What effects can testosterone trigger in a
woman’s body?

All women have some amounts of testosterone, and the hormone is in fact essential for good health. High levels of testosterone cause health problems, however, including psychological disorders like depression.

Just like estrogen, male hormones like testosterone (officially known as “androgens”) have an important influence on cognitive development. In utero, testosterone may play a role in the brain’s growth and behavioral responses. The hormone also appears to have an influence on cognition well after infancy. Some medical investigators propose that testosterone hormones may impact an adult brain’s neurotransmitter receptors, which could cause the brain to react to stimuli in unusual ways, thus causing mood disorders such as depression or anxiety.

Medical investigators have found evidence that androgens appear to be linked to mood disorders in women in various cases: for instance, free testosterone levels tend to be higher in women who have premenstrual syndrome (PMS) and depression. High testosterone levels are also associated with postpartum depression, while women receiving testosterone as part of their hormone replacement therapy during menopause reported atypical antagonistic feelings.

A recent trial conducted by Weiner et al examined the relationship of testosterone to mood by following 27 women with polycystic ovarian syndrome (PCOS), compared to 27 normal menstruating women. PCOS is an illness of the endocrine system (the hormone-regulating system) that is defined in part by markedly augmented levels of free testosterone and depressed levels of estrogen and progesterone, which triggers symptoms such as acne, increased body hair, and weight gain. PCOS is one of the most common causes of infertility in women.

27 women with PCOS were matched with 27 normally menstruating women according to body mass index (since being overweight, a common symptom of PCOS, can also be a trigger of depression) and other demographic factors. Blood samples were taken at distinct points in the menstrual cycle to gauge testosterone, estrogen and progesterone levels, and women were told to answer questionnaires to self-evaluate levels of anxiety, depression, anger, life events, eating disorders, self-image and acne (another possible factor in depression).

The investigation concluded that compared with women with normal levels of testosterone, women with higher testosterone levels suffered from symptoms of depression that were more constant and more chronic. Paradoxically, however, risk for depression was raised only if testosterone levels were slightly above normal; extremely augmented androgen levels do not seem to have an affect on depression, anxiety or aggression.

Weiner et al determined that although the PCOS women could be at greater risk for depression due to the symptoms of their ailment (such as acne, weight gain, and hirsutism, or increased body/facial hair), because the symptoms of depression and anxiety decreased with increased testosterone (and hence increased symptoms), one may conclude that this is a hormonal, and not a psychological effect.

In conclusion, high testosterone levels were found to be the main cause of depression in women with PCOS.

Sources: Weiner, Cindy, et al. “Androgens and Mood Dysfunction in Women: Comparison of Women With Polycystic Ovarian Syndrome to Healthy Controls.” Psychosomatic Medicine 66:356–362 (2004).