August 21, 2018
A systematic review published on July 14, 2018 in European Urology Focus found a significant association between the use of testosterone replacement therapy (TRT) and a reduction in symptoms of mild depression.
For their review, Mihai Dorin Vartolomei and colleagues at the Medical University of Vienna selected 15 randomized, placebo-controlled trials that included a total of 1,586 adult men with late-onset testosterone deficiency who were treated with TRT. Treatment duration ranged from six weeks to six months.
Testosterone replacement therapy was associated with a reduction in depressive symptoms among men with clinical mild depression. The therapy was also associated with decreased depressive symptoms in men without pretreatment depression. Treatment with the hormone was not found to be associated with improvement among men with major depressive disorder; however, the authors note that in the current studies, men with major depressive disorder received only six weeks of TRT, which is unlikely to be sufficient to improve symptoms.
"Testosterone replacement therapy should thus be considered after taking into account all the risks, benefits, and alternatives in patients with dysthymia and mild depression as part of a shared decision-making process together with the patient," the authors conclude. "The optimal length and type of TRT and the synergistic effect with standard antidepressive strategies need to be further studied, taking into account long-term benefits, risks, and adverse events."