Using testosterone replacement therapy may help you enhance your emotional health.

Testosterone Replacement Therapy for Anxiety: What the Evidence Tells Us

by Charlotte

Andy was tired of being tired and tense. He couldn’t remember the last time he felt in control at work, focused on the job. His mind was constantly moving, especially in the direction of unfortunate what-if’s. He had been on an antidepressant for anxiety for years, but it no longer seemed to do the trick. Nor did any of the other SSRIs he tried, or the therapy he attended weekly. 

When the other treatment routes failed to bring relief, Andy’s doctor finally decided to test his hormone levels. And when the results showed less than optimal testosterone, she ordered another round of tests to verify a pattern of testosterone deficiency. With the combination of frustrating symptoms and concrete biomarkers, Andy’s doctor was able to map out a route for hormone replacement therapy to help restore his health and his mood from the inside.

Testosterone replacement therapy for anxiety may not be a well-known treatment option, but evidence suggests that it can provide significant relief for those struggling with anxiety symptoms as a result of low T. If hormone imbalance is the cause of your distress, hormone rebalancing may be the solution.

Does Testosterone Replacement Therapy Work for Anxiety Symptoms?

Many people do not find relief with first and second-line anxiety treatments, often leaving them feeling adrift. In some cases, treatments such as SSRIs and benzodiazepines also cause undesirable side effects—and may even present significant health risks. What’s more, if an individual’s anxiety is linked to low testosterone, none of the typical treatments will address the underlying cause.

Testosterone plays a critical role in both physical and emotional health. While loss of muscle mass and sexual desire may be some of the most well-known symptoms of low testosterone, low T can also increase feelings of anxiety and anxiety symptoms. Correspondingly, researchers have found that hypogonadal men taking testosterone replacement therapy (TRT) see a significant decrease in anxiety. While part of this improvement may be due to the resolution of other symptoms—including depression and sexual dysfunction—testosterone is also believed to impact anxiety levels independent of other factors—and the effects aren’t restricted to men. 

A 2016 study published in Psychoneuroendocrinology uncovered an important connection between testosterone levels and anxiety in women. Researchers found that women with social anxiety disorder (SAD) experienced less gaze avoidance and aversion to images of angry faces—core features of SAD—when treated with testosterone. According to the researchers, these findings suggest that by reducing submissive reactions, testosterone replacement therapy might help to alleviate social anxiety disorder symptoms and disempowerment.

In 2017, a research cohort from the University of Texas at Austin also explored the fear-reducing properties of testosterone therapy. According to their data, “testosterone reactivity is associated with benefits during social challenges, such as increased self-efficacy, persistence, enhanced learning, and better performance.” But while testosterone can produce powerful anxiety-relieving effects regardless of sex, the degree of benefit may vary between men and women due to different numbers of testosterone receptors. 

Is Testosterone Replacement Therapy for Anxiety Right for You?

Whether you have tried anxiety treatment options to no avail or you are just getting started exploring the possibilities for healing, a compassionate practitioner can help you to consider your next steps. If there is a chance you may have low testosterone, a hormone practitioner can work with your psychiatrist to determine the most effective all-around treatment plan.

Hormone tests are necessary to determine whether your testosterone levels are out of balance and may allow you to put related symptoms into context. If insufficient levels of testosterone are negatively affecting your psychiatric state, then it’s reasonable to expect that rebalancing the hormone levels will help restore your sense of emotional well-being. However, a comprehensive treatment plan is important—even if your anxiety is entirely attributable to low testosterone, establishing healthy patterns of thought and behavior can require additional supports beyond TRT.

What Can You Expect from Testosterone Replacement Therapy for Anxiety?

When you are struggling against anxiety symptoms, it can be hard to know the next best steps forward for your wellness. In fact, you may experience significant internal barriers to even starting the healing process. But the first step toward diagnosing and treating low testosterone—or any other hormone imbalance—is simple: meet with a health practitioner who specializes in hormone health. This compassionate expert can be your guide along throughout your journey. 

The diagnostic process begins with a series of assessments that help your practitioner gain greater insight into your symptoms, your physical health, and your personal needs. These may include:

  • A full physical examination
  • A review of your medical and family history
  • A review of any medications you’re taking
  • Comprehensive hormone testing to determine your testosterone levels
  • A discussion of your health goals

If your hormone practitioner establishes that you are a good candidate for testosterone replacement therapy for anxiety, they will discuss your treatment options to find the best fit for your goals and your lifestyle. If you are currently working with a psychiatrist or other mental health professional, they can also consult with them to ensure you are getting the best possible care.

There are several administration methods commonly used for testosterone replacement therapy, including topical creams and gels, injections, patches, and pellets. Your practitioner may recommend one over another based on health or convenience concerns. For anxiety, in particular, it’s important to proceed with a treatment method that is steady and reliable with few ups and downs in the process of hormonal regulation. As such, testosterone pellet therapy may be a uniquely effective option.

One of the stand-out characteristics of pellet therapy is consistent hormone delivery over time; testosterone pellets can maintain their efficacy for months before needing a replacement. Like other bioidentical hormone replacement therapy treatment options, pellet dosages are customizable for each individual, and your practitioner will be careful to personalize your treatment for long-term wellness. 

For some, TRT alone is enough to improve low T-related anxiety. If you need additional support, your practitioner can help you find lifestyle strategies to help you regulate anxiety, or you may want to seek support from mental health specialists. 

Life After Anxiety

Feeling relief from your anxiety symptoms can be a life-changing phenomenon. Regaining your focus, your confidence, your ability to feel grounded and present means that the path ahead will be brighter and more fulfilling. And for men with low T, the benefits of TRT aren’t limited to reducing anxiety; it can help you maintain a healthy weight, improve your bone density and reduce your risk of osteoporosis, enhance muscle mass, and revitalize your sex life. At its best, it can help you to feel more connected to yourself and to others. And that is truly transformative.

If you have questions about whether testosterone replacement therapy may help your anxiety, BodyLogicMD has your answers. The BodyLogic network is comprised of highly trained and experienced practitioners who are experts in helping men restore hormonal balance—and reclaim their lives. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz to better understand how your hormones may be affecting your daily life.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.