[Testosterone and depression in men aged over 50 years. Andropause and psychopathology: minimal systemic work-up]

A reduced feeling of well being with unusual anxiety and irritability, nervousness, mood swings and a depressive state are often mentioned as the psychological symptoms of the age-related hypogonadism. However, psychological aspect of andropause has not yet been specifically studied and most data on psychological symptoms come from researchers' clinical impressions rather than from systematic studies. Therefore, it seems premature to assign them to the age-associated decline in testosterone levels. The implication of testosterone in psychological state has yielded mixed results. Among elderly men, lower testosterone levels were associated with depressive or dysthymic symptoms. Moreover, lower testosterone levels were reported in men with depression, independently of age. In contrast, some studies did not observe any significant difference in testosterone levels between depressed men and controls. Furthermore, several studies have suggested that testosterone replacement improved mood in hypogonadal men, but others did not, as in studies on eugonadal men. Several researchers have also suggested the potential use of testosterone as an antidepressant or adjuvant to current treatments in depressed hypogonadal men. The relationship between andropause and psychological symptoms such as depression is far from clear. Andropause may be associated with "minor depressive symptoms" that are not considered as pathological. Psychological manifestations do not appear specific to andropause and probably have a multifactorial origin.