Highlights
- •Interpretation of data from studies that have explored a possible association between depression and testosterone is limited by methodological heterogeneity.
- •Studies that have measured testosterone by liquid/gas chromatography with tandem mass spectrometry are lacking.
- •The available data does not support an association between testosterone and depression in postmenopausal women.
Abstract
Objective
The contribution of testosterone to depression in older women is uncertain. This review
was conducted to investigate the association between endogenous testosterone blood
concentrations and depression in postmenopausal women.
Methods
We searched Ovid MEDLINE, EMBASE, PsycINFO, and Web of Science databases for observational
studies with at least 100 community-dwelling participants. The results were categorised
by study design, and the reporting of total, bioavailable and free testosterone findings
is narrative.
Results
The search strategy retrieved 28 articles for full-text review, of which eight met
the criteria for inclusion; these described 6 cross-sectional and 2 longitudinal studies.
Testosterone was measured by immunoassay in all of the included studies. No association
was seen between total testosterone or free testosterone and depression in either
the cross-sectional or the longitudinal studies. A significant association between
bioavailable testosterone and incident depressive symptoms was limited to women at
least 21 years postmenopause in one study. Most of the cross-sectional studies were
not representative of national populations and lacked random selection.
Conclusions
This systematic review does not support an association between testosterone and depression
in postmenopausal women. However, as the included studies had substantial methodological
limitations, studies of community-based samples, employing validated instruments for
depression and precise measurement of blood testosterone, are needed to address this
knowledge gap.
Keywords
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Article info
Publication history
Published online: December 06, 2022
Accepted:
November 7,
2022
Received:
July 22,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
