Anger, Aggression, and Testosterone

Dr. Kathy Maupin and Brett Newcomb discuss whether testosterone replacement therapy causes anger and aggression. They also explore the topic of anger and defense mechanisms.

There is a myth that taking testosterone will cause men to experience increased levels of anger and aggression. The source of this myth is the belief that when an angry and aggressive man who has become passive because of his lack of testosterone gets it back, he reverts to his own personality which may be demanding and aggressive. This is “normal” for that individual and not caused by the testosterone itself.

The majority of men who replace their testosterone tend to revert to their individual “normal.” They begin to feel like themselves and become the men they had been before their testosterone levels began to decline. There is a wealth of data to support the conclusion that administering replacement testosterone does not cause men to become angry or to act aggressively.

Another myth about testosterone comes from the confusion between pure testosterone and “adrenal androgens,” which include androstenedione and androsterone. These are illegal hormone injections that athletes and body builders sometimes get from other countries and use. These particular hormones damage the adrenal gland as well as suppress the production of natural testosterone from the testicles. One can obtain what is called “steroidal rage” from these adrenal steroids, but that is not true of testosterone.

The issue then becomes how does one experience and handle anger? Since anger is not naturally hormonal, then we must turn our attention to the real problem—anger itself. My friend Brett Newcomb shares with us some theories regarding the natural element of anger that is a feeling and an experience that we are born with. He calls it “original issue equipment.” The point he makes is that feeling angry is unavoidable, at times. When a child is an infant, he will experience anger and even rage. He will lash out at his mother when she does not give him what he wants. As he gets older and can direct his anger, he will bite or hit in order to communicate his frustration and his desire. One of the elementary responsibilities of parenting is to teach young children how to experience and express their anger appropriately and with controlled determination. That is why teachers are often heard saying to their young students, “Johnny use your words!”

Freud had a theory which contended that anger was one of our principle defense mechanisms. In the beginning, we develop the defense we call “flight-or-fight” which is commanded by the release of adrenaline. As we mature and develop, we can direct those feelings and channel them into the second level of defense which Freud called “anger.” We can lash out or hit or bite or whatever seems to work to achieve our goals and express our anger and frustration. As we mature further and learn more about how to manipulate our environment and our relationships, we advance to the highest level of defenses which Freud called the “compromise reactions.” Things such as sublimation, reaction formation, and compromise reactions are the more sophisticated of the defenses that protect us.

Sometimes we lose our focus and our sense of control and act out in more primitive ways. Road rage is an example of the loss of the compromise reactions and a return to anger as a defense to protect ourselves and obtain relief for our feelings. We can even regress further to the flight-or-fight mechanism and experience dissociation or be frozen in fear, so that we do not have to feel anything.

So listen to our podcast and learn a little about how to manage your anger, how to teach your children to manage theirs appropriately. The fear that replacing your testosterone will unleash the beast within you is a myth and not a fact.