In the past several years the phenomenon of increased low testosterone in men over 50 has become more widespread. Part of the reason for this is a greater degree of communication between psychiatrist and genitourinary medicine providers about the role of low testosterone in creating depression, apathy, and memory loss. Men don’t and can’t feel their full degree of not just sexual vigor, but the drive for life, if they have suppressed levels of this hormone. The complicated part is that testosterone replacement therapies are not without their effects for physical and mental health. If you or a loved one start treatment, it can be very useful to have a psychiatric baseline of functioning. This gives you a baseline from which to assess the psychiatric effects that may occur — which include, depression, mania, moodiness, irritability, and aggression. About 20-30% of men on testosterone replacement suffer from some degree of mood change during the course of treatment. The good news is that with good coordination of care between a psychiatrist and an endocrinologist prescribing the testosterone things can usually be adjusted so that the benefits far outweigh these problems.