A perennial joke among women is that the wheel of medical research seems to grind slowly with women’s sexual health problems but goes from zero to 100 miles per hour in seconds when it comes to men’s sexual problems. In decades past, men did not usually admit that they were suffering from depression. This was a “woman’s illness,” and it wasn’t manly to be depressed. Thankfully, all this has changed and men can now feel comfortable in being treated for depression.
There is a connection between levels of testosterone, the primary men’s hormone, and depression. On this, the medical researchers agree. But the debate remains as to whether low levels of testosterone causes depression in men, or if depression causes low levels of testosterone. Men who suffer from depression find this to be a moot point; they would just like to be effectively treated for depression with appropriate medication.
How are Testosterone and Depression Connected?
Men with depression usually have a low libido, or sexual drive. This can result in both loss of interest in sex and erectile dysfunction. To make matters worse, antidepressant medications can also cause erectile dysfunction. During an episode of depression, levels of testosterone decrease both as a symptom of depression and as a result of antidepressant medication. This puts men with depression in a quandary. Should they use antidepressant medication long enough (about a year) to put their depression into full, sustained remission and cope with the side effect of lowered testosterone and low libido? Women with depression can “fake it” sexually. Men cannot.
In depressed men, signs of low testosterone include gradual breast enlargement (gynecomastia), a raise in voice pitch, shrinking of the testicles, loss of pubic hair, thinning of the bones, loss of energy and loss of muscle mass. Unfortunately, some depressed men resort to testosterone-based anabolic steroids to prevent these effects. This is an extremely dangerous and illegal practice. It is vitally important that men discuss depression and testosterone with their physician. Some antidepressant medications have less sexual side effects than others.
In addition to antidepressant medication, men suffering from depression should see mental health therapy to help them cope with this condition. By helping depressed men raise their self-esteem, therapists can help these men to understand that sexual performance is not nearly as important in relationships with women as genuine affection and non-sexual demonstrations of intimacy. In other words, sex is not what sustains a loving, committed relationship. Women have always known this, but men have difficulty with this concept of a different sort of intimacy.
The link between depression and testosterone is well documented in the medical literature. The testosterone patch is just now receiving the attention of physicians as a possible resolution to this problem.