Rising testosterone levels predict anxiety and depression risk in preteen girls

A new study suggests that increasing levels of testosterone during early puberty may play a significant role in the emotional development of adolescent females, predicting a higher risk for anxiety and depression symptoms. The research, published in the journal Psychoneuroendocrinology, provides evidence that these hormonal shifts influence emotional well-being before physical signs of puberty even appear. These findings highlight a specific age window where young adolescents might benefit most from proactive emotional support.

The transition into adolescence often brings a surge in emotional difficulties, particularly for young females. Mental health professionals frequently observe an increase in internalizing symptoms during this time of rapid development. Internalizing symptoms refer to emotional struggles that a person directs inward, such as feelings of anxiety, sadness, loneliness, and depression.

To understand why this vulnerability occurs, experts often look at the complex biological and social changes that define puberty. Historically, scientific consensus suspected that estrogen, specifically estradiol, was the primary driver of mood changes in young females. Estradiol is a form of estrogen that plays a major role in female reproductive health and physical maturation.

Other theories suggest that the social challenges of looking physically older than one’s peers cause emotional distress. This idea is known as the maturation disparity hypothesis. It proposes that early visible physical changes invite social pressures that a young person is not yet emotionally prepared to handle.

Another perspective is the hormonal influence hypothesis, which proposes that the release of hormones directly affects how the brain develops and processes emotions, regardless of outward physical changes. Based on this idea, the current research team wanted to isolate the effects of androgenic hormones, like testosterone and dehydroepiandrosterone. Dehydroepiandrosterone is a naturally occurring hormone that serves as a precursor to testosterone and helps initiate early pubertal changes.

The team of researchers from the University of Georgia and Augusta University structured their study to see if these specific hormones present a unique biological pathway to emotional distress. They aimed to determine if testosterone increases could predict anxiety and depression symptoms, even when factoring in estrogen levels and observable physical maturation.

To track these developmental changes, the authors analyzed data from 5,476 female participants. These individuals were part of the Adolescent Brain Cognitive Development Study, a large and ongoing project tracking child health in the United States. The scientists followed the participants over four annual assessments, covering the ages of 9 to 13.

The researchers collected morning saliva samples from the youth each year to measure their hormone levels. Laboratory tests determined the specific concentrations of dehydroepiandrosterone, testosterone, and estradiol in each sample. The team also gathered information about the participants’ physical pubertal development. Caregivers filled out a standardized questionnaire detailing their child’s visible physical changes, such as growth spurts and menarche, which is the medical term for a first menstrual period.

To measure emotional well-being, the youth filled out self-report surveys starting between the ages of 10 and 11. These surveys asked the adolescents to rate their own internalizing symptoms, such as how often they felt worried, sad, or anxious. By combining the biological data with the surveys, the scientists built complex statistical models to see how hormonal shifts over time related to the onset of emotional distress.

The statistical models allowed the scientists to look at how a change in one biological marker predicted a change in another factor down the line. The analysis revealed distinct developmental patterns for the different hormones as the youth aged. Dehydroepiandrosterone levels showed an accelerating, non-linear growth trajectory, starting with gradual increases that spiked sharply as the children grew older. Testosterone followed a different pattern, showing a modest and steady increase across the early adolescent years.

When looking at the link to mental health, the researchers found that increases in testosterone predicted higher internalizing symptoms specifically between the ages of 10 and 12. Females who experienced greater increases in testosterone were more likely to report feelings of depression and anxiety. This association held true even when the statistical models adjusted for the participants’ levels of estradiol and their visible physical maturation.

To explain this link between testosterone and mood, the authors point to changing brain circuitry. As testosterone levels rise, the hormone interacts with developing brain regions like the amygdala, which plays a major role in processing threats and emotions. This biological shift tends to make young females much more sensitive to social evaluation and environmental stressors, explaining the rise in inward-directed emotional struggles.

Interestingly, the study found that physical maturation did not have the same negative impact on emotional distress as the hormonal changes. At one point during the study, around ages 11 to 12, higher rates of visible physical development actually predicted lower internalizing symptoms. This suggests that physical maturation may sometimes offer social advantages that buffer against anxiety and depression during certain developmental stages.

Estradiol also played a role in the emotional landscape of the participants, but its effects appeared slightly later in development. Estradiol levels were associated with internalizing symptoms in the older age bracket, specifically between ages 11 and 13. The presence of estradiol did not explain away the link between testosterone and emotional distress in the younger window, meaning the two hormones operate on distinct timelines.

Several limitations apply to this study that require consideration. The researchers collected hormone data only once a year, which means the study could not capture the natural daily or monthly fluctuations in hormone concentrations. A single annual snapshot provides a limited view of a person’s overall endocrine activity and might miss shorter-term dynamics.

The reliance on parent reports for physical development also presents a limitation for the study design. Adolescents’ own perceptions of their physical changes might have a stronger connection to their psychological vulnerability than what a parent observes. Additionally, the scientists focused exclusively on internalizing symptoms and did not measure externalizing behaviors, such as acting out or aggressive actions, which might also relate to testosterone changes.

The sample only included females, which means the findings may not apply to male pubertal development. Testosterone increases much more steeply in males, which could result in entirely different neurological and behavioral effects. Future research should examine similar models in males to see if these hormonal pathways act differently depending on biological sex.

Future studies would also benefit from more frequent hormone sampling to capture rapid biological shifts. Scientists might also look directly at brain imaging to see exactly how these hormones alter the neural circuits responsible for processing stress. Understanding the exact biological mechanisms at play could help researchers create better mental health resources for youth.

These findings offer helpful clinical context for mental health professionals and parents. The ages of 10 to 12 seem to represent a specific window of sensitivity where young females are highly responsive to social feedback and stress. The researchers note that these findings do not suggest that doctors should start routinely screening young girls’ hormone levels, as early symptoms often represent expected developmental distress rather than clinical disorders.

Instead, this information provides a helpful timeline for early intervention. If parents and schools know that ages 10 to 12 bring invisible biological changes that heighten emotional sensitivity, they can introduce foundational emotion regulation and coping skills early. Being aware of this biological transition may help families provide proactive emotional support before clinical mental health disorders develop.

The study, “Links between hormonal and pubertal development, and adolescent females’ risk for affective symptoms,” was authored by Avary I. Evans, Steven M. Kogan, Kalsea J. Koss, Ellen M. House, Charles F. Geier, and Assaf Oshri.