Can Low Testosterone Cause Anxiety?

Many men experiencing anxiety don’t realize that a hormonal imbalance—specifically low testosterone—may be contributing to how they feel. Testosterone plays a critical role in more than just physical health; it also affects mood, cognitive function, and stress resilience. When levels dip too low, symptoms like anxiety, fatigue, and irritability can emerge. This article explores the science-backed connection between testosterone and anxiety, common causes of low testosterone, and how treatment can help you feel more like yourself again.

What Is Testosterone and Why Does It Matter?

Testosterone is a vital hormone primarily (but not exclusively) produced in the testes. While it’s commonly known for its role in male reproductive health, testosterone also influences a wide range of physical and emotional functions. It helps regulate sex drive, muscle mass, fat distribution, red blood cell production, and bone density. Importantly, it also supports mood stability, motivation, and cognitive clarity.

What Does Low Testosterone Mean?

Clinically, low testosterone—also known as hypogonadism—is typically defined as a blood testosterone level below 300 ng/dL. While testosterone naturally declines with age (about 1% per year after age 30), certain health and lifestyle factors can accelerate or intensify this drop, leading to a range of emotional and physical symptoms.

Explore: How Low Is Too Low? Understanding Low Testosterone

What Is Anxiety?

Anxiety is a common mental health condition characterized by persistent feelings of worry, nervousness, or fear that can interfere with daily life. Symptoms may include restlessness, rapid heart rate, muscle tension, trouble sleeping, and difficulty concentrating. While occasional anxiety is a normal response to stress, chronic or excessive anxiety may indicate an underlying issue—such as hormonal imbalance.

Visit the National Institute of Mental Health’s page on Anxiety Disorders

Can Low Testosterone Cause Anxiety?

Yes, low testosterone can contribute to anxiety. Research shows that testosterone helps regulate neurotransmitters that influence mood and stress response. When levels are low, men may experience anxiety, irritability, and poor stress resilience. Fortunately, hormone therapy can help restore balance and relieve symptoms.

How Does Low Testosterone Affect Mood and Anxiety?

Multiple studies have shown a clear link between testosterone levels and mood regulation.

• Low testosterone is associated with increased activity in brain regions responsible for threat vigilance and reduced GABA and serotonin activity, which are crucial for calming the nervous system.
• A 2020 review by Dr. Michael Zitzmann found that testosterone plays a direct role in psychological balance, influencing stress resilience, self-perception, and emotional regulation. (PubMed)
• A 2013 review from Massachusetts General Hospital and Harvard Medical School noted that men with low testosterone frequently report symptoms such as fatigue, irritability, and anxiety—even without a clinical depression diagnosis. (ScienceDirect)
• Research in Biological Psychiatry confirmed testosterone’s role in modulating brain circuits involved in fear, reward, and anxiety responses. (PMC)

Together, these findings support the idea that low testosterone can exacerbate or even trigger anxiety disorders in some individuals.

Can Low Testosterone Cause Anxiety in Women, Too?

Yes—although testosterone is often thought of as a “male” hormone, women also produce small but essential amounts in their ovaries and adrenal glands. In women, low testosterone can contribute to fatigue, low mood, and anxiety, especially during perimenopause and menopause when hormone levels fluctuate. While this article focuses on low testosterone in men, women experiencing similar symptoms should speak with a healthcare provider experienced in hormone health to explore testing and treatment options.

What Are the Causes of Low Testosterone?

Medical Factors

• Primary Hypogonadism: Testicular failure due to conditions like Klinefelter syndrome or injury
• Secondary Hypogonadism: Pituitary or hypothalamic disorders that reduce hormone signaling
• Chronic Illnesses: Including obesity, diabetes, HIV/AIDS, and some cancer treatments
• Genetic Disorders: Such as Kallmann syndrome or other congenital issues

(Source: Mayo Clinic – Male Hypogonadism)

Lifestyle Factors

• Poor diet or inadequate exercise
• High stress and insufficient sleep
• Alcohol or drug use
• Smoking and environmental toxins
• Age-related hormonal decline

Recognizing the Symptoms

Symptoms of low testosterone and anxiety often overlap, which can make it harder to identify the root cause.

Mood-Related Symptoms

• Anxiety or nervousness
• Irritability
• Depressed or low mood
• Brain fog

Physical Symptoms

• Fatigue and low energy
• Poor sleep quality
• Decreased libido
• Muscle loss or weight gain

If these symptoms sound familiar, it’s worth having your hormone levels checked by a provider who understands the full picture—both physical and mental.

Can Doctors Treat Low Testosterone Anxiety Effectively?

Common Treatments and Effectiveness

Testosterone Replacement Therapy (TRT) is the most common treatment for low testosterone.

Options include:

• Gels
• Injections
• Patches
• Pellets

These therapies restore hormone balance, which in turn can improve mood, reduce anxiety, and boost energy. A 2009 meta-analysis found that TRT significantly improved depression scores in men with low testosterone, especially those with treatment-resistant depression or HIV-related depressive symptoms.

Example of testosterone enanthate injection, one form of TRT available at Aligned Modern Health.

Why Diagnostic Testing Matters Before Starting TRT

Hormonal health is complex, and the most effective treatments start with comprehensive diagnostic testing. While many providers use a basic hormone panel, this may not offer a complete picture—especially for individuals with adrenal dysfunction, thyroid conditions, or metabolic concerns.

At Aligned Modern Health, we use advanced hormone testing to help ensure that testosterone therapy is safe, effective, and personalized. Dr. Zahra Jafry, a hormone health specialist, emphasizes that additional testing is particularly valuable for individuals with co-existing conditions, such as:

• Adrenal fatigue or chronic stress
• Thyroid disorders (e.g., Hashimoto’s, hypothyroidism)
• Insulin resistance or metabolic syndrome
• Hormone-sensitive conditions like PCOS or a history of breast cancer risk factors

These deeper insights allow our care team to tailor therapy that works with your body, not against it. We also monitor progress over time to adjust care as your needs evolve.

Read more: Smarter Hormone Testing at Aligned Modern Health

How Aligned Modern Health Treats Anxiety from Low Testosterone

At Aligned Modern Health, we take a comprehensive, personalized approach:

1. Comprehensive Lab Testing – We measure both total and free testosterone, as well as related hormones and markers.
2. Individualized Care Plans – Our functional medicine experts tailor treatment to your lifestyle, symptoms, and lab results.
3. Ongoing Monitoring – We adjust treatment based on your response and ensure safe, effective results over time.
4. Supportive Therapies – We may combine TRT with nutrition, sleep, and stress management strategies.

Learn more: Andropause – Understanding the Male Hormonal Shift

Discuss Your Low Testosterone and Anxiety with an Aligned Modern Health Doctor

If you’ve been feeling anxious, off-balance, or just not like yourself, your hormones may be a contributing factor. At Aligned Modern Health, our team specializes in diagnosing and treating hormone imbalances, including low testosterone. We offer personalized treatment plans that address your symptoms holistically—so you can start feeling better, faster.

Don’t wait to get answers. Schedule a consultation with an Aligned Modern Health provider today and take the first step toward restoring your hormonal health and emotional well-being.

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