The Sexual Effects of Testosterone Replacement in Depressed Men: Randomized, Placebo-Controlled Clinical Trial

Department of Psychiatry, Columbia University, New York, New York, United States
Journal of Sex and Marital Therapy (Impact Factor: 1.27). 06/2006; 32(3):267-73. DOI: 10.1080/00926230600575355
Source: PubMed


Symptoms of male hypogonadism such as low libido and erectile dysfunction (ED) respond to testosterone (T) replacement. In hypogonadal men with major depressive disorder (MDD), the extent to which T replacement alleviates sexual symptoms of hypogonadism is not known. We conducted 6 week double-blind placebo-controlled clinical trial in men with low and low-normal T levels (i.e., total T <or= 350 ng/dl) and MDD. Men were randomized to receive weekly intramuscular injections of either T enanthate 200 mg or sesame-seed oil (placebo). The primary outcome measure was self-reported sexual functioning. We randomized 30 patients. The mean age was 52(SD +/- 8) years, mean T level 262.5(SD +/- 8) ng/dl, and mean baseline Hamilton Rating Scale for Depression (HAM-D) score 21(SD +/- 8). At baseline, sexual function was low, with the majority reporting having had normal erectile and orgasmic functioning 0-1 time in the preceding month. All patients who received T achieved normalization of their T levels. The HAM-D scores decreased significantly in both T and placebo groups, and there were no significant between-group differences: reduction in mean HAM-D score from baseline to endpoint was 10.1 in patients who received T and 10.5 in those who received placebo. Self-reported sexual functioning improved slightly in both groups; a between-group difference was not detected. Both T replacement and placebo were associated with improvement in sexual function and mood, but differences between T and placebo were not distinguishable.

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    • "These symptoms overlap with disease characteristics of major depression [3] [4]. Testosterone treatment can enhance several aspects of mood and cognition in hypogonadal men [5], it normalizes synaptic neurogenesis, and it reduces depressive symptoms [6]. Still, the role of reduced androgens in psychiatric problems, such as mood disorders, remains largely unknown. "
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    Nuclear Medicine and Biology 02/2015; 42(6). DOI:10.1016/j.nucmedbio.2015.02.003 · 2.41 Impact Factor
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    • "Emotional functions [24–26], energy and drive functioning [27–29], cognitive functions [30–32], employment [33–35], and relationship with the others [36–38] were the most common psychosocial problems emerging both in the literature and the patients' answers. The frequency of the appearance of PSDs was also comparatively identical. "
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