Free testosterone is associated with perceived stress in women

Background

The role of testosterone in mood regulation has been studied by different authors with inconsistent results. It seems that low testosterone could be related to depressed mood in hypogonadal men; however, in women, both high and low testosterone levels have been implicated in depression. In this study, we evaluated androgen levels in depressed patients, comparing between sexes, and testing anxiety levels.

Methods

We included unmedicated women and men diagnosed with major depressive disorder, according to DSM-5 criteria. Patients with drug and alcohol abuse, hormonal medication, uncontrolled medical illness, or psychiatric disorders other than depression or anxiety were excluded. We applied the HDRS, State and Trait Anxiety Inventory (STAI), and Perceived Stress Scale (PSS) to all participants and measured cortisol, total testosterone, free testosterone, and dehydroepiandrosterone.

Results

A total of 71 participants (21 male) completed all evaluations. In the overall sample, we detected correlations between cortisol levels and STAI scores, as well as between perceived stress and cortisol. In our correlation analysis of testosterone and psychological evaluations stratified by sex, we found that in women, higher levels of free testosterone were associated with increased perceived stress, as indicated by the PSS.

Limitations

A small sample was recruited for the study. Furthermore, although validated anxiety scales were used, all data were self-reported.

Conclusions

The role of testosterone in anxiety differs between male and female depressed patients. Perceived stress could be an important measurement in women, as it was related to FT levels in this sample.