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


Gudrun Schneider, MD, Department for Psychosomatics and Psychotherapy, University of Muenster, Domagkstr.22, Muenster 48149, Germany. Tel: 0049-251-8352902; Fax: 0049-251-8352903; E-mail:


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. Schneider G, Nienhaus K, Gromoll J, Heuft G, Nieschlag E, and Zitzmann M. Sex hormone levels, genetic androgen receptor polymorphism and anxiety in ≥50-year-old males. J Sex Med **;**:**–**.