Anecdotal reports have indicated that androgen treatment may cause increased anger and "rage" attacks in men. Moreover, higher testosterone salivary levels were found in athletes and other subjects who were engaged in more competitive activities (22). By contrast, studies of men who were hypogonadal administered different preparations of testosterone have demonstrated enhanced positive mood parameters, such as well-being, energy, friendliness, and reduction in negative mood parameters, including anger, fatigue, irritability, and nervousness (23-26). In a placebo-controlled study in normal men administered testosterone in a supraphysiological dose, there was no significant change in aggression, and mood parameters were not changed in the testosterone treated group (26). Thus, in contrast to anecdotal reports, testosterone replacement in hypogonadal men improves mood.
Whether quality-of-life measures improve after androgen replacement in young or elder hypogonadal men has not been studied systematically in randomized controlled clinical trials. Improvement in sexual function, mood, and increased vigor working in synchrony would most likely improve quality of life in hypogonadal men.
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