TD;LR: Kisspeptin may affect how we act and feel. It seems plausible that a TRT-induced reduction in this hormone is a problem for some men.
I’d previously asked if suppression of GnRH by TRT is a problem. The literature at least hints that it is possible. The situation with kisspeptin may be similar. The kisspeptin hormone sits near the top of the male sex hormone cascade. It helps stimulate GnRH production, which in turn leads to LH and FSH, which leads to testosterone and then estradiol. Testosterone and estradiol then provide negative feedback for kisspeptin production in the hypothalamus. Testosterone replacement therapy tends to swamp this feedback mechanism, leading to a presumed suppression of hypothalamic kisspeptin and the other intermediate hormones. However, there are other sources of kisspeptin, albeit maybe smaller ones. These include the hippocampus and the adrenal gland. This leaves uncertainly about the importance of the likely reduction in kisspeptin caused by TRT. Nonetheless, it may be that due to inter-individual variably some men tolerate the reduction, while others have issues.
What issues? This review article lays out some possibilities. After explaining kisspeptin’s role in GnRH production, the authors say “… kisspeptin signaling is not limited to the hypothalamus but also occurs in other extrahypothalamic brain regions. It is these locations for kisspeptin signaling that gave the first clues to kisspeptin’s role in sexual and emotional processing.” In particular, in various species there’s “a role for kisspeptin in behavioral networks related to reproduction including olfaction, audition, fear, anxiety, mood, and sexual arousal.”
Of particular interest are the references to anxiety, mood and libido. These are common problem areas. It is encouraging that experiments on men yielded some positive results:
So we have some hints of the potential importance of kisspeptin. While speculative, it seems possible that kisspeptin suppression via TRT can have detrimental effects. If so then the next question is, can these problems be resolved by supplementation? Further research is needed to give us some answers.
I’d previously asked if suppression of GnRH by TRT is a problem. The literature at least hints that it is possible. The situation with kisspeptin may be similar. The kisspeptin hormone sits near the top of the male sex hormone cascade. It helps stimulate GnRH production, which in turn leads to LH and FSH, which leads to testosterone and then estradiol. Testosterone and estradiol then provide negative feedback for kisspeptin production in the hypothalamus. Testosterone replacement therapy tends to swamp this feedback mechanism, leading to a presumed suppression of hypothalamic kisspeptin and the other intermediate hormones. However, there are other sources of kisspeptin, albeit maybe smaller ones. These include the hippocampus and the adrenal gland. This leaves uncertainly about the importance of the likely reduction in kisspeptin caused by TRT. Nonetheless, it may be that due to inter-individual variably some men tolerate the reduction, while others have issues.
What issues? This review article lays out some possibilities. After explaining kisspeptin’s role in GnRH production, the authors say “… kisspeptin signaling is not limited to the hypothalamus but also occurs in other extrahypothalamic brain regions. It is these locations for kisspeptin signaling that gave the first clues to kisspeptin’s role in sexual and emotional processing.” In particular, in various species there’s “a role for kisspeptin in behavioral networks related to reproduction including olfaction, audition, fear, anxiety, mood, and sexual arousal.”
Of particular interest are the references to anxiety, mood and libido. These are common problem areas. It is encouraging that experiments on men yielded some positive results:
“… peripheral kisspeptin administration to healthy men reduces negative mood…”
“These data from rodent, zebrafish, and human studies therefore implicate kisspeptin signaling in the modulation of mood and anxiety with antidepressant-like effects which may have clinical implications.”
“This suggests that kisspeptin signaling could enhance reward-system activity during sexual arousal (particularly in those generally less responsive to reward), thereby triggering a desire for sexual activity and possibly subsequent reproduction.”
“It is therefore possible, that other factors are also important in modulating libido that may include upstream kisspeptin signaling. Certainly, the expression pattern of kisspeptin and its cognate receptor in limbic and paralimbic structures would point towards this as well as the more recent studies identifying a role in sexual brain processing and erection generation. Further studies are required to determine if kisspeptin signaling could be exploited in future therapies for patients with sexual and emotional disorders.”
So we have some hints of the potential importance of kisspeptin. While speculative, it seems possible that kisspeptin suppression via TRT can have detrimental effects. If so then the next question is, can these problems be resolved by supplementation? Further research is needed to give us some answers.