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The Hidden Link Between Testosterone, Motivation, Mood, and Performance

The Hidden Link Between Testosterone, Motivation, Mood, and Performance

June 2026 | Clinical Commentary
Author: Michael Murphy, MSN, PMHNP-S

Introduction

Few hormones carry as much cultural baggage as testosterone. It has become shorthand for dominance, drive, and masculinity itself, as though, turned high enough, it produces success and confidence. That framing is mostly wrong. The opposite error appears in clinical settings, where testosterone is treated as relevant only to libido and fertility, its links to mood, energy, motivation, and physical function underappreciated. The honest position sits in between: testosterone is a real, measurable contributor to how men feel and function, but not the master switch marketing or mythology implies. A 2021 University of Bristol study shows why much of that narrative collapses under scrutiny; recent clinical literature shows where testosterone genuinely matters.

About the study

The primary research came from Harrison and colleagues at the University of Bristol, published in Science Advances in 2021. The question was simple: does a man’s testosterone actually influence where he ends up in life? Observational studies had long shown that men with higher testosterone tend to have higher incomes, more education, and more senior roles. But this kind of correlation cannot tell you which way the arrow points.
To separate cause from association, the researchers used Mendelian randomization in 306,248 UK Biobank adults — a method that exploits the fact that the gene variants influencing testosterone are essentially assigned at random at conception. If testosterone truly drove success, genetically predicted differences should track with those outcomes. They largely did not. The team found little evidence that testosterone meaningfully affected socioeconomic position, self-rated health, body mass index, or risk-taking in men or women.
The conclusion is narrow. Genetically determined testosterone does not appear to be a meaningful cause of life success or risk-taking; the earlier associations probably reflected reverse causation and confounding, with circumstance shaping testosterone rather than the reverse. What the study cannot tell us matters just as much: it was not about men with clinically low testosterone, did not measure depression, anxiety, or motivation, and was less precise in women. It is strong evidence against the success-hormone myth, but says little about the clinical questions that bring patients into the office.

What else do we know?

Newer literature fills in the clinical picture, and the theme is that context decides everything: testosterone behaves very differently in a man with a normal level than in one who is genuinely deficient.
On mood and depressive symptoms, the largest recent evidence comes from the TRAVERSE trial program. In 2024 analyses, testosterone replacement produced modest but significant improvements in mood and energy versus placebo in hypogonadal men with depressive symptoms — yet in the small subgroup with rigorously defined persistent depressive disorder, it did not outperform placebo. Testosterone is not an antidepressant, but correcting a true deficiency can lift the low mood and flat energy deficiency produces. The relationship also runs both ways, which makes cause and effect hard to separate in any individual
On replacement therapy more broadly, the 2024 TestES individual-participant meta-analysis and related work found that TRT in confirmed hypogonadism reliably improves sexual function and quality of life, with smaller effects on mood and energy. The benefits are consistent but not dramatic, and they apply to genuinely deficient men, not those with normal levels seeking enhancement.
On motivation and reward, the biology is plausible — androgen receptors sit within dopaminergic reward circuitry — but the human evidence stays associative, not causal, and the Bristol data caution against assuming testosterone drives every case of low drive. On cognition and executive function, results are mixed and modest: small gains appear in some older-men trials, but large trials show little effect on general cognition. Testosterone is not a cognitive enhancer in men with normal levels.
Physical performance and body composition show the most consistent effects. Meta-analyses find testosterone treatment increases lean body mass by roughly two to five kilograms and improves strength, particularly in the legs and grip, though strength gains vary more than mass gains. This is a genuine physiological effect — which is why it is essential to distinguish physiological replacement in deficient men from supraphysiologic use for performance, which carries a very different risk profile.

What this means

For the high-performing adults we see — executives, entrepreneurs, clinicians, athletes, veterans, and first responders — the practical message is to take symptoms seriously without assuming testosterone is the cause. Persistent fatigue, low motivation, poor recovery, declining strength, depressed mood, and reduced libido all warrant evaluation, which should include a morning total testosterone on at least two occasions, since one low reading is not a diagnosis. Testosterone deserves a real look when symptoms are consistent and levels are repeatedly and clearly low.
Far more often, the likelier explanation is lifestyle, and these factors deserve attention first because they frequently lower testosterone themselves. Insufficient sleep suppresses it measurably, sometimes within a week. Excess visceral fat lowers it through increased conversion to estrogen and is among the most common reversible contributors. Heavy alcohol suppresses it directly, and chronic stress raises cortisol, which opposes it. Resistance training and adequate protein support healthy levels, while overtraining and underfueling can do the opposite. Such a man may show a low reading that is a downstream signal, not the root problem.
This is the part most worth holding onto: low testosterone is frequently both a symptom and a contributor. It can be the body’s readout of poor sleep, obesity, alcohol, and stress, and it can simultaneously make those problems harder to escape by draining energy and motivation. That two-way relationship is why a serious look at the basics usually matters more than a prescription.

The bottom line

The best available evidence suggests testosterone does not determine success, intelligence, or life outcomes, and that much of its reputation reflects confounding rather than cause. Genuinely low testosterone is clinically real and worth addressing, with the clearest benefits of replacement seen in confirmed deficiency: improved sexual function, quality of life, lean mass, and strength, plus modest gains in mood and energy. For most men with fatigue and flagging motivation, sleep, weight, alcohol, and stress are the likelier culprits and the more durable levers. Testosterone matters more than many people realize, but less than many people claim.

Sources

Harrison, S., Davies, N. M., Howe, L. D., & Hughes, A. (2021). Testosterone and socioeconomic position: Mendelian randomization in 306,248 men and women in UK Biobank. Science Advances, 7(31), eabf8257. https://doi.org/10.1126/sciadv.abf8257
Bhasin, S., Seidman, S., Travison, T. G., et al. (2024). Depressive syndromes in men with hypogonadism in the TRAVERSE trial: Response to testosterone-replacement therapy. The Journal of Clinical Endocrinology & Metabolism, 109(7), 1814-1826. https://doi.org/10.1210/clinem/dgae026
Cruickshank, M., Hudson, J., Hernandez, R., et al. (2024). The effects and safety of testosterone replacement therapy for men with hypogonadism: the TestES evidence synthesis and economic evaluation. Health Technology Assessment, 28(43). https://doi.org/10.3310/JRYT3981
Lee, T.-W., Kao, P.-Y., Chen, Y.-C., & Wang, S.-T. (2023). Effects of testosterone replacement therapy on muscle strength in older men with low to low-normal testosterone levels: A systematic review and meta-analysis. Gerontology, 69(10), 1157-1166. https://doi.org/10.1159/000532062
Indirli, R., Lanzi, V., Arosio, M., Mantovani, G., & Ferrante, E. (2023). The association of hypogonadism with depression and its treatments.