not even realize they’re depressed, instead attributing their symptoms to stress, fatigue, or aging.

When we look deeper into the root causes of depression in men, hormonal imbalances, particularly low testosterone, often emerge as a significant but overlooked factor. This leads us to ask: can low testosterone cause depression, and how can you tell the difference?

Common Symptoms of Depression

Depression manifests in many ways, and symptoms can vary depending on the individual. However, there are several hallmark signs to watch for—especially if they last for more than two weeks.

Emotional and Behavioral Symptoms

• Persistent sadness or low mood

• Loss of interest in hobbies, social activities, or relationships

• Feelings of hopelessness, emptiness, or pessimism

• Excessive guilt or feelings of worthlessness

• Suicidal thoughts or ideation

Physical and Cognitive Symptoms

• Sleep disturbances, including insomnia or oversleeping

• Changes in appetite and weight

• Fatigue or reduced energy levels

• Difficulty concentrating, remembering, or making decisions

• Slowed thinking, speech, or movement

For men in particular, depression may manifest differently. Instead of expressing sadness, many may:

• Become more irritable or angry

• Engage in risky behavior (reckless driving, gambling, substance use)

• Isolate themselves from loved ones

• Turn to alcohol or drugs as coping mechanisms

• Experience decreased work productivity or job performance

Who’s Most at Risk for Low Testosterone and Depression?

Not everyone has the same risk of developing low testosterone or depression—yet there’s significant overlap in the factors that contribute to both. Certain populations are more vulnerable due to a combination of age, lifestyle, medical history, and environmental stressors. Recognizing these risk factors is key to early intervention and prevention.

• Men Over 40: Testosterone levels naturally begin to decline around the age of 30–40, often dropping by about 1% per year. This gradual decrease can lead to noticeable low testosterone symptoms such as fatigue, reduced libido, and mood swings, which may contribute to the onset of depression.

• Individuals with Obesity or Diabetes: Excess body fat—particularly visceral fat—converts testosterone into estrogen, reducing overall hormone levels. Additionally, insulin resistance associated with type 2 diabetes can impair the body’s ability to produce and regulate testosterone. 

• People Exposed to Chronic Stress or Trauma: Prolonged stress elevates cortisol, a hormone that directly suppresses testosterone production. Individuals with high-stress lifestyles or unresolved trauma are more likely to develop depressive symptoms and experience disruptions in their endocrine system.

• Those with Poor Sleep Hygiene: Testosterone production peaks during deep sleep, particularly REM cycles. Inconsistent sleep patterns, insomnia, or sleep apnea can drastically reduce testosterone levels and exacerbate depressive symptoms such as irritability, low energy, and difficulty concentrating.

• Men with a Family History of Mental Illness or Hypogonadism: Genetic predisposition plays a significant role. A family history of depression, anxiety, or male hypogonadism (low T) increases your likelihood of developing either—or both—conditions. Being aware of this background can encourage earlier screening and preventative care.

• Substance Users (Alcohol, Steroids, Narcotics): Chronic use of substances like alcohol, anabolic steroids, or opioids disrupts the brain’s hormone regulation. These substances can both lower testosterone and alter mood chemistry, contributing to a cycle of emotional instability and physical decline.

Diagnosing Low Testosterone and Depression

For many men, experiencing unexplained fatigue, mood swings, or lack of interest in life often leads to frustration and confusion. These symptoms may appear psychological, but in many cases, they are rooted in hormonal imbalances. When it comes to identifying the cause—whether it’s a mental health disorder, a hormonal issue, or both—a comprehensive and well-rounded diagnostic approach is essential.

Testing for Low Testosterone

Testosterone testing involves more than a single blood draw. Since hormone levels can fluctuate daily—and are influenced by sleep, diet, and stress—it’s important to follow best practices for an accurate diagnosis.

What to Expect During Hormone Testing

• Morning Blood Draws: Testosterone peaks in the early morning, making 7:00 to 10:00 AM the optimal window for testing. Midday or evening tests may produce artificially low readings.

• Total Testosterone Levels: This test measures the total amount of testosterone circulating in your blood. Readings below 300 ng/dL typically suggest low testosterone, although some men with borderline levels (300–400 ng/dL) may still exhibit low testosterone symptoms.

• Free Testosterone Measurement: Free testosterone is the bioavailable hormone not bound to proteins like SHBG (sex hormone-binding globulin). This form has the most physiological impact, especially on mood and energy.

• Repeat Testing: Because testosterone can fluctuate based on stress, sleep, and illness, your doctor may recommend testing on two or more separate occasions before confirming a diagnosis.

What Happens Next?

If your test results indicate a deficiency—and you’re also experiencing several signs of low testosterone—your doctor may diagnose you with male hypogonadism, commonly referred to as low T. From there, additional tests (e.g., LH, FSH, prolactin) may be ordered to determine whether the issue originates in the brain or the testes.

Screening for Depression

While hormone levels are measured in a lab, depression requires a different diagnostic approach. Diagnosing depression is a clinical process based on behavioral symptoms, mood patterns, and how these symptoms interfere with daily life.

Key Tools for Depression Diagnosis

• Self-Assessment Questionnaires: Tools like the PHQ-9 (Patient Health Questionnaire) are commonly used to identify depressive symptoms. These ask patients to rate the frequency and severity of issues such as sadness, fatigue, appetite changes, and suicidal thoughts.

• Clinical Interviews: A licensed psychologist, psychiatrist, or primary care provider will evaluate your mental health through in-depth questions about your mood, emotional triggers, family history, and lifestyle.

• Rule-Out Process: Since several conditions—like hypothyroidism, vitamin D deficiency, and chronic fatigue—mimic depression, physicians must rule out alternative causes through lab work and clinical history before making a definitive diagnosis.

Frequently Asked Questions

Age Is Just a Number—Low T Doesn’t Have to Be Your Reality!

If you’re struggling with unexplained fatigue, mood changes, weight gain, or loss of motivation, you’re not alone—and it’s not just “getting older.” A significant portion of the male population experiences low testosterone, and many suffer silently, believing there’s nothing they can do. But there is.

BioRestore in Connecticut offers Testosterone Replacement Therapy (TRT) that’s designed to get you back to feeling like your best self—not just within the “normal” range, but at the optimal levels you had in your prime. Think more energy, sharper focus, a stronger sex drive, and a body that works with you instead of against you.

Visit BioRestore today to learn how personalized TRT can help you restore your strength, confidence, and overall health.