Acute decrease in testosterone level has few negative effects on healthy men

October 04, 2004

CHICAGO - Short-term, artificially-induced reductions in testosterone levels in healthy young men had little effect on mood or depressive symptoms, according to an article in the October issue of The Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, levels of androgens (hormones, including testosterone) decrease with age in men, sometimes leading to hypogonadism, a condition characterized by decreased testicular functioning. Hypogonadism may also have negative effects on bone metabolism, muscle mass, and mood and behavior. Some studies have shown that the administration of androgens causes mood changes in men, and other studies, administration of testosterone produced anti-depressant-like effects in hypogonadal men. However, no studies have examined the relationship between mood and acute suppression of testosterone.

Peter J. Schmidt, M.D., of the National Institute of Mental Health, Bethesda, Md., and colleagues studied the effects of medication-induced hypogonadism in 31 healthy men (aged 23 to 46 years) by administering leuprolide acetate (a drug that lowers testosterone levels in the body) every four weeks for three months. Then, in addition to leuprolide, participants received testosterone enanthate (a testosterone replacement drug) or placebo every two weeks for one month. Participants then switched groups (those receiving testosterone enanthate received placebo and vice versa). Mood and behavior questionnaires were completed and blood samples were taken at clinic visits every two weeks throughout the study.

The researchers found that men taking leuprolide plus placebo had significantly lower blood levels of testosterone than men taking leuprolide plus testosterone, and blood levels of testosterone were higher during testosterone replacement than before beginning the study (at baseline). With the exception of hot flushes, libido and feeling emotionally charged, there were no significant differences in symptoms between the leuprolide plus placebo and the leuprolide plus testosterone groups.

The researchers write, "Few subjects in this study developed negative mood symptoms during an otherwise dramatic albeit brief (four-week) withdrawal and replacement of testosterone under double-blind conditions."

They conclude: "These data, the first to describe the effects on mood of induced hypogonadism in healthy young men, suggest that short-term hypogonadism is sufficient to precipitate depressive symptoms in only a small minority of younger men. The predictors of this susceptibility remain to be determined."
-end-
(Arch Gen Psychiatry. 2004;61;997-1004. Available post-embargo at archgenpsychiatry.com)

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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