Sex Hormone Levels, Genetic Androgen Receptor Polymorphism, and Anxiety in ≥50-Year-Old Males

Abstract

Introduction While associations between somatic changes and sex hormone levels in aging men have been explored in many studies, the association of testosterone and estradiol with psychic symptoms other than depression and the role of the genetically determined CAG repeat (CAGn) polymorphism of the androgen receptor (AR) have received much less attention. Aim The purpose of this article is to investigate the associations between general anxiety, phobic anxiety and panic with sex hormone levels and the genetic androgen receptor polymorphism in aging males. Methods This cross-sectional study of males aged ≥50 years included 120 consecutive patients of the Department of Psychosomatics and Psychotherapy, 76 consecutive patients of the Andrology Clinic, and 100 participants from the general population; all of them completed the Brief Symptom Inventory (BSI), the Aging Males’ Symptoms (AMS) Scale, and the Patient Health Questionnaire (PHQ-9). Morning blood samples were analyzed for total and free testosterone, estradiol, sex hormone-binding globulin (SHBG), and the CAGn AR polymorphism. Psychosomatic patients also underwent psychiatric assessment. Main Outcome Measures Scores on the Anxiety subscales of the BSI and PHQ, Anxiety disorders according to International Classification of Diseases, 10th revision (ICD-10). Results The two clinical samples had significantly longer CAGn of the AR and higher anxiety levels compared to the population sample. Anxiety scores were positively correlated with CAGn in psychosomatic patients and in andrological patients, in the latter also with estradiol levels, while the population sample showed no significant correlations between anxiety scores, CAGn and sex hormones. Anxiety cases according to BSI, PHQ, and ICD-10 had significantly longer CAGn of the AR when compared to the other participants, but there were no significant differences in testosterone or free testosterone levels. Conclusions Our results indicate that genetically determined long CAGn of the AR is an independent risk factor for higher anxiety, panic and phobic anxiety levels.

The correlation between emotional distress and aging males’ symptoms at a psychiatric outpatient clinic: sexual dysfunction as a distinguishing characteristic between andropause and anxiety/depression in aging men

“…Other risk factors include less than good overall health, diabetes mellitus, cardiovascular disease, genitourinary disease, psychiatric disorders, other chronic conditions, smoking, and hormonal factors 30. Schneider et al reported that significantly more individuals in clinical samples had ED than did a general population sample (28.9%–30.8% versus 15%), and subjects with ED were older, had lower testosterone levels, and more anxiety than those without ED 20. The point prevalence of ED in our sample was 28.4%, and subjects with ED were significantly older, more likely to be unemployed, and had significantly higher AMS scores than did those without ED.…”

Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials

“…Results demonstrated findings similar to those observed in men with low T, including depressed mood, anxiety, impaired spermatogenesis, and loss of bone mineral density (BMD), among others. 31–33 Men with low numbers of CAG repeats (improved AR function) may also experience improved response rates to T supplementation. 34 …”

5-HT2A Receptor -1438 G/A Polymorphism and Serotonergic Antidepressant-Induced Sexual Dysfunction in Male Patients with Major Depressive Disorder: A Prospective Exploratory Study

“…The father of psychoanalysis Sigmund Freud thought that unconscious sexual desire might lead to adult neuroses [2]. Interestingly, Schneider and colleague [3] recently reported the association of androgen receptor polymorphism with higher anxiety levels in older adult men. Undoubtedly, psychiatrists who always have emphasized a biopsychosocial model play a role in the evolving field of sexual medicine.…”