Hormones of the hypothalamic-pituitary-gonadal (HPG) axis in male depressive disorders - A systematic review and meta-analysis

Sexual dysfunctions are common in men with depression. As the hypothalamic-pituitary-gonadal (HPG) axis is a crucial regulator of sexual function, and also affects mood and cognition, the following question arises: Is the HPG axis altered in depressed men when compared to healthy controls? To answer this question, PubMed and PsycINFO were searched. Inclusion criteria for the systematic review and meta-analysis were: (1) case-control study including male patients with a depressive disorder and (2) assessment of follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, or testosterone. Seventeen studies were identified. Follicle-stimulating hormone and LH did not differ between patients and controls. By contrast, in patients, oestradiol was marginally increased (g = 0.52, 95% CI [-0.01, 1.04]; Z = 1.92, p = .055) and testosterone was significantly decreased (g = -0.45, 95% CI [-0.80, -0.10]; Z = -2.53, p = .012). Depressed men may be characterised by diminished testosterone and potentially elevated oestradiol, which beyond contributing to sexual dysfunction, could impact mood and cognition.