The association between testosterone and depression in postmenopausal women: A systematic review of observational studies

Chandima Hemachandra, Rakibul M. Islam, Robin J. Bell, Farhana Sultana, Susan R. Davis AO

Research output: Contribution to journalReview ArticleResearchpeer-review

4 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)62-70
Number of pages9
Publication statusPublished - Feb 2023


  • Androgen
  • Depression
  • Major depressive disorder
  • Postmenopause
  • Testosterone

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