How Low Testosterone And Depression Are Connected In Men

Low testosterone and depression are linked, but not in the simple way the hype around testosterone suggests. Low testosterone can flatten mood, drain energy, and lower sex drive, and those symptoms overlap so much with depression that the two are easy to confuse. What the evidence does not clearly establish is low testosterone acting as an independent cause of clinical depression. A 2025 study following more than 4,000 men aged 70 and older found no association between testosterone levels and the later onset of depression, even among men with low testosterone levels, though findings in younger men are less certain (Forbes et al., 2025). That distinction changes how a low mood paired with low energy should be handled. Marek Health treats low testosterone with testosterone replacement therapy only after lab testing confirms a deficiency, so testing comes before any conclusion.

The link between low testosterone and depression

The link between low testosterone and depression is mostly an overlap in symptoms, not a clean cause-and-effect chain. Low testosterone is associated with low mood, fatigue, and lost motivation, the same complaints that define depression. The relationship also runs both ways, since depression may itself contribute to lower testosterone (Indirli et al., 2023).

Testosterone acts on receptors in parts of the brain that help regulate mood, so it is reasonable that very low levels could affect how a man feels. The human data are mixed and weaker than that mechanism implies. In a NHANES analysis of more than 4,000 men, both unusually low and unusually high testosterone were tied to depressive symptoms, and the links pointed to specific physical complaints like appetite and sleep rather than depression as a whole (Määttänen et al., 2021).

Depression may also pull testosterone down. Depression may interfere with the hypothalamic-pituitary-gonadal axis, the signaling loop that tells the testes to make testosterone, which is one reason it can contribute to low testosterone and not only result from it (Indirli et al., 2023). Poor sleep, weight gain, and ongoing stress can lower it as well. So a man with a low result and a low mood could be facing depression driving the hormone, the hormone weighing on the mood, or two separate problems sharing a symptom list. Telling them apart is the real clinical task, which is why your results and symptoms have to be read together.

Shared symptoms of low testosterone and depression

Low testosterone and depression overlap on fatigue, low libido, poor concentration, irritability, and lost motivation, which is exactly why one gets mistaken for the other. The difference shows up in the symptoms that do not overlap. Depression tends to bring persistent sadness, hopelessness, and loss of pleasure, while low testosterone is more likely to come with loss of muscle, added body fat, and erectile difficulty. The full symptoms of low testosterone reach past mood, which is part of how a provider separates diagnosed hypogonadism from a mood disorder.

This comparison is general and not a substitute for medical evaluation. These symptoms overlap and vary from person to person, so a clinician should identify the cause.

Can low testosterone cause anxiety?

The evidence for an anxiety link is thinner than it is for depression. Men with low testosterone do report anxiety, along with insomnia and memory trouble, and mild symptoms may ease when a confirmed deficiency is treated (Indirli et al., 2023). But the size of that effect, and how often it happens, are not well established, and most of the stronger research has studied depressive symptoms rather than anxiety disorders. Any claim that testosterone fixes anxiety deserves caution, because the data do not back it.

When should you get your testosterone tested?

Get tested if you have ongoing symptoms like low mood, fatigue, low libido, or loss of strength, because identifying low testosterone depends on symptoms together with testing, not one result on its own. The American Urological Association defines testosterone deficiency as a consistently low testosterone level interpreted together with symptoms (Mulhall et al., 2018). The Endocrine Society advises confirming a low result with a second early-morning draw, since testosterone peaks in the morning and shifts day to day (Bhasin et al., 2018). One low reading is not enough on its own.

Testing has also gotten loose. Testosterone testing and prescriptions have nearly tripled in recent years, and the AUA notes that many men use testosterone without a clear indication (Mulhall et al., 2018). Chasing a number you saw online, with no symptoms behind it, is the wrong reason to start. A better first step is getting your testosterone tested with a full hormone panel, interpreted by a clinician, since a single result can mislead.

When treatment fits, testosterone therapy treats a confirmed deficiency, and results vary by individual. It may ease some mood symptoms tied to that deficiency, but it is not a treatment for depression, and severe depression is unlikely to improve with it (Indirli et al., 2023). Safety belongs in the conversation too. The FDA updated testosterone labeling in 2025 after the TRAVERSE trial, removing the older cardiovascular boxed warning, adding a warning about increased blood pressure, and keeping the limitation that testosterone is not approved for low testosterone caused by aging alone (FDA, 2025). In men at higher cardiovascular risk, the trial found no overall rise in major cardiac events but reported higher rates of atrial fibrillation, acute kidney injury, and pulmonary embolism, findings worth discussing individually (Lincoff et al., 2023). Testosterone therapy can also lower sperm production, an effect that varies between men and is not guaranteed to reverse, so fertility should be settled before you start. Dosing, monitoring, and whether to treat at all are decisions made with a licensed clinician from your labs and evaluation, and a prescription follows that evaluation rather than coming before it.

The honest read on low testosterone and depression is that the symptoms overlap, low testosterone can weigh on mood, and treating a confirmed deficiency may relieve some of those symptoms, yet testosterone is neither a cause of clinical depression nor a treatment for it. If low mood and low energy are showing up together, the next move is testing and a real evaluation, not a guess.

Disclaimer: This blog post is intended for informational purposes only and should not be considered medical advice. Always consult a healthcare professional before making changes to your health routine.

FAQs

How are low testosterone and depression connected? 

Low testosterone and depression are connected mainly through shared symptoms like fatigue, low libido, and low mood, not a clear cause-and-effect link. A 2025 study of more than 4,000 older men found no association between testosterone levels and the later onset of depression, even in men whose testosterone tested low, though findings in younger men are less certain (Forbes et al., 2025). The relationship can also run both ways, since depression may itself contribute to lower testosterone (Indirli et al., 2023).

Can low testosterone cause anxiety? 

Men with low testosterone sometimes report anxiety, insomnia, and memory problems, and mild symptoms may ease when a confirmed deficiency is treated (Indirli et al., 2023). The evidence here is weaker than for depression and the effect is not well quantified. There is no strong support for using testosterone to treat an anxiety disorder.

Does testosterone therapy treat depression? 

No. Testosterone treats a confirmed deficiency and may relieve some mood symptoms tied to it, but it is not a treatment for depression. Severe depression is unlikely to improve with testosterone therapy (Indirli et al., 2023).

How do you know if your testosterone is low? 

There is no single cutoff that fits everyone. The American Urological Association defines testosterone deficiency as a consistently low level judged together with symptoms, not a number alone (Mulhall et al., 2018). Because levels are highest in the morning and vary from day to day, a low result should be confirmed with a second early-morning blood draw (Bhasin et al., 2018).

What else can lower testosterone besides aging? 

Several things can. Beyond age, poor sleep, excess weight, and ongoing stress can lower testosterone, and depression may lower it as well (Indirli et al., 2023). The two can influence each other, which is part of why a low result is worth evaluating rather than assuming a single cause.

Is testosterone therapy safe for the heart? 

The TRAVERSE trial, in men with hypogonadism at higher cardiovascular risk, found no overall increase in major cardiac events but did report higher rates of atrial fibrillation, acute kidney injury, and pulmonary embolism (Lincoff et al., 2023). In 2025 the FDA removed the older cardiovascular boxed warning from testosterone labels and added a warning about increased blood pressure (FDA, 2025).

Can low testosterone and depression occur together? 

Yes. They share symptoms and can coexist, and the relationship can run in both directions, since depression itself may lower testosterone (Indirli et al., 2023). That overlap is why a man with low mood and low energy should have both evaluated rather than assuming one explains everything.

References

• Compr Psychoneuroendocrinol. 2021;6:100044

• FDA. Class-wide labeling changes for testosterone products. 2025

• Front Endocrinol (Lausanne). 2023;14:1198437

• J Clin Endocrinol Metab. 2018;103(5):1715-1744

• J Gerontol A Biol Sci Med Sci. 2025;80(6):glaf019

• J Urol. 2018;200(2):423-432

• N Engl J Med. 2023;389:107-117