Does Lexapro Lower Testosterone Levels? (3+ Factors)

By Ivan Kahwa

Page last updated: 05/02/2024 | Next review date: 05/02/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will discuss whether Lexapro decreases the levels of testosterone or not. We will also explore what research suggests on this, the potential relationship between Lexapro and testosterone, factors that may influence lower testosterone levels while taking Lexapro, signs and symptoms of lower testosterone levels and management strategies to prevent hormonal changes from Lexapro.

Does Lexapro lower testosterone levels?

Yes, Lexapro may decrease testosterone levels in some men. However, it’s not a commonly reported side effect of Lexapro and happens in rare cases, as people are unique and may respond differently to medications, especially antidepressants. (1)

Lexapro is classified as a selective serotonin reuptake inhibitor (SSRI). It works by balancing the levels of a neurotransmitter in the brain called serotonin, which improves a person’s mood and boosts their motivation, thereby helping those who suffer from depression and anxiety by making them feel happy. (1)

Testosterone is a male hormone, responsible for the development and maintenance of sexual characteristics in men like face and body hair growth, deepening of voice when a boy hits puberty etc. Any fluctuations in this hormone, such as an increase or decrease in its levels, can impact a person’s health. (3)

It’s crucial to recognize that the effects of antidepressants like Lexapro can vary in different people, as everyone is unique in terms of their brain chemistry and how they react to the medication.

How does Lexapro lower testosterone levels?

There is no direct relationship between Lexapro (escitalopram) and the hormonal system. However, it is believed that the mechanism by which Lexapro works might affect the levels of testosterone indirectly.

Serotonin not only regulates mood to improve depression, but it also impacts the functioning and regulation of hypothalamus-pituitary-gonadal (HPG) in the brain, which plays an important role in controlling the activity of sex hormones, including testosterone. Thus, alterations in serotonin levels may influence how this system functions and may indirectly lower testosterone levels. (2,4)

Some studies have also suggested that serotonin receptors are also present in male testes and their imbalance may affect the production of testosterone.

SSRIs like Lexapro are also found to impact other hormones like cortisol and prolactin, which can, in turn, affect the HPG axis and testosterone production. (4)

It’s important to keep in mind that the mechanism behind SSRI’s impact on the hormonal system is not entirely clear and individual’s reactions to medications may vary.

What does research suggest?

According to a research study, taking medications for depression and anxiety is crucial for many people, but in some cases, it can also affect fertility in men.

Most antidepressants like Lexapro can cause sexual side effects by altering the levels of testosterone, specifically reducing them to such an extent that men may have difficulty in achieving erection but these effects tend to go away when the dose is adjusted or they completely stop taking the medication with doctors approval. (2)

Men who suffer from depression or anxiety might already have the issues of reduced libido and difficulty ejaculation due to stress but taking these medications may increase the risk. The risk and frequency of sexual side effects from SSRIs like Lexapro are estimated to be 59.1% according to a Spanish clinical trial. (2)

What are the signs and symptoms of lower testosterone levels?

Some common signs and symptoms of low testosterone levels include: (3)

Low sex drive (libido)
Erectile dysfunction (trouble getting or maintaining an erection)
Fatigue
Reduced muscle mass
Mood changes
Increased body fat
Hair loss
Hot flashes
Sleep disturbances
Decreased bone mass
Difficulty concentrating
Changes in cholesterol levels (imbalances in LDL and HDL)

If you suspect you have low testosterone levels and are experiencing the above-mentioned symptoms, it’s important to discuss this with your doctor.

What other factors influence lower testosterone levels while taking Lexapro?

Several factors can contribute to low testosterone levels while taking Lexapro and in general, some might include: (5)

Other antidepressants: Antidepressants from the same class such as SSRIs like paroxetine and fluoxetine, or different classes such as SNRIs and TCAs can also affect the levels of testosterone in a person. (4)

Psychological factors: The underlying health condition such as depression or anxiety, a person is going through might affect hormonal balance and reduce the levels of testosterone.

Lifestyle factors: Antidepressants might indirectly affect your lifestyle factors like your sleeping cycle, exercise routine and diet. This may in turn impact your testosterone levels negatively.

Age and genetics: The levels of testosterones are naturally supposed to decline with age in men. If someone is taking Lexapro at an older age, the effect of medication can coincide with age-related hormonal changes. Genetic variations can also greatly influence a person’s hormonal system.

How to manage testosterone levels while taking Lexapro?

Here are some general strategies that might help you maintain your testosterone levels while taking Lexapro, including: (5)

Regular exercise: Do exercises like walking or lifting weights as exercises are good for your hormones.

Healthy diet: Eat a balanced diet with good foods including vitamins and minerals. Ensure you are getting enough nutrients as this keeps your body and hormones in good shape.

Sufficient sleep: Make sure you get enough sleep at night as sleep is good for your hormones. Try to aim for 7-9 hours of quality sleep each night.

Limit alcohol consumption: Excessive intake of alcohol can mess up with your hormonal levels so try to limit the consumption or stop drinking at all.

Stress management: Practice techniques to relax your mind and body like inhaling and exhaling deeply, stretching your body and doing yoga or meditation to reduce stress.

Maintain a healthy weight: If you’ve experienced weight changes due to medication, talk to your doctor as keeping a healthy weight is important for hormones.

Regular check-ins with your doctor: Keep in touch with your doctor so they can monitor your hormonal changes and make any adjustments if necessary.

Considerations of alternative medications: If you’re having problems, ask your doctor about trying a different medication with a low dose and fewer side effects, according to your specific situation.

As a pharmacist, based on my knowledge, Lexapro can decrease the levels of testosterone in some individuals. However, if you experience any serious signs of sexual dysfunction, contact your healthcare provider promptly and ask for either adjusting your dose to limit side effects or prescribing you an alternative more safer towards sexual health.