The evidence shows that testosterone treatment does not change the strength or rate of urine flow, does not change the ability to empty the bladder, and does not change other symptoms such as frequency or urgency of urination, as assessed by the American Urological Association Symptom Score or the International Prostate Symptom Score. I’ve had a couple of patients over the years who had some worsening of urinary symptoms with testosterone, but that’s rare, even with long-term use.

The T Trials are a set of seven clinical trials hosted at 12 sites around the country. In the aggregate, 790 men aged 65 or older with low levels of testosterone and associated symptoms participated. First, participants had to qualify for one of the main three trials: the Sexual Function Trial, the Physical Function Trial, or the Vitality Trial. Then, participants could participate in any of the other trials for which they qualified.


Mood disturbance and dysthymia are part of the clinical syndrome of hypogonadism. Epidemiological studies have found a positive association between testosterone levels and mood, and depressed aging males have lower testosterone levels than controls (Barrett-Connor, Von Muhlen et al 1999). Furthermore, induction of a hypogonadal state during treatment of men for prostate cancer leads to an increase in depression scores (Almeida et al 2004). Trials of testosterone treatment effects on mood have varied in outcome. Data on the effects on men with depression are conflicting (Seidman et al 2001; Pope et al 2003) but there is evidence that testosterone treatment of older hypogonadal men does result in improvements in mood (Wang et al 1996) and that this may occur through changes in regional brain perfusion (Azad et al 2003).
Women also feel the effects of testosterone imbalance. Common knowledge holds that testosterone is just for men, but that’s not true. Low testosterone in women results in a wide variety of hard to diagnose symptoms: fatigue, anxiety, sleeplessness, depression, and weight gain are some common symptoms. These effects are commonly seen after menopause, but hormone imbalances can happen at any age. Properly balancing the body’s natural testosterone and estrogen levels prevents these symptoms.
Some studies have looked at testosterone therapy and cognition. Although the findings weren’t definitive, there was some evidence of cognitive improvement. Other studies have shown that it improves mood. Testosterone therapy has also been shown to be effective in the treatment of osteoporosis and in increasing muscle bulk and strength. [See “Testosterone’s impact on brain, bone, and muscle,” above.]
Some of these signs and symptoms can be caused by various underlying factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions may be the cause of low testosterone levels, and treatment of these problems may cause testosterone levels to rise. A blood test is the only way to diagnose a low testosterone level.
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