Can Low Testosterone Cause Anxiety and Depression?

October 6, 2022 / Men’s Health

Low testosterone levels can mimic symptoms of depression and cause anxiety over time

This article is a repost which originally appeared on Cleveland Clinic healthessentials.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our takes:

‧ Low testosterone will manifest itself via several symptoms.

‧ Depression can be a symptom but can also be a contributing factor to developing low T.

‧ Having too high levels of T may result in irritability/becoming easily angered.

If you’re experiencing low sex drive, diminishing energy and overall fatigue, you may feel like it’s just another part of getting older. But if you’re a man or a person assigned male at birth (AMAB) and you’re experiencing a host of physical symptoms, coupled with a consistent depressive mood, you could actually be dealing with hypogonadism (low testosterone) or undiagnosed depression.

But figuring out whether you’re dealing with depression or low testosterone is tricky and requires further examination from a healthcare provider. Urologist Lawrence Hakim, MD, explains more about the connection between low testosterone and your mood, and how these conditions may be related.

How low testosterone impacts your mood

Androgens, including testosterone, are the hormones that give people their “male” and “female” characteristics. They also play a critical role in puberty, the development of your sexual reproductive system and your ability to reproduce.

You can think of all hormones, including androgens, like switches on a circuit board: When the production of these hormones are turned on or off, different things happen. You can experience physical, mental and emotional changes whenever production of these hormones increase, decrease or stop completely. The severity of these changes can vary widely from one hormone to the next, and these changes don’t happen in a vacuum. When the levels of one hormone changes, others may change in response. An increase in one hormone might mean a decrease in others. And when you have these hormonal imbalances, it can cause a variety of conditions to develop.

Testosterone levels tend to decrease normally as you get older, but they can also fluctuate for many reasons. Studies show these changes in testosterone can impact your mood in different ways. And these changes can occur in response to many different factors, including stress, lack of sleep, changes in your diet, aging and increasing or decreasing your physical activity.

If your testosterone levels are too high, for example, you may feel irritable or quick to anger. In comparison, low testosterone can make you feel extremely tired, depressed, weak or low in energy.

“People with hypogonadism, or low testosterone, will often say they have no energy, no desire for sexual activity and that they noticed a decrease in muscle mass,” says Dr. Hakim.

“In fact, hypogonadism is often associated with increased fat mass and reduced muscle mass, which can lead to obesity and other health risks, including cardiovascular disease. Those are all common signs and symptoms that may be associated with low testosterone.”

Signs and symptoms of low testosterone and depression

Low testosterone and depression share a lot of the same symptoms, including:

‧ Irritability.
‧ Mood swings.
‧ Decreased libido.
‧ Fatigue.
‧ Lack of motivation.
‧ Social withdrawal.
‧ Anxiety.
‧ Difficulty focusing.
‧ Interrupted sleep and restlessness.

“When we say people are depressed, what are we describing? We’re often describing someone as having low energy and no desire to partake in activities that normally bring them pleasure — these are common things we see with low testosterone, too,” notes Dr. Hakim. “Sometimes, people are actually misdiagnosed with clinical depression and they might instead have low testosterone or hypogonadism. It is therefore important to rule-out a physical cause of the condition, such as hypogonadism, prior to treatment.”

Various physical symptoms may be associated with either depression or low testosterone. People who have depression might complain of back pain or neck pain, but might not experience other symptoms typically associated with low testosterone that include:

‧ Decrease in muscle mass.
‧ Increase in breast tissue.
‧ Loss of strength.
‧ Sudden weight gain.
‧ Erectile dysfunction

And if you also have depression or even an anxiety disorder, your symptoms may worsen over time if low testosterone levels are leading to a further decline in sexual performance and libido.

“If you come in to see your doctor with any of these symptoms, especially if you have some form of sexual dysfunction, it is important to evaluate your total and free testosterone levels, since hypogonadism may be the underlying cause,” advises Dr. Hakim. “You don’t want to ignore low testosterone. You want to address it as well as look for any other underlying diagnosis that needs to be addressed.”

When to see a doctor

If you’re experiencing physical symptoms like sudden weight gain or decrease in your sex drive or sexual performance and other mental and emotional symptoms, you should talk to a doctor about testing your testosterone levels. There are many effective treatment options to restore your testosterone levels to the normal range, if your testosterone levels are abnormally low. But even if you discover you don’t have low testosterone levels, understanding those test results will often provide some reassurance and help your healthcare provider better understand and manage your symptoms.

“Many of these symptoms, especially as men get older, can be due to other factors such as stress, anxiety, pressure, work, aging, relationship issues and even other medications,” says Dr. Hakim. “Ultimately, a multispecialty approach is important to assure the best outcomes and patient satisfaction.”

The Opposite of Premature Ejaculation: Delayed Ejaculation (from The Ultimate Guide To Male Enhancement)

The following is a chapter taken from the book: The Ultimate Guide To Male Enhancement.

Our Takeaways:

· Delayed Ejaculation (DE) can be caused by a number of factors

· Poor masturbation habits in conjunction with pornography use appears to be a chief contributing factor to DE

· There are methods for mitigating and even reversing DE- to include exercises

Another less common, less understood but still notable issue is delayed (or impaired) ejaculation. This is a problem on the opposite end of the sexual spectrum from premature ejaculation. Delayed ejaculation is when an inordinate amount of intense stimulation and/or time is required to ejaculate. An extreme version of this problem can manifest itself in a condition known as anorgasmia- or the inability to orgasm. The clinical definition of delayed ejaculation is when you suffer from this condition for six months or greater.

Causes of Delayed Ejaculation

The most common cause of delayed ejaculation among younger men is due to poor masturbation habits. As men age, delayed ejaculation becomes more common. For men over the age of 50, the chance of experiencing delayed
ejaculation increases significantly, even without negative masturbatory conditioning.

A high frequency of ejaculations can also lead to temporary delayed ejaculations, as well as exhaustion and lowered libido. This becomes more notable as men age, as it’s common for the refractory period to lengthen. The remedy for delayed ejaculation caused by ejaculating too frequently is simply to avoid ejaculating for a few days to ensure full recovery.

The causes of age-related delayed ejaculation may be related to lowered androgen levels, though some men with
normal levels of androgens still appear to suffer these effects. If this is the case, specific treatments, as prescribed by a medical professional, or supplementation may be of assistance with this.

Certain medications can induce delayed ejaculation. Most notable among these are anti-anxiety medications, selective serotonin reuptake inhibitors (SSRIs), painkillers, and blood pressure medications. If your delayed ejaculation is caused by medication, please consult with your doctor to see if a change in dosage or medication is possible.

Lifestyle choices can also result in delayed ejaculation. Alcohol can cause a dulling of sensation, which can lead to temporary delayed ejaculation. Drinking daily can result in a chronic case of delayed ejaculation as well as lower your libido. The easiest way to correct this problem is to stop drinking completely. Even one beer can negatively affect your ability to orgasm. Getting daily exercise and eating a healthy diet can also help improve your orgasm responsiveness, as your body will feel better and your cardiac health will improve.

Low testosterone levels and libido may also case delayed ejaculation. This is often accompanied by erectile
dysfunction. To determine if your testosterone levels are abnormally low, your doctor can perform a simple blood test.

How to Combat Delayed Ejaculation

Viagra has been prescribed with good success for the treatment of delayed ejaculation. Some prescription medications may also improve the effect as well, notably those for Parkinson’s and certain anti-allergy drugs. Speak with your doctor about these options, to see if any of them are right for you.

The herb piper auritum kunth (hoja santa) has been promoted as an aphrodisiac in traditional medicine, but it has also been shown to be an effective agent at improving sensory thresholds. It’s also shown to be effective in improving electromyographic activity of pelvic floor. Ensuring you are getting necessary levels of zinc in your diet can go a long way toward minimizing sexual dysfunctions and ensuring optimal genitourinary health and function.

If your delayed ejaculation is due to poor masturbation habits and the desensitization of your penis, a great exercise to alleviate delayed ejaculation and to reset your sensory threshold is the “Reverse” Stop and Starts movement. The Reverse Stop and Starts is very simple to perform.

How to Perform the Reverse Stop and Start

Using an extremely light grip, attempt to ejaculate as quickly as possible.

Time yourself on this, and attempt to bring yourself to the 10-minute mark. From here, you should have reset your sensory threshold and can revert to the standard Stop and Starts for training. It won’t take many of these sessions to reset your sensory threshold!

The Emotional Component of Delayed Ejaculation

As with all stamina and other male enhancement exercises, it’s important to cultivate an emotional backdrop of confidence and a feeling of being unencumbered. Some cases of delayed ejaculation may have an emotional
component to it. In cases like these, repeated use of emotional visualizations during training can be effective at improving the timing of your ejaculations.

Stress and anxiety are huge factors in emotional delayed ejaculation. Worrying about other aspects of your life can result in a difficulty in orgasming. This then increases stress and anxiety while having sex, which exponentially can compound the problem and even lead to other sexual dysfunctions, like erectile dysfunction.
Speaking to a mental health professional can help if there’s an emotional component to your delayed ejaculation. They can help you address the underlying issues affecting you. They can also give you cognitive behavior exercises.

Communication is the Key When Dealing with Delayed Ejaculation

It’s important to note open communication with your partner when contending with any type of sexual dysfunction or less than satisfactory performance is vital. Communication and understanding can go a very long way in helping to resolve many of these issues, as emotional stress can often make them worse.

Delayed ejaculation can be just as devastating to a relationship as any other sexual dysfunction. For the man, it can be an ego crusher, when he can’t orgasm. It can also be physically frustrating and tiring. This often results in a reduced libido.

For their partner, it can also be equally ego-crushing. Your partner may worry they are doing something wrong. They may worry you’re no longer physically attracted to them. Perhaps the most destructive worry is the concern you’re being unfaithful. Be 100% up front with your partner about what’s going on, no matter how embarrassing and uncomfortable it may be. Reassure your partner the problem isn’t with them, and continue this reassurance, while you work on your delayed ejaculation.

Vaginal Laxity as a Contributor to Delayed Ejaculation

Communication becomes really important in cases where you may not have negative conditioning or even any
functional problems with ejaculation but are still experiencing delayed orgasm due to vaginal looseness in their sexual partner. The Kegel exercise is recommended for toning the vaginal walls and can also improve the intensity of orgasms for women. In extreme cases, surgery may be required or preferred to Kegels as a solution for vaginal laxity.

Broaching this sensitive subject can be difficult and requires great tact. One effective way of introducing the Kegel to women in cases of vaginal looseness is for the man to suggest vaginal contractions to his partner during penis-in- vagina (PIV) sexual contact. Repeated sessions of this type of activity should lead to increased tone and vaginal response in just a few weeks.

Another version of conditional delayed ejaculation is when your sexual partner can’t withstand long bouts of sexual activity due to health-related issues. As with the above, communication and alternate arrangements during sexual activity can go a long way toward creating better sexual harmony.

 

The Ultimate Guide to Male Enhancement

Testes: Anatomy and Function, Diagram, Conditions, and Health Tips

Testes: Anatomy and Function, Diagram, Conditions, and Health Tips

Medically reviewed by Alana Biggers, MD on May 29, 2018 — Written by Tim Jewell

This article is a repost which originally appeared on HealthLine

Edited for content

What are testes?

The testes — also called testicles — are two oval-shaped organs in the male reproductive system. They’re contained in a sac of skin called the scrotum. The scrotum hangs outside the body in the front of the pelvic region near the upper thighs.

Structures within the testes are important for the production and storage of sperm until they’re mature enough for ejaculation. The testes also produce a hormone called testosterone. This hormone is responsible for sex drive, fertility, and the development of muscle and bone mass.

Anatomy and function of testes

The main function of the testes is producing and storing sperm. They’re also crucial for creating testosterone and other male hormones called androgens.

Testes get their ovular shape from tissues known as lobules. Lobules are made up of coiled tubes surrounded by dense connective tissues.

Seminiferous tubules

Seminiferous tubules are coiled tubes that make up most of each testis. The cells and tissues in the tubules are responsible for spermatogenesis, which is the process of creating sperm.

These tubules are lined with a layer of tissue called the epithelium. This layer is made up of Sertoli cells that aid in the production of hormones that generate sperm. Among the Sertoli cells are spermatogenic cells that divide and become spermatozoa, or sperm cells.

The tissues next to the tubules are called Leydig cells. These cells produce male hormones, such as testosterone and other androgens.

Rete testis

After sperm is created in the seminiferous tubules, sperm cells travel toward the epididymis through the rete testis. The rete testis helps to mix sperm cells around in the fluid secreted by Sertoli cells. The body reabsorbs this fluid as sperm cells travel from the seminiferous tubules to the epididymis.

Before sperm can get to the epididymis, they can’t move. Millions of tiny projections in the rete testis, known as microvilli, help move sperm along to the efferent tubules.

Efferent ducts

The efferent ducts are a series of tubes that join the rete testis to the epididymis. The epididymis stores sperm cells until they’re mature and ready for ejaculation.

These ducts are lined with hair-like projections called cilia. Along with a layer of smooth muscle, cilia help move the sperm into the epididymis.

The efferent ducts also absorb most of the fluid that helps to move sperm cells. This results in a higher concentration of sperm in ejaculate fluid.

Tunica: Vasculosa, albuginea, and vaginalis

The testes are surrounded by several layers of tissue. They are the:

  • tunica vasculosa
  • tunica albuginea
  • tunica vaginalis

Tunica vasculosa is the first thin layer of blood vessels. This layer shields the tubular interior of each testicle from further layers of tissue around the outer testicle.

The next layer is called the tunica albuginea. It’s a thick, protective layer made of densely packed fibers that further protect the testes.

The outermost layers of tissue are called the tunica vaginalis. The tunica vaginalis consists of three layers:

  • Visceral layer. This layer surrounds the tunica albuginea that shields the seminiferous tubules.
  • Cavum vaginale. This layer is an empty space between the visceral layer and the outermost layer of the tunica vaginalis.
  • Parietal layer. This layer is the outermost protective layer that surrounds almost the entire testicular structure.

What conditions affect the testes?

Many conditions can affect the testes. Here’s a list of some of the most common ones.

Hydrocele

A hydrocele happens when excess fluid builds up in the cavities around one of your testicles. This is sometimes present at birth, but it can also result from an injury or inflammation.

Hydrocele symptoms include:

  • testicular swelling that gets more noticeable as the day goes on
  • a dull ache in your scrotum
  • feeling heaviness in your scrotum

Hydroceles usually don’t require treatment unless they’re very large or painful. Most go away on their own, but more severe cases might require surgical removal.

Testicular torsion

Testicular torsion means that your testicle has rotated in the scrotum. This can wind up the spermatic cord, cutting off blood supply, nerve function, and sperm transport to your scrotum.

Symptoms of testicular torsion include:

  • severe scrotum pain
  • swelling of the testicle
  • lower abdominal pain
  • feeling nauseous
  • vomiting
  • feeling like the testicle is out of place
  • urinating more than usual

Several things can cause testicular torsion, including:

  • injury to the scrotum
  • exercising too long or hard
  • being exposed to cold temperatures
  • free movement of the testicle in the scrotum caused by a genetic condition

Your doctor can treat testicular torsion by moving the testicle by hand. Some cases might require surgery to untwist the spermatic cord.

Orchitis

Orchitis refers to a swollen or inflamed testicle. Like epididymitis, orchitis often results from an infection caused by an STI.

Orchitis symptoms include:

  • testicular pain and tenderness
  • a swollen testicle
  • fever
  • feeling nauseous
  • vomiting

Both bacterial and viral infections can cause orchitis. A combination of antibiotics or antiviral medication, along with nonsteroidal anti-inflammatory drugs or cold packs can help reduce discomfort and pain. Orchitis usually disappears in 7-10 days.

Hypogonadism

Hypogonadism happens when your body doesn’t make enough testosterone. It can result from a testicular issue or because your brain doesn’t properly stimulate hormone production.

You can be born with this condition. It can also happen due to an injury, infection, or other condition that affects testosterone production.

Symptoms of hypogonadism vary depending on age:

  • In infants. The genitals might not be clearly male, or both sets of genitals might be present.
  • In teenagers. Symptoms may include:
    • a lack of muscle development
    • little body hair growth
    • no voice deepening
    • unusual arm and leg growth relative to the rest of the body
  • In adults. Symptoms may include:
    • a lack of fertility
    • loss of body hair
    • growth of breast tissue
    • loss of bone density
    • an inability to get an erection

Hypogonadism is usually treated with hormone replacement therapy. It’s aimed at either the brain or testes, depending on the source of low testosterone production.

Testicular cancer

Testicular cancer happens when cancerous cells multiply within the tissue of your testicles. It commonly starts in the tubular testicle structures that help produce sperm.

The cause of testicular cancer isn’t always clear.

Symptoms of testicular cancer can include:

  • a lump in your testicle
  • feeling heaviness in your scrotum
  • fluids in your scrotum
  • testicular pain
  • abdominal or back pain
  • swollen or tender breast tissue

Sometimes, your doctor can surgically remove the affected tissue. In other cases, you may need to have an entire testicle removed. Radiation therapy or chemotherapy can also help destroy cancer cells.

What are common symptoms of a testicular condition?

See your doctor if you notice any of the following symptoms in one or both of your testes:

  • long-term pain that’s either dull or sharp
  • swelling
  • tenderness
  • a sensation of heaviness

Other symptoms of a problem with the testes include:

  • feeling sick
  • throwing up
  • abnormal abdominal or back pain
  • having to pee frequently
  • abnormal growth of breast tissue

Tips for healthy testes

Try the following to keep your scrotum in good health:

Do a monthly testicular self-exam

Roll each testicle around in your scrotum using your fingers. Check for lumps and swollen or tender areas.

Bathe regularly

Take a shower or bath every day to keep your entire genital area clean. This reduces your risk of infections that can cause other complications. Keep your penis and scrotal area dry after bathing. Moisture trapped in the area can quickly become a breeding ground for bacteria.

Wear loose, comfortable clothing

Try to avoid wearing tight underwear and pants. Allow your scrotum to hang naturally from your body to help keep the scrotal temperature low and prevent injury.

Wear protection when you have sex

Wear a condom when doing any kind of sexual activity involving your penis. This helps to prevent sexually transmitted diseases that affect your scrotum and testicles.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.