Does trazodone lower testosterone? (+3 factors)

In this article, we will discuss whether trazodone reduces the levels of testosterone. We will also explore the research studies linking the effects of trazodone on testosterone levels, as well as the factors that may influence the effects of trazodone on testosterone. Additionally, we will discuss the management tips for low testosterone levels.

Does trazodone lower testosterone?

Trazodone does not typically lower testosterone levels; instead, some research studies have indicated that it may increase testosterone levels. Individual responses to medications can vary, and any concerns about the effects of trazodone on hormone levels should be discussed with a healthcare provider for personalized guidance based on individual health factors.

Generally, trazodone is an antidepressant medication that is employed in the management of various health conditions, including depression, anxiety, fibromyalgia, and chronic pain.

The common side effects of this medication may include nausea, vomiting, dizziness, headache, nightmares, fatigue, drowsiness, and dry mouth (1).

What does research suggest?

There is no research evidence suggesting a lowering of testosterone with trazodone. In fact, some studies have reported cases where individuals experienced increased levels of testosterone with trazodone.

In a research study investigating the effects of trazodone on reproductive hormones, the results showed that this medication not only increased testosterone levels but also luteinizing hormone and follicle-stimulating hormone after daily dosing of 20 mg for one month (2).

In another research study, trazodone was explored for its potential role in managing impotence alongside testosterone in men with reported impotence. The results indicated a significant improvement in symptoms compared to a placebo, suggesting a potential role for this medication in the treatment of sexual dysfunctions in men (3).

What factors influence testosterone imbalances with trazodone?

While the induction of testosterone imbalances by trazodone is less common, they may occur in the presence of several risk factors, including the following:

Risk factors  Responses 
Individual factors Genetic factors and individual sensitivity to trazodone may increase the risk of experiencing unusual side effects that are generally uncommon with this medication.
Underlying medical conditions Individuals with underlying medical conditions such as hypogonadism or pituitary gland disorders are at a higher risk of developing testosterone imbalances and sexual side effects while taking trazodone.
Concurrent medications The concurrent use of trazodone with medications that are more likely to cause hormonal imbalances, such as opioids, some chemotherapy medications, and certain antipsychotics, increases the risk of these side effects.

What to do if trazodone impacts testosterone levels?

While trazodone rarely affects testosterone, if you experience any unusual symptoms associated with testosterone imbalance, such as acne, weight changes, mood swings, or alterations in sex drive, you should consult your healthcare provider as soon as possible.

Your healthcare provider may assess your condition and recommend some blood tests for accurate diagnosis to determine the actual cause of your symptoms. In cases where the presence of risk factors is responsible for your symptoms, your healthcare provider may address them first before making any changes to your treatment plan.

However, if trazodone is responsible for your testosterone imbalances, they may recommend a dosage adjustment if a higher dosage of trazodone is causing side effects.

If your symptoms persist even at a lower dosage, your healthcare provider may recommend how to discontinue and provide you with an alternative that is less likely to cause sexual side effects, such as fluoxetine, citalopram, or duloxetine.

How to address low testosterone levels? 

If you suspect that trazodone is impacting your testosterone levels, it’s crucial to address this concern with your healthcare provider. They may offer general considerations and management tips to address your condition.

  • One potential recommendation could be Testosterone Replacement Therapy (TRT), a medical intervention to restore optimal testosterone levels. However, TRT should only be administered under the guidance and supervision of a qualified healthcare professional.

 

  • Your healthcare provider may also prescribe medications to restore testosterone levels. Clomiphene citrate is one such option, particularly considered for individuals with low testosterone and fertility issues.

 

  • Lifestyle changes are integral to managing low testosterone levels. Regular exercise, a balanced diet rich in essential nutrients, and weight management all contribute positively to overall hormonal health.

 

  • Stress management is equally important, as chronic stress can elevate cortisol levels, potentially negatively impacting testosterone levels.

In my opinion, the effects of trazodone on testosterone levels are infrequent, and patients generally do not commonly complain of symptoms associated with this side effect while taking trazodone. However, it’s essential to follow your healthcare provider’s guidance and undergo regular monitoring to ensure the safety and efficacy of your treatment.

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References

1.-

Shin JJ, Saadabadi A. Trazodone. [Updated 2022 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560

2.-

Ilgın S, Aydoğan-Kılıç G, Baysal M, Kılıç V, Ardıç M, Uçarcan Ş, Atlı Ö. Toxic Effects of Trazodone on Male Reproductive System via Disrupting Hypothalamic-Pituitary-Testicular Axis and Inducing Testicular Oxidative Stress. Oxid Med Cell Longev. 2018 Jul 29;2018:7196142. doi: 10.1155/2018/7196142. Erratum in: Oxid Med Cell Longev. 2018 Nov 5;2018:8294061. PMID: 30151072; PMCID: PMC6087606. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087606/

3.-

Aydin S, Odabaş O, Ercan M, Kara H, Ağargün MY. Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction. Br J Urol. 1996 Feb;77(2):256-60. doi: 10.1046/j.1464-410x.1996.86316.x. PMID: 8800895. https://pubmed.ncbi.nlm.nih.gov/8800895/

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