Borderline Testosterone Levels Linked to Higher Rates of Depression in Men

Men with borderline testosterone levels have higher rates of depression and depressive symptoms than the general population, according to a new study.

“Over half of men referred for borderline testosterone levels have depression,” said Michael S. Irwig, M.D., F.A.C.E., associate professor of medicine and director of the Center for Andrology in the Division of Endocrinology at George Washington University in Washington, D.C.

“This study found that men seeking management for borderline testosterone have a very high rate of depression, depressive symptoms, obesity and physical inactivity. Clinicians need to be aware of the clinical characteristics of this sample population and manage their comorbidities, such as depression and obesity.”

For their study, Irwig and his colleagues studied 200 men between 20 and 77 years of age whose testosterone levels were borderline (between 200 and 350 nanograms per deciliter).

The researchers collected the men’s demographic information, medical histories, medication use, and signs and symptoms of hypogonadism.

They then remeasured the men’s total testosterone and assessed depression from their medical history and with the validated Patient Health Questionnaire 9 (PHQ-9).

Using a score of 10 or higher on the PHQ-9, 56 percent of the men in the study had significant depressive symptoms, known diagnosis of depression and/or were using an antidepressant, according to the study’s findings.

Their rates of depressive symptoms were markedly higher than the 15 percent to 22 percent in an ethnically diverse sample of primary care patients and the 5.6 percent among overweight and obese U.S. adults, the researchers noted.

The most common symptoms reported were erectile dysfunction (78 percent), low libido (69 percent), and low energy (52 percent).

The men in the study also had a high prevalence of overweight (39 percent), obesity (40 percent) and physical inactivity, according the researchers. They found that, other than walking, 51 percent of the men did not engage in regular exercise.

“This study underscores the utility of a validated instrument to screen for depression, especially as some subjects may deny signs and symptoms during the interview,” Irwig said. “Appropriate referrals should be made for formal evaluation and treatment of depression.”

The study’s results were presented at the annual meeting of the Endocrine Society in San Diego.

Source: The Endocrine Society