Can Low Testosterone Cause Depression? What the Evidence Shows

By Noophoric Editorial Team Updated August 31, 2026

Short answer: Low testosterone can be associated with low mood and depressive symptoms in some men, but depression usually has multiple possible causes. Fatigue, poor concentration, reduced motivation and low libido can occur with either condition, so symptoms alone cannot tell you whether testosterone is responsible.

Low testosterone should be diagnosed only when compatible symptoms occur alongside consistently low blood-test results. Testosterone therapy is not a substitute for evidence-based depression care.

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Key takeaways

Men with depression have had lower average testosterone levels in some studies, but an association does not prove that low testosterone caused the depression.
Depression and testosterone deficiency share several nonspecific symptoms.
A diagnosis of hypogonadism requires symptoms plus consistently low testosterone measurements, usually confirmed with a second morning test.
Testosterone replacement therapy (TRT) may produce small mood improvements in some men with confirmed hypogonadism, but it has not been shown to treat major depressive disorder reliably.
Do not delay mental-health care while investigating a possible hormone problem.

Can low testosterone cause depression?

Low testosterone may contribute to depressive symptoms in some men, especially when it occurs with other signs of hypogonadism. However, it is rarely possible to identify testosterone as the sole cause of depression.

Depression is a medical condition influenced by biological, psychological and environmental factors. The National Institute of Mental Health notes that genetics, biology, environment and psychology can all play a role.^[1] Testosterone is only one possible part of that larger picture.

A 2019 systematic review and meta-analysis compared reproductive hormones in men with depressive disorders and healthy controls. Across 17 studies, testosterone was lower on average in the depressed groups, while luteinizing hormone and follicle-stimulating hormone did not differ significantly.^[2] This supports a relationship, but it does not establish which condition came first or whether another factor affected both.

The relationship may work in both directions

Testosterone deficiency can affect sexual function, body composition, sleep, energy and overall well-being. Those changes may contribute to emotional distress or make existing depression harder to manage.

Depression may also be associated with behaviors and health changes that influence testosterone, including disrupted sleep, reduced physical activity, weight changes, chronic illness and changes in alcohol or drug use. Some medications can affect sexual function or reproductive hormones as well. If symptoms began after starting psychiatric medication, see our evidence-based guide to antidepressants and testosterone levels and discuss the timing with the prescribing clinician.

Because the relationship can be bidirectional, a single testosterone result cannot determine the cause of someone’s mood symptoms.

Symptoms shared by low testosterone and depression

Symptoms that can occur with either condition include:

Low energy or persistent fatigue
Reduced motivation or enjoyment
Difficulty concentrating
Sleep disturbance
Irritability or low mood
Reduced sexual desire
Changes in physical performance

These symptoms are important, but they are not specific enough to diagnose testosterone deficiency. Depression, sleep apnea, thyroid disorders, anemia, medication effects and other conditions can produce a similar pattern.

Signs that make testosterone deficiency more likely

A clinician may be more likely to investigate testosterone when mood or energy changes occur with signs such as:

Reduced spontaneous or morning erections
Persistent low sexual desire
Infertility or reduced sperm production
Loss of body hair or reduced shaving frequency
Hot flashes when testosterone is severely low
Unexplained anemia, reduced bone density or loss of muscle mass
A condition or medication known to affect the testes, pituitary gland or hypothalamus

Even these findings require proper evaluation. Some men have low laboratory values without meaningful symptoms, while others have symptoms despite testosterone values within the laboratory reference range.

When should someone with depression have testosterone tested?

Routine testosterone screening is not recommended for every man with depression. Testing may be reasonable when depressive symptoms occur with sexual symptoms, infertility, physical signs of androgen deficiency or a relevant medical history.

The Endocrine Society recommends diagnosing hypogonadism only in men who have compatible symptoms or signs and unequivocally, consistently low testosterone concentrations. An initially low result should be confirmed with a repeat morning fasting total-testosterone measurement using an accurate assay.^[3]

If low testosterone is confirmed, a clinician may measure luteinizing hormone and follicle-stimulating hormone to help distinguish a testicular cause from a pituitary or hypothalamic cause. Other testing depends on the medical history and results.

Testosterone can vary from day to day and may be temporarily affected by acute illness, inadequate sleep, significant calorie restriction and some medications. One low result should not automatically lead to TRT.

Can testosterone therapy improve depression?

Possibly, but the average effect appears modest and depends heavily on the population being studied.

A 2019 meta-analysis of 27 randomized trials involving 1,890 men found that testosterone treatment was associated with a small reduction in depressive symptoms compared with placebo. The authors also noted substantial differences among the studies and called for better trials designed specifically around depression outcomes.^[4]

More recent evidence adds important context. A 2024 depression substudy from the large TRAVERSE trial included middle-aged and older men with symptoms of hypogonadism and two low morning testosterone measurements. TRT produced small average improvements in mood and energy, but it did not improve sleep or cognition. Among the small group meeting rigorous criteria for persistent depressive disorder, remission was not significantly different from placebo. Men with more severe depressive symptoms also did not show a significant mood benefit in a post hoc analysis.^[5]

These findings do not support using testosterone as a general antidepressant. The American College of Physicians recommends considering testosterone for age-related low testosterone primarily when sexual dysfunction is present—not as a treatment to improve energy, vitality, physical function or cognition.^[6]

What to do if you have depression and suspect low testosterone

Address the depression directly. Speak with a qualified healthcare or mental-health professional rather than waiting for hormone testing to solve the problem.
Describe the complete symptom pattern. Mention sexual symptoms, changes in erections, sleep problems, medication timing, fertility concerns and relevant medical conditions.
Ask whether testing is appropriate. If the clinical picture supports it, obtain properly timed testing and confirm a low result before discussing treatment.
Look for other contributors. Sleep apnea, thyroid disease, anemia, substance use, chronic illness and medication effects may need evaluation.
Do not start testosterone on your own. TRT requires a valid diagnosis, consideration of fertility, discussion of contraindications and ongoing monitoring.

Testosterone therapy can suppress sperm production and is generally inappropriate for men planning fertility in the near term. It may also be unsuitable with elevated hematocrit, untreated severe sleep apnea, certain prostate or breast conditions, recent heart attack or stroke and several other circumstances identified in clinical guidelines.^[3]

Frequently asked questions

How can I tell whether my symptoms come from depression or low testosterone?

You usually cannot tell from fatigue, mood or libido alone. A clinician considers the complete symptom pattern, performs an examination when appropriate and uses properly timed blood tests to evaluate testosterone deficiency.

What testosterone level causes depression?

There is no single testosterone number that proves depression is hormone-related. Laboratories use different assays and reference ranges, and guidelines require both compatible symptoms and consistently low measurements.

Should I try TRT if antidepressants have not worked?

Not unless a clinician confirms testosterone deficiency and determines that TRT is otherwise appropriate. TRT has not been shown to reliably treat major depressive disorder or replace established depression treatments.

Can depression lower testosterone?

It may be associated with lower testosterone in some men, either directly or through related changes in sleep, weight, activity, health and medication use. The direction of the relationship is often difficult to determine.

Does this information apply to women?

This article focuses on adult men because the diagnostic guidelines and most treatment trials discussed here studied men. Testosterone evaluation and treatment in women involve different indications and should be discussed with a qualified clinician.

The bottom line

Low testosterone can coexist with depression and may contribute to mild depressive symptoms in some men, but it should not be assumed to be the cause. The safest approach is to evaluate depression and possible hormone deficiency in parallel: treat urgent or persistent mental-health symptoms, test testosterone only when clinically appropriate and confirm low results before considering TRT.

Sources

Evidence reviewed August 2026. This article is for educational purposes and is not a substitute for diagnosis or treatment from a qualified healthcare professional.