Testosterontherapie: Ein neuer potenzieller Verbündeter gegen Depressionen?

Zuletzt aktualisiert: August 29, 2026

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Before anything else. Depression is a serious medical condition, and it is treated by doctors and mental health professionals — not by a hormone from a urologist. Nothing on this page is a reason to stop an antidepressant, delay seeing someone, or treat low mood as a hormone problem until it has been properly assessed.

If you are struggling badly, or having thoughts of harming yourself, please reach out now rather than reading on. In Thailand the Department of Mental Health runs a free 24-hour helpline on 1323. For a medical emergency, call 1669. If you are outside Thailand, contact your local emergency number or crisis line. Speaking to a doctor, a mental health professional or someone you trust matters more than anything on this page.

With that said, there is a genuine and interesting question underneath this topic, and men ask it often enough that it deserves a careful answer.

For many men, depression is more than feeling low — it is a heavy mix of persistent low mood, negative thinking and physical exhaustion. Standard antidepressants are the mainstay of treatment, and they do not work fully for everyone, which is part of why alternatives attract interest.

During my time as a Research Scholar and Clinical Observer at the Scott Department of Urology, Baylor College of Medicine, with Professor Mohit Khera, he often pointed out that low testosterone can quietly contribute to low mood in men. That is why I wanted to look closely at the evidence — including the parts of it that are usually left out of the headline.

Testosterone is more than a sex hormone; it is a systemic hormone that influences mood, energy and cognition, as I set out in why testosterone is a barometer of a man’s overall health. A 2019 study in JAMA Psychiatry asked whether that connection can be used therapeutically.

Was die Forschung ergab

Researchers pooled 27 clinical trials involving nearly 1,900 men to see whether testosterone treatment reduced depressive symptoms. The results were published in JAMA Psychiatry.

1. There Was a Real Signal

Testosterone treatment was associated with a significant reduction in depressive symptoms, and men on testosterone were roughly twice as likely as those on placebo to achieve a 50% or greater fall in depression scores.

That is a genuine finding and worth taking seriously. It is also a pooled result from 27 trials that differed considerably from one another — in the men they enrolled, the doses they used, and how depression was defined, with many participants having depressive symptoms rather than a diagnosis of major depression. A meta-analysis of varied small trials generates a hypothesis worth testing; it is not the same as a treatment being established.

2. The Dose Finding — and Why It Should Worry You Rather Than Tempt You

The effect was clearest in trials using higher doses, with the analysis pointing to regimens above roughly 500 mg per week.

This is the most misread number in the whole study, so let me be blunt about it. A normal replacement dose of testosterone is in the region of 50 to 100 mg a week. Five hundred milligrams a week is not a higher dose of therapy — it is several times replacement, in the territory of non-medical steroid use, and it is not what testosterone therapy at any responsible clinic involves. Doses like that were used in research settings for research reasons.

Read the other way round, this finding is a caution rather than a recommendation: the clearest antidepressant signal appeared at doses no one should be taking for their mood, which is a reason to be more sceptical about the result, not more enthusiastic. Nobody should seek out, or be offered, supraphysiological testosterone to treat low mood. The risks of that — to the blood count, the heart rhythm, fertility and the body’s own hormone production — are covered in testosterone therapy today.

3. Baseline Testosterone Did Not Predict Response

The analysis found the effect on mood did not clearly depend on how much testosterone a man started with: men with normal levels appeared to improve too.

This is often quoted as if it means any man with low mood might benefit. It does not mean that in practice. Giving testosterone to a man whose testosterone is normal is not treatment of a deficiency — it is a hormone given to someone who does not need it, and it is not something offered here or recommended in any guideline for depression. If anything, a result that does not track with the deficiency being corrected raises the question of whether the effect is really about testosterone at all.

Tolerability — and What Dropout Rates Do Not Tell You

• Acceptability: men were no more likely to drop out of testosterone treatment than placebo, which suggests it was tolerable over the trial periods. Worth noting that a dropout rate measures how many people stopped, not how safe something is — short trials are not designed to detect uncommon or delayed harm.
• Delivery: effects were seen across gels and injections. Testosterone here is provided as injection or gel; oral testosterone is not part of practice at Bangkok Hospital Headquarters.
• Timing: where improvement occurred, some men noticed it within about 3 to 6 weeks.

The wider safety picture of testosterone therapy has moved on since 2019, and it is worth reporting accurately rather than as a vague warning. The TRAVERSE trial found no increase in major cardiac events. Two of its adverse findings reached statistical significance: erythrocytosis, a thickening of the blood, by a wide margin the clearest; and a roughly 43% increase in clinical fractures in the fracture subtrial. Atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher on testosterone but did not reach statistical significance, and an earlier version of this page reported them without that qualification. Separately from the trial, therapy suppresses the body’s own testosterone and sperm production for as long as it continues.

That balance is a reasonable trade for a man with a confirmed deficiency and real symptoms. It is a poor trade for a man whose testosterone is normal and who is hoping it will lift his mood. The full account of the trial is in what TRAVERSE actually found.

The Direction People Miss

There is a more useful way to hold all this. Low mood, exhaustion and loss of drive overlap almost completely with the symptoms of testosterone deficiency — and also with those of sleep apnoea, thyroid disease, anaemia and simply being under sustained strain. A man who arrives convinced his problem is hormonal sometimes turns out to have untreated sleep apnoea; a man who has been treated for depression for two years without improvement sometimes turns out to have a genuine deficiency nobody measured.

The point of measuring testosterone in a man with persistent low mood is not to find a new treatment for depression. It is to avoid missing a treatable contributor — and, just as often, to rule it out so that attention goes where it belongs. Weight, sleep and metabolic health sit underneath all of it, as set out in the link between weight and testosterone.

Das Endergebnis

Testosterone is not a treatment for depression, it is not recommended as one in any guideline, and it should never replace psychiatric or psychological care. What the evidence supports is narrower and still worth something: in a man with bestätigt testosterone deficiency and persistent low mood, correcting the deficiency may help how he feels alongside proper mental health treatment.

If you are a man with persistent low mood, fatigue, brain fog or loss of motivation, and antidepressants have not worked fully, checking testosterone is a reasonable part of a broader assessment — done alongside the mental health care, not instead of it. Any decision to add hormonal therapy begins with confirmed blood work rather than assumption: testosterone deficiency treatment starts with two morning tests and a full symptom review.

Dr. Soarawee Weerasopone consults at Bangkok Hospital Hauptsitz and at Samitivej Sriracha Hospital in Chonburi on 088-022-1445. Where mood is a significant part of the picture, care is shared with a mental health professional rather than managed from the urology clinic alone.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. It suits reviewing blood results and planning follow-up; the initial assessment needs an in-person visit and morning blood tests. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital rather than through this website. Telemedicine is not the right route for a mental health crisis — call 1323 or 1669.

Häufig gestellte Fragen (FAQ)

Can testosterone therapy help with depression?

A 2019 meta-analysis in JAMA Psychiatry pooling 27 trials in nearly 1,900 men found testosterone was associated with a significant reduction in depressive symptoms, with men on treatment about twice as likely to achieve a 50% or greater fall in scores. That is a real signal, but the trials varied widely and many participants had depressive symptoms rather than diagnosed major depression. Testosterone is not an established or recommended treatment for depression, and it does not replace psychiatric or psychological care.

The study mentions doses above 500 mg a week. Is that what treatment involves?

No, and this is the most important thing to understand about that finding. A normal replacement dose is roughly 50 to 100 mg a week. Doses above 500 mg a week are several times replacement, sit in the territory of non-medical steroid use, and are not offered in responsible practice. That the clearest signal appeared at those doses is a reason for caution about the finding, not a reason to seek higher doses.

Do I need low testosterone for it to help my mood?

The analysis found the effect did not clearly track baseline testosterone, and men with normal levels appeared to improve. In practice that does not translate into treating men who are not deficient: giving testosterone to someone whose level is normal is not correcting anything, carries the same risks, and is not recommended for depression in any guideline. It is also a result that raises questions about the finding rather than extending it.

Sollte ich mein Antidepressivum durch eine Testosterontherapie ersetzen?

No. Do not stop or reduce an antidepressant on the basis of this or any article — stopping suddenly can cause withdrawal effects and a relapse of symptoms. Where testosterone has a role it is alongside standard treatment in a man with confirmed deficiency, decided with both your urologist and the professional managing your mental health.

What are the risks of testosterone therapy itself?

It suppresses the body’s own testosterone and sperm production, frequently to zero, for as long as it continues. In the large TRAVERSE safety trial, two adverse findings reached statistical significance: erythrocytosis, a thickening of the blood, which is why haematocrit is monitored throughout; and a roughly 43% increase in clinical fractures. Atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher but did not reach statistical significance and should not be described as established harms. The trial found no increase in heart attack, stroke or cardiovascular death.

What else can look like low testosterone?

Low mood, exhaustion and loss of drive overlap with obstructive sleep apnoea, thyroid disease, anaemia, iron overload and sustained stress, as well as with depression itself. That overlap is the reason for a broad assessment rather than a single hormone test, and the reason a normal testosterone result is useful information rather than a dead end.

Haftungsausschluss: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for general education only and does not constitute medical advice, and it is not mental health advice. No advice, diagnosis or prescription is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account. Do not start, stop or change an antidepressant or any other prescribed medicine on the basis of this article. If you are struggling with your mental health, or having thoughts of harming yourself, please contact a doctor, a mental health professional or emergency services. In Thailand: the Department of Mental Health helpline on 1323, free and available 24 hours, or 1669 for a medical emergency.