The research is still new, but antidepressant medications may lower testosterone in some people. However, this side effect is treatable and usually mild.

If you’re one of the millions of people who take antidepressants for their mental health, you’re likely already familiar with the variety of side effects they can sometimes cause.

For example, both physical symptoms and mood changes are commonly reported side effects, especially when you first start taking antidepressants.

But there’s one potential side effect antidepressants can cause that you might not be aware of: changes in testosterone levels.

In this article, we explore what the research says about the impact of antidepressants on testosterone levels, including how to treat low testosterone caused by antidepressant medications.

Language matters

In this article, we use “male” and “female” to refer to someone’s sex as determined by their chromosomes, and “men” and “women” when referring to their gender.

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum, both historically and by modern scientific consensus.

This article also discusses the effects of antidepressants on testosterone in both males and females.

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Research on the role of antidepressants on testosterone is sparse. However, the research that’s available on the topic does suggest that antidepressants can have an effect on various hormones in the body — including testosterone.

One 2021 review explored the available research on the impact of antidepressants on both testosterone and estrogen levels.

According to researchers, while antidepressants do appear to influence testosterone and estrogen levels, study results are mixed. For example, antidepressants appeared to lower testosterone levels in some studies, yet raise hormone levels in others.

In one 2017 study in particular, however, researchers analyzed the impact of six of the most widely used selective serotonin reuptake inhibitors (SSRIs) on androgen and estrogen levels.

Of the six SSRIs tested, all of them decreased testosterone levels and increased the ratio of estrogen to testosterone. The six medications studied were:

  • citalopram
  • escitalopram
  • fluoxetine
  • fluvoxamine
  • paroxetine
  • sertraline

So, while there does appear to be a link between antidepressants and changes in testosterone levels, more research is needed to determine the extent of this relationship.

Testosterone plays an important role in human metabolism in all sexes. Not only is testosterone the leading hormone in puberty in males, but it also plays a role in sex drive, bone health, muscle formation, red blood cell production, and so much more. It’s an essential hormone.

Because testosterone has such an important function in the human body, low testosterone can cause a wide range of symptoms.

The effects of low testosterone in males

In males, low testosterone can cause a handful of symptoms, including:

  • decreased mood
  • changes in concentration
  • chronic fatigue
  • changes in muscle and bone mass
  • changes in body weight
  • decreased sex drive
  • difficulty with erections

The effects of low testosterone in females

While low testosterone levels might not be as obvious in females, it can still cause a handful of symptoms, such as:

Alternatives to antidepressants

If you’re taking antidepressants and want to consider other treatment options, whether because of potential side effects or other reasons, here are two alternatives to consider:

  • Psychotherapy: Therapy has been shown to be helpful for not only depression and anxiety but also many other mental health conditions. Cognitive behavioral therapy (CBT) is considered one of the most effective forms of therapy for depression and anxiety. However, there are many therapeutic approaches to consider, depending on your condition.
  • Other medications: Antidepressants are often one of the first medications doctors prescribe for depression and anxiety, but other medication options can also be effective in treating these conditions. For example, combination therapies show promising results for treating depression, while nonantidepressant medications may be helpful for people living with anxiety disorders.

Make sure to always discuss any changes in medication with your doctor. Stopping antidepressant medication needs to be regulated carefully to avoid side effects.

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If you believe you’re experiencing low testosterone caused by antidepressant use, the first step is to reach out to your doctor to discuss your concerns.

If they determine your testosterone levels are low, they can offer lifestyle suggestions or prescribe medications to help restore your levels back to normal.

Treatment for low testosterone can involve multiple approaches. Lifestyle strategies, such as making dietary changes or incorporating certain vitamin or mineral supplements, can sometimes help increase low testosterone levels.

However, if your testosterone is abnormally low, your doctor may prescribe testosterone replacement therapy to help get your levels back up quickly.

If antidepressants are causing your low testosterone levels, you may also decide that you want to change medications or stop taking antidepressants entirely. However, although this is a personal decision, you should still consult with your doctor before abruptly changing or stopping any of your medications.

Can I take testosterone while on antidepressants?

Whether you’re taking testosterone to replenish low levels or as a part of gender affirming care, know that it is safe to take testosterone while taking antidepressants.

In fact, research shows that testosterone may actually improve antidepressant effectiveness, as well as function in an antidepressant capacity itself:

  • In one 2015 study, researchers found that transgender people taking high dose testosterone supplementation had increased serotonin reuptake transporter binding.
  • A 2019 review found that not only does testosterone appear to activate the serotonin system, but it also increases the neuroplasticity of the brain.
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Antidepressants play an important role in mental health treatment for millions of people. If you’re taking antidepressants for your mental health, it’s because you and your doctor decided that the benefits of treatment outweighed the potential risks.

However, if you’re worried about the impact that antidepressants can have on your testosterone levels, reach out to your doctor to discuss your concerns.

Whether you decide to continue taking your medication or explore other treatment options, there’s never any harm in learning more about the best options for treating your mental health.