Hone Data: 83% of Men with Moderate Depression Improved on TRT
Anxiety and depression can be signs of low testosterone.
For years, testosterone has been considered a solution for low libido, stubborn weight gain, and age-related muscle loss. But new Hone patient data suggests some of its most meaningful benefits are mood-related.
Among more than 3,000 men who underwent 12 months of treatment for low testosterone, 83% of those who began treatment with moderate depression — defined as a PHQ-9 score of 10 or higher — saw clinically meaningful improvement, with average scores dropping from 11.7 to 3.9.
It’s well established that American men are in a mental health crisis — depression rates have been rising steadily over the last two decades, and men’s suicide rate is four times that of women.1 2 For years, the conversation around men’s declining mental health has focused on loneliness, social isolation, economic stress, and the stigma against seeking help, but these data show that low levels of testosterone could be a contributing factor. 3 4 Testosterone declines with age, acts directly on mood centers in the brain, and produces symptoms clinically indistinguishable from depression.
The findings don’t prove that testosterone replacement therapy (TRT) treats depression from any cause, or that hormones are fully responsible for mental health issues in men. But they do suggest that low testosterone may be an overlooked contributor to men’s low mood.
About the Expert
Joshua Calvert, M.D., is a urologist specializing in male infertility and low testosterone management.
Treatment Improves Mood Significantly
Because of testosterone’s association with muscle, sex drive, and body composition, many men seek treatment for physical symptoms — they’re gaining weight, losing strength, or feeling less interested in sex.
The data shows that mood and energy often move alongside those physical markers, and the shift can be substantial.
The 3,239 Hone patients who completed baseline and 12-month assessments report the following TRT benefits:
- Nearly 69% reported greater enjoyment of life
- 66% reported greater happiness
- 81% reported higher energy levels
- Nearly 46% reported falling asleep after dinner less often
The biggest score jumps took place between 3 and 6 months, with continued improvement through the one-year mark. Notably, fewer than 9% of participants reported a history of mental health conditions, and only 4.5% were taking antidepressants, which means the mood improvements weren’t limited to men receiving psychiatric treatment.
“We can’t say from this data how much of these improvements came from testosterone itself,” says Joshua Calvert, M.D., a urologist who specializes in testosterone deficiency. “What we can say is that many men reported feeling happier, more energetic, and more engaged in their lives after treatment.”
These findings echo a 2019 meta-analysis of 12 placebo-controlled clinical trials that showed restoring testosterone to a physiological range significantly reduced depressive symptoms in men with hypogonadism or mild-to-moderate depression.5
Why Low Testosterone Gets Missed
Low testosterone and depression often look remarkably similar, says Calvert. A review article published in Frontiers in Endocrinology Reproduction in 2023 found that between 35%–50% of men with clinically low testosterone experience fatigue, insomnia, reduced motivation, and anhedonia, absence of pleasure.6
According to a 2022 study published in Reviews in Endocrine and Metabolic Disorders testosterone receptors are found throughout the brain, including in regions involved in motivation, reward, and emotional regulation, which may explain why men with low testosterone often describe feeling flat, disconnected, or less interested in things they once enjoyed.7
Because testosterone levels naturally decline by 1–2% per year beginning in a man’s thirties, it’s easy for men to attribute symptoms like fatigue, low motivation, and poor sleep to stress, getting older, or simply feeling burned out.8 It doesn’t help that low testosterone symptoms can overlap with symptoms caused by medication side effects, hypothyroidism, diabetes, and obesity.
“It’s not uncommon for doctors to see men who have been in therapy for years or who’ve tried multiple antidepressants without meaningful relief, and then we find they have low testosterone levels,” Calvert says, noting that men can be prescribed an SSRI without anyone first checking their testosterone. “These men could have been a lot happier for a lot longer if someone had just thought to test their hormones.“
Low Testosterone is More Common Than Many Men Realize
Research from the Endocrine Society suggests testosterone levels have declined among men over the past several decades, likely due to rising rates of obesity, metabolic dysfunction, poor sleep, and other lifestyle factors — yet many remain undiagnosed.9 10 During an FDA expert panel on testosterone in December one panel expert recommended that all men over 40 be tested for low testosterone.
Part of the problem is how low testosterone has been defined. Most clinical guidelines use a total testosterone level below 300 ng/dL as the threshold for diagnosis. But many physicians who routinely treat testosterone deficiency believe symptoms appear at levels much higher. A man whose testosterone falls within the “normal” lab range may still experience symptoms associated with testosterone deficiency.
“The lab value is only part of the picture,” says Calvert. “What matters is whether a patient has symptoms that are affecting his quality of life.”
Men experiencing persistent fatigue, low motivation, reduced enjoyment of life, or poor sleep may benefit from discussing hormone testing with a physician — particularly if those symptoms haven’t responded to other treatments.
These findings come from an observational study of patients who completed 12 months of Hone’s testosterone therapy program — not a randomized controlled trial. The data should be read as real-world patient outcomes rather than proof of cause and effect.
After 12 months of Hone’s testosterone optimization program, men with low mood experienced measurable gains in life enjoyment, happiness, and energy. The findings underscore the link between testosterone and mood and suggest that it may be worthwhile for men experiencing depression symptoms to consider hormone testing or consulting a physician.
After 12 months of Hone’s testosterone optimization program, men with low mood experienced measurable gains in life enjoyment, happiness, and energy. The findings underscore the link between testosterone and mood and suggest that it may be worthwhile for men experiencing depression symptoms to consider hormone testing or consulting a physician.
Centers for Disease Control and Prevention. (2025) Depression Prevalence in Adolescents and Adults: United States, August 2021–August 2023
↑Centers for Disease Control and Prevention. (2024). Suicide mortality in the United States
↑Anxiety & Depression Association of America. Understanding Men’s Mental Health
↑Gallup. (2024). Younger men among loneliest in West
↑Walther, Andreas, et al. (2018) Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men
↑Indirli, Rita, et al. (2023) The association of hypogonadism with depression and its treatments
↑Hauger, Richard L. et al. (2022) The role of testosterone, the androgen receptor, and hypothalamic-pituitary–gonadal axis in depression in ageing men
↑Cheng, Haoyang, et al. (2024) Age-related testosterone decline: mechanisms and intervention str
↑Travison, Thomas, et al. (2007) A population-level decline in serum testosterone levels in American men
↑Anaissie, James, et al. (2017) Testosterone deficiency in adults and corresponding treatment patterns across the globe
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About the author
Aviva, Hone's Executive Editor, is an award-winning health-science journalist and former executive editor of Psychology Today, Reader's Digest, and The Healthy. She has written for national print and digital publications including Health, Prevention, Women’s Health, Men’s Health, Shape, Fitness, SELF, New York Magazine, and more.
About the reviewer
Natalie Kunsman, M.D., is a board certified physician specializing in functional, anti-aging, and regenerative medicine. She is a fellow of the American Academy of Anti-Aging medicine and the American Academy of Family Physicians.
