Does testosterone cause a euphoric state?

From the Guidelines

Testosterone does not typically cause a euphoric state. While testosterone replacement therapy can improve mood, energy levels, and overall well-being in individuals with clinically low testosterone levels, it does not produce euphoria like recreational drugs do. When prescribed medically (such as testosterone cypionate 50-400mg every 2-4 weeks or testosterone gel 50-100mg daily), patients may experience positive mood changes, increased motivation, and better sense of vitality, but these effects are generally subtle and develop gradually over weeks to months. The mood improvements from testosterone therapy are primarily related to the hormone's role in regulating neurotransmitters, supporting brain function, and alleviating symptoms of low testosterone such as fatigue and irritability. However, using testosterone at supraphysiological doses (beyond normal levels) can potentially cause mood swings, aggression, or irritability rather than euphoria. Any mood effects from testosterone are quite different from the intense, immediate euphoric high associated with substances like opioids or stimulants.

Key Points

• Testosterone replacement therapy can improve mood and overall well-being in individuals with low testosterone levels 1.
• The effects of testosterone on mood are generally subtle and develop gradually over weeks to months 1.
• Testosterone does not produce euphoria like recreational drugs do 1.
• Using testosterone at supraphysiological doses can potentially cause mood swings, aggression, or irritability rather than euphoria 1.

Recommendations

• Clinicians should consider the potential benefits and harms of testosterone treatment in adult men with age-related low testosterone 1.
• Testosterone treatment should only be initiated in men with age-related low testosterone who have symptoms of androgen deficiency and low testosterone levels, and who have no underlying medical conditions that could be causing their symptoms 1.
• Clinicians should monitor patients receiving testosterone treatment for potential adverse effects, such as mood swings, aggression, or irritability 1.

From the Research

Testosterone and Euphoric State

• There is no direct evidence to suggest that testosterone causes a euphoric state 2, 3, 4, 5, 6.
• However, some studies suggest that testosterone replacement therapy (TRT) can improve mood and energy in hypogonadal men with and without depressive symptoms 2, 4.
• Testosterone levels have been found to be lower in men with depression, and TRT has been shown to improve depressive symptoms in some cases 5, 6.
• The relationship between testosterone and mood disorders is complex, and more research is needed to fully understand the role of testosterone in mood regulation 6.
• Some studies have found that testosterone levels are reduced in men with major depressive disorder (MDD) and bipolar disorder (BD), suggesting that testosterone may be a useful biomarker in mood disorders 6.

Key Findings

• TRT can improve mood and energy in hypogonadal men with and without depressive symptoms 2, 4.
• Testosterone levels are lower in men with depression, and TRT may improve depressive symptoms in some cases 5, 6.
• The relationship between testosterone and mood disorders is complex and requires further research 6.

Study Limitations

• The studies reviewed had varying sample sizes, psychometric scales, and therapeutic regimens, which may have contributed to conflicting results 6.
• More research is needed to fully understand the role of testosterone in mood regulation and its potential as a biomarker in mood disorders 6.