Can Low Testosterone cause Anxiety?

Low Testosterone affects millions of men, and the number is rising. Is anxiety a good symptom of hypogonadism, and how do you fix it?

Testosterone is generally associated with male sex drive. When you hear the term “low testosterone,” the first thing that might spring to mind is a poor sex life or physical difficulties such as erectile dysfunction.

However, testosterone also plays a role in far more than just getting you aroused. Testosterone is a hormone that has a major influence on one’s emotional health and is associated with increased stress, anxiety, and sadness.

The hormone is produced by the gonads and is regulated by the hypothalamus and pituitary glands, the parts of the brain involved in regulating hormones. According to a global study testosterone deficiency (TD) in men ranges from 10-40% and is known to increase with age.

Treatment for TD with testosterone replacement therapy (TRT) is becoming more popular, with a concentration on the possible advantages in mental well-being. But Can Low Testosterone cause Anxiety?

Normal Testosterone Levels

Testosterone is an essential hormone for men. According to the American Urological Association, men should have, on average, testosterone levels of at least 300 ng/dL. Levels below 300 ng/dL may be considered a testosterone abnormality.

However, it’s important to note that testosterone levels can vary throughout the day and even from one day to the next. So if your testosterone levels are below 300 ng/dL on just one test, it might not necessarily mean you have testosterone deficiency.

Low Testosterone on Mood and Anxiety

Low levels of testosterone can cause a man to feel sad or blue, have trouble concentrating, and feel exhausted all the time. Other symptoms include irritability, decreased interest in sex, and erectile dysfunction. Low testosterone levels can also cause physical changes such as increased body fat, reduced bone density, and shrunken testicles.

Anxiety is a common mental health condition that causes feelings of fear, worry, and uneasiness. It can be mild or severe, and it can last for a short time or long periods of time. Low levels of testosterone have been linked to anxiety in both men and women.

What we know so far

A study published in the journal Hormones and Behavior found that men with subpar levels of testosterone was associated with increased anxiety in men. The study looked at 86 men with low levels of testosterone and found that those with the lowest testosterone levels had the highest levels of anxiety.

Another study published in The Journal of Clinical Psychiatry found that testosterone replacement therapy improved anxiety symptoms in men with low T.

The study included 43 men who were treated with testosterone replacement therapy for 12 weeks. At the end of the study, the testosterone-treated group had significantly lower levels of anxiety than the placebo group.

Causes of Low Testosterone

There are many possible causes of low testosterone. One common cause is simply aging. After the age of 30, testosterone levels in men drop by about 1% each year. This may not seem like much, but over time, the effects can be significant. Failure to produce sufficient testosterone in the gonads is known as hypogonadism.

The loss of testosterone in the body can lead to mood changes and an increase in anxiety and depression. This is known as hypoandrogenism, a condition in which levels of testosterone are abnormally low.


There is a significant association between hypogonadism, anxiety, and depression with erectile dysfunction. Because low testosterone can result in a decrease in libido (sexual desire), difficulty achieving or maintaining an erection, and low sperm count.

The loss of testosterone can also cause symptoms such as fatigue, depression, irritability, and difficulty concentrating.

Testosterone levels are generally highest in the morning and decline throughout the day. This hormone imbalance may be why some men experience a “mid-life crisis” as levels of testosterone decrease.

The symptoms of low testosterone can also mimic those of other conditions such as anxiety and depression. It’s important to see a doctor to order some testosterone tests, properly diagnosis, and help you identify between the two types of hypogonadism.

Primary hypogonadism

This is a condition in which the testes fail to make testosterone. It can be caused by genetic defects, family history, injuries, or infections.

Secondary hypogonadism:

This occurs when the pituitary gland fails to produce enough of the hormone that stimulates testosterone production (luteinizing hormone) due to signal failures. It can be caused by stress, aging, anabolid-steroid use, obesity, or infections.

Men of all ages can have low testosterone, but it is generally more prevalent in men over the age of 30.

Testosterone and The Brain: The Connection

While it’s not entirely clear why testosterone affects peoples mood, some evidence suggests it has to do with testosterone being a neurosteroid (a hormone that can act on central nervous system functions).

The amount of testosterone plays a role in the activity of neurotransmitters (chemicals that transmit messages between nerve cells). This, in turn, affects mood and emotional state. In fact, testosterone is one of the steroid hormones that influence the function of neurons.

Testosterone receptors are found in various regions of the brain, including the hypothalamus, which is involved in the regulation of the stress response. Testosterone also affects the release of neurotransmitters such as serotonin and dopamine, which are associated with mood. It binds to androgen receptors in the brain which alters the excitability of neurons.

This results in changes in mood and behavior.

Testosterone Levels and Mental Health

Anabolic steroids (synthetic steroids that imitate testosterone) disrupt the hypothalamic-pituitary-gonads (HPG) axis, which is responsible for testosterone production. The testis is where testosterone is predominantly produced as a result lutenizing hormone being released from the pituitary gland. But, anabolic steroids can interfere with this process by binding to testosterone receptors in the brain, which leads to decrease production of bioavailable testosterone in the testis.

In 2005 a review was published that looked at the long-term psychiatric consequences of anabolic-androgen steroid (AAS) use in athletes. What they noted was that men who abused AAS exhibited more aggressive behavior, were far more anxious, and suffered from mood syndromes than those who did not use. This was one of the first reviews that outlined the influence of testosterone on mental stability.

Since then, several research have linked low testosterone to an increased level of anxiety in both men and women. In one study, men with low testosterone were more likely to have anxiety disorders than men with normal levels of testosterone.

Another preliminary study (which needs to be confirmed in a larger trial) found that men who were on testosterone replacement therapy (TRT) improved symptoms of anxiety and depression in men with low testosterone.

Low Testosterone in Women

Typically when discussing testosterone, it’s natural to think of men. However, women also produce testosterone, albeit in smaller quantities (about 15-70 ng/dL versus 300-1000 ng/dL in men). In women, testosterone is produced in the ovaries and adrenal glands.

Function of Testosterone in Women

When there is an imbalance of either more or less testosterone in women, it can have a wide range of effects. Testosterone levels fluctuate throughout a woman’s menstrual cycle, with levels peaking during ovulation (when an egg is released) and declining during the luteal phase (after ovulation).

Some functions of testosterone in women include:

– regulating sex drive

– improving energy levels

– fertility

Because there are already low levels of testosterone produced in women, even lower levels of testosterone in women could mean early onset of menopause or some adrenal problem.

Low Testosterone in Women and Mental Health Disorders

The effects of testosterone on mental health in women are not as well researched. However, some studies have suggested how low testosterone levels in women may be associated with depression and anxiety. In one study, testosterone was lower in women with major depression compared to healthy controls.

One of the first papers published in 1999 outlined the importance of testosterone in women. The women with adrenal problems were treated with DHEA, a hormone that helps produce other hormones like estrogen and testosterone, and found that testosterone increased and so did their reported scores for depression and anxiety.

Another study found that testosterone replacement improved symptoms of depression in postmenopausal women who had both low testosterone and depression. The study authors suggested that testosterone could have antidepressant effects in women as well.

Other Factors

The symptoms of low testosterone can be emotionally stressful, which can create a vicious cycle. When testosterone is low, it can cause anxiety and depression. But the stress of anxiety and depression can also lead to lower testosterone levels.

When you’re dealing with the frustration of low testosterone-related problems, it might put a strain on both your emotional well being and your relationships. According to director of Low T Center in Indianapolis, Aaron Davis, men with low testosterone typically report that the lack of sex drive is one of the anxiety-inducing problems.

“If a man’s testosterone levels are low, he may have less interest in sex. When you don’t have satisfying sex, it can lead to anxiety and relationship problems,” says Davis. “It becomes a vicious cycle.”

Testosterone Replacement Therapy

If you’re struggling with anxiety and think it might be due to low testosterone, there are treatment options available. One of the most common treatments is testosterone replacement therapy (TRT) or hormone replacement therapy.

Hormone therapy can come in a few different forms, including gels, injections, patches, and pellets that are placed under the skin. The most common choice are injections or patches and gel, which easily absorbs through your skin.

TRT is generally considered safe, but there are some risks involved. These risks include:

– acne

– sleep apnea

– enlarged breasts

– shrunken testicles

– lower sperm count

It’s also important to note that TRT is not prescribed as a cure for anxiety or depression. However, it can help alleviate some of the symptoms that might be causing anxiety or depression.

If you’re considering TRT, it’s important to speak with a doctor who specializes in testosterone replacement therapy. They will be able to discuss the risks and benefits of testosterone replacement therapy and help you make the best decision for your individual needs.

Signs of Low Testosterone levels

Finally, it’s worth noting that low T and your mental health issues often have similar symptoms. This can make it difficult to tease apart whether the cause of your anxiety or depression is low testosterone or something else entirely.

Some common signs and symptoms associated with both low testosterone and mental health issues include:

– fatigue

– irritability

– difficulty concentrating

– brain fog

– anxiousness

– Depression

If you’re experiencing any of these symptoms, it’s important to speak with a doctor. They will be able to help you determine whether the cause is low testosterone or another psychological health issue.

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Daniel Louwrens BSc PT

Daniel Louwrens BSc PT | Writer

Daniel Louwrens is a well-rounded fitness professional with over 10 years of experience in bodybuilding and fitness. He holds a BSc in Chemistry from the University of Western Cape and is a certified International Personal Trainer and Nutritionist. He is also a skilled bodybuilder and head coach for Muscle and Brawn. With his knowledge and expertise, he provides personalized training, nutrition, and recovery guidance to help clients reach their fitness goals.

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