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Normative hypogonadism and depression: Does 'andropause' exist?

S N Seidman1

  • 1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. sns5@columbia.edu

International Journal of Impotence Research
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Summary

Aging men often experience declining testosterone levels, leading to hypogonadism. This review examines the link between androgens, or testosterone deficiency, and depression in older men.

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Area of Science:

  • Endocrinology
  • Geriatrics
  • Men's Health

Background:

  • Testosterone levels progressively decline with age, affecting at least 25% of men over 70.
  • Age-associated hypofunctioning of the hypothalamic-pituitary-gonadal (HPG) axis, termed 'andropause', is linked to symptoms in elderly men.
  • Symptoms may include sexual dysfunction and depression, though direct correlations with testosterone levels are challenging to establish.

Purpose of the Study:

  • To review the relationship between androgens and depression in aging men.
  • To explore the concept of 'andropause' and its potential impact on mood.

Main Methods:

  • Literature review of cross-sectional and longitudinal studies.
  • Analysis of evidence regarding testosterone replacement therapy and its effects.
  • Examination of the link between HPG-axis dysfunction and depressive illness.

Main Results:

  • Testosterone deficiency (hypogonadism) is common in older men.
  • Testosterone replacement may improve muscle strength, bone density, and erectile function.
  • Evidence linking HPG-axis dysfunction to depression is limited; androgens are not consistently antidepressant.

Conclusions:

  • While andropause is associated with various symptoms in aging men, its direct link to depression is not well-established.
  • Further research is needed to clarify the role of androgens in mood disorders in older men.
  • Testosterone replacement shows benefits for physical symptoms but not consistently for depression.