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Boost testosterone with personalized treatment plans

Key Takeaways:
Testosterone’s reputation for causing anger and aggression is overstated — the science shows a more complex story.
High, non-medical doses of anabolic steroids — which are technically testosterone — can increase aggression and mood swings. But normal testosterone levels or medically prescribed therapy generally don’t have these effects.
Research suggests that testosterone may amplify behaviors that enhance social status — both competitive and cooperative — as opposed to simply fueling hostility.
Testosterone replacement therapy (TRT) restores hormone balance for men who have low levels, often improving mood, energy, and well-being. It does not trigger a state of aggression popularly known as “roid rage.”
There’s a commonly held stereotype that men with high testosterone levels are aggressive beefcakes who are prone to “roid rage,” ready to throw a tantrum if you look at them the wrong way.
But does science back up that vignette?
Not exactly. While testosterone can influence traits like confidence, competitiveness, and social dominance, it’s not the villain behind every angry outburst. In fact, the link between testosterone and aggression is far more nuanced when you dig a little deeper.
Here, you’ll learn more about the connection between testosterone and anger, along with other ways the hormone may impact mood, energy, and more.
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The term “roid rage” is commonly used to describe the mood swings that can occur with anabolic steroid use, with the word “roid” being short for “steroid.” But despite containing testosterone, anabolic steroids aren’t the same as testosterone replacement therapy (TRT). TRT is a prescription treatment for clinically low testosterone (hypogonadism) that aims to restore levels of the hormone to the normal range. Anabolic steroids, on the other hand, are typically administered in much higher doses without a prescription with the goal of increasing muscle size and enhancing physical performance.
There are many risks associated with anabolic steroids, some of which are emotional in nature — including increased aggression.
In a 2022 study, bodybuilders who had previously used steroids were more likely to show anger issues and psychopathic traits than those who hadn’t. Earlier research has found similar results, noting that steroid users often become more moody, impulsive, aggressive, and even violent as their testosterone doses increase. Scientists think this may be due to changes in the brain, such as thinning of the cortex, reduced gray matter, and an enlarged amygdala.
Steroid use can also speed up brain aging, affect cognitive function, and disrupt normal brain signaling, which may increase anxiety and aggression while lowering self-control.
We know that there’s a link between anabolic steroid use and aggressive behavior in some users, but is the same true for those who have naturally high testosterone levels? After all, testosterone is technically a steroid hormone.
It’s not a new idea that a hormonal imbalance that leads to unusually high levels of testosterone could cause roid rage. In fact, researchers have been trying to link testosterone to aggression for decades. However, better and more reliable data is needed in order to provide a confident conclusion..
One of the first studies linking testosterone to aggression was published back in 1972, when researchers discovered that prisoners who had committed violent crimes during their adolescence had higher testosterone levels. While other studies have since revealed similar findings, some researchers have advised viewing these results with caution because of methodological limitations.
These studies typically involve a small sample size, and it’s also key to consider that prisoners live in unnatural and likely uncomfortable conditions. For these reasons, it’s unfair to presume the same results would apply to subjects who aren’t imprisoned. To that point, most studies that don’t focus on prisoners and still link high testosterone to aggression rely on data that’s self-reported and provides conflicting results.
Sometimes, testosterone’s reputation may function as a self-fulfilling prophecy.
In one study, men who believed they had received testosterone became angrier and more aggressive during a task — even if they’d only received a placebo. Their expectations about how testosterone “should” make them feel seemed to drive their reactions more so than the hormone itself.
A similar experiment with women found the same result, but in reverse. Those who actually received testosterone (but weren’t told so) behaved more fairly and cooperatively in a bargaining game, while those who merely believed they had taken it (but had not) acted more selfishly and aggressive. Together, these findings illustrate that testosterone’s reputation may have more sway over behavior than the hormone does on its own.
Studies support that testosterone and cortisol, which are both steroid hormones, may influence risk-taking behavior, which is often mistaken for aggression.
Testosterone generally increases risk-taking, not because it makes people more reckless, but because it boosts confidence, status-seeking tendencies, and optimism about outcomes. In lab and trading settings, higher or experimentally raised testosterone is linked to riskier bids and more positive price expectations. But it’s not a one-size-fits-all situation. Context, timing, and individual biology (e.g., androgen receptor sensitivity) shape the degree to which the risk-taking effect shows up.
Cortisol adds important nuance to risk-taking behavior because the hormone is timing-sensitive. Short, acute spikes of stress can push people toward faster, more reward-seeking choices and sloppier error-checking. Chronically high cortisol (or a disrupted daily rhythm) tends to impair thinking and self-control, which can either dull risk-taking or make it less advantageous.
In real life, both hormones operate together, and some evidence suggests testosterone’s risk-boosting effects are strongest when cortisol is low.
Taken together, testosterone tilts the table toward taking the shot, but cortisol decides whether it’s a bold move or a stressed one.
Much of the research on testosterone and aggression focuses on whether or not the hormone leads to antisocial behaviors (aggression being just one type).
However, one small 2016 study sought to investigate if the opposite could also be true: Could testosterone also cause prosocial behavior?
In the double-blind, randomized study, men were injected with either testosterone or a placebo before playing a money-splitting game. In each round, another player made them an offer on how to divide a sum of money — fair or unfair. The participants could then spend their own money to either punish the proposer (by taking away their earnings) or reward them (by giving them more).
Those who received testosterone were more likely to punish unfair offers, reacting more strongly to provocation, but they were also more generous toward fair, high offers. The takeaway? Testosterone doesn’t necessarily just fuel aggression — it may also amplify both prosocial and antisocial behaviors that help enhance social status.
While higher testosterone may be popularly perceived to appeal to a competitive and dominant nature, some research shows that it’s the competition itself that actually leads to testosterone spikes.
In two studies, researchers examined how elite male hockey players responded after watching themselves succeed competitively. Results showed that watching a previous victory produced a significant increase in testosterone concentrations (by 42–44 percent), whereas watching a previous defeat or a neutral video didn’t have that effect.
After all this talk about testosterone and behavior, it’s easy to see why you might worry that taking it as a prescribed therapy for low testosterone could spark aggression. While anabolic steroids might cause problems (aggression, among many others), TRT is a different story entirely.
Here’s why:
Anabolic steroids flood the body with unnaturally high doses of testosterone, but TRT is designed to restore levels to a healthy, natural range for men with clinically low T levels. Rather than triggering anger, research shows that testosterone therapy often does the opposite – it can lift mood, reduce irritability, and improve overall well-being in men whose low hormone levels were dragging them down.
Other positive effects of testosterone treatment may include:
Higher libido
More energy
Increased bone density
Enhanced strength
Improved muscle mass
Better cognitive function
However, like any other medication, TRT can also cause adverse side effects. These include:
Skin irritation or swelling for topicals and injectables
Acne
Allergic reactions
Infections
Low sperm count and infertility
Increased risk of hair loss
Higher red blood cell count
Worsening of sleep apnea
Reduction in high-density lipoprotein (HDL) cholesterol, aka “good cholesterol”
For some men, especially those looking for fertility-safe treatments, other testosterone treatments like enclomiphene may be more appealing. Enclomiphene is an oral medication that helps your body make more testosterone without shutting down sperm production.
Read more about how enclomiphene works.
Testosterone may not turn you into a bodybuilding beast, but it has a lot more to offer.
As the primary male sex hormone, testosterone is the behind-the-scenes player in everything from sexual function and strength to mood, focus, and overall well-being. Think of it as the body’s built-in performance optimizer — not just for the gym, but for everyday life.
Testosterone helps support various aspects of men’s health, including:
Sex drive (libido) and sexual performance
Muscle growth and strength
Bone density
Red blood cell production and oxygen delivery
Mood stability and cognitive function
Energy and motivation
If testosterone levels drop below normal, you may experience symptoms, like:
Decreased libido
Low energy or fatigue
Loss of muscle mass
Reduced bone density
Brain fog or difficulty concentrating
Mood changes
Increased body fat
Less body hair or low sperm count
A simple blood test can confirm low testosterone (testosterone deficiency). If levels are below the healthy range, treatment options like TRT or alternatives such as enclomiphene may help restore balance and vitality.
Despite its tough-guy reputation, testosterone isn’t the anger hormone it’s often made out to be. In reality, testosterone is more likely to fuel drive, confidence, and motivation rather than rage or violence. High levels don’t automatically make someone aggressive, and restoring low levels through TRT is more likely to improve mood and energy than cause hostility.
The real culprit behind “roid rage” is usually anabolic steroid abuse, where testosterone is taken in unnaturally high doses. When used responsibly and under medical supervision, testosterone supports balance — not chaos.
Not necessarily. Research shows that higher testosterone levels are linked to confidence, competitiveness, and status-seeking traits — not uncontrollable aggression. Environmental factors, stress, and personality play an important contextualizing role in human aggression that hormone levels alone won’t reveal.
When taken as prescribed for low testosterone, testosterone therapy typically improves mood, focus, and energy. It doesn’t cause aggression or “roid rage.” That reputation comes from the misuse of anabolic steroids, which involve much higher, non-medical doses.
TRT is designed to return testosterone levels to a healthy, natural range. Anabolic steroids, on the other hand, are synthetic versions of testosterone often taken in dangerously high doses to build muscle or improve performance. Those high doses can disrupt normal hormone balance and sometimes trigger aggression, mood swings, or other serious health risks.
Common signs of low testosterone include low sex drive, fatigue, erectile dysfunction, loss of muscle mass, brain fog, increased body fat, and mood changes. The only way to know for sure is with a blood test, which measures total and free testosterone levels.
Normal testosterone levels typically fall in a range between 300 and 1,000 nanograms per deciliter (ng/dL), but each person’s specific baseline varies. Your doctor will consider both your numbers and your symptoms when deciding if treatment is appropriate for you.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Full Name: Darragh O’Carroll MD
Professional Title(s): Board Certified Emergency Physician
Current Role at Hims & Hers: Medical Advisor
Education:
Bachelor of Science in Human Physiology - Boston University, 2007
Medical Doctorate - University of Hawaii John A. Burns School of Medicine, 2012
Training:
Internship & Residency - Los Angeles General + USC Emergency Medicine, 2016
Medical Licenses:
California, 2013
Hawaii, 2016
Board Certifications:
Years of Experience: 14
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