Can Stress Affect Testosterone Levels? What You Should Know

We live in a fast-paced society. Stress seems almost unavoidable. Yet, chronic stress can significantly impact your mental and physical health. It can disrupt your hormonal health, including your sex hormones.

Can stress affect testosterone levels? Testosterone is a major male sex hormone that has a vital role in both the male and female body. Stress hormones can affect everything from your sexual health to your mood and muscle mass. Chronic stress increases cortisol which in turn can reduce your testosterone levels.

In this article, we’ll share the connection between stress and testosterone. You will learn how chronic stress may disrupt your hormonal balance and share our best strategies to manage stress and support healthy testosterone levels. Let’s dive in.

How Stress Affects Hormone Levels

Before we discuss how stress can affect testosterone and other hormone levels, let’s discuss what stress is.

What Is Stress?

Stress is a part of life, we all experience it. You may experience psychological stress, psychosocial stress, or physical stress. Examples of psychological stressors include losing a job, having to relocate, or financial troubles. Examples of psychosocial stressors include divorce, chronic health issues, work troubles, or experiencing abuse. Examples of physical stress include noise pollution, air pollution, extreme temperatures, and natural disasters.

How much it affects our health depends on what types of stress we are dealing with and how often. There are two types of stress: acute stress and chronic stress (1).

Acute stress refers to short-term stress. It happens because of a specific stressor. For example, if you hear some unexpected bad news or you get caught in traffic, you may experience some acute emotional stress. This acute stress may result in irritability, anxiety, anger, mood swings, poor sleep, nightmares, or poor concentration. However, acute stress doesn’t last long. It is a short-term response to a stressor.

Chronic stress, however, is another ball game. It’s ongoing, long-term stress that often happens due to a multitude of stressors, not just one. Chances are, you can’t even pinpoint why you are stressed. It generally happens due to a combination of many things, including financial issues, work troubles, health issues, relationship struggles, and any other psychological, psychosocial, and physical stressors.

Acute stress can also turn chronic. For example, you may experience acute psychological stress after losing a job, which could turn into chronic stress if you continue to struggle finding work. Chronic stress can result in ongoing anxiety, irritability, anger, agitation, depression, loneliness, inflammation, pain, and health issues. Moreover, you can develop post-traumatic stress disorder (PTSD) from both acute and stress that results in trauma (2). You may develop complex PTSD or c-PTSD from complex or ongoing trauma. Just like in chronic stress, in c-PTSD, the cause of your symptoms is not one acute event but ongoing stressors (3).

Your Body’s Stress Response

Now that you understand what stress is, let’s talk about what happens in your body, specifically to your hormones, when you are experiencing a stress response.

When you are experiencing stress, your body can respond in a variety of ways, including:

• Increased breathing: Your breathing rate increases to move more oxygen to your muscles and tissues quickly.
• Increase heart rate: Your heart rate gets elevated to deliver oxygenated blood to where it’s needed in your body.
• Increased blood pressure: Your blood pressure increases to move oxygen to your muscles.
• Glucose release: Glucose gets released from your liver to send energy to your cells.
• Slower digestion: Your digestion decreases to redirect energy into areas of your body responsible for survival instead of breaking down food.
• Dilated pupils: Your pupils may dilated to improve vision and allow more light.
• Sweating: Your sweat glands may get activated due to hormonal release.
• Hormone release: Your adrenal glands will release hormones such as adrenaline and cortisol.

Let’s talk about the hormone released during stress. The two hormones you’ll hear about frequently when discussing stress are adrenaline and cortisol. Adrenaline, also known as epinephrine, is the body’s quick-response hormone. It makes the heart beat faster and prepares your body for a fight-or-flight response to stress.

Cortisol, on the other hand, is your main stress hormone and has a broader impact on your body. It adjusts various body functions that aren’t critical in the moment, like digestion and immune response, and it provides energy by tapping into your body’s fat, protein, and carbohydrate stores. Essentially, cortisol helps keep your body’s resources focused on handling stress.

In fact, when you hear the word ‘stress hormone’, chances are, people are referring to cortisol. Cortisol influences many systems in your body, including your nervous, immune, respiratory, cardiovascular, musculoskeletal, reproductive, and skin systems.

It’s designed to be helpful by suppressing inflammation and controlling how your body uses carbohydrates, fats, and proteins. But if your cortisol levels stay high for too long, due to ongoing stress, it can lead to problems like chronic inflammation, weakened immune function, high blood pressure, changes in your blood sugar levels, and disruptions in your sleep cycle.

So how does your body regulate cortisol? It’s a team effort involving your hypothalamus and pituitary gland, both located in your brain.

If your cortisol levels drop, your hypothalamus will release corticotropin-releasing hormones (CRH) that signal your pituitary gland to make adrenocorticotropic hormone (ACTH). ACTH is responsible for prompting your adrenal glands to create and release cortisol in times of stress. Under chronic stress, you may end up with constant cortisol production, too much cortisol, and related health issues (4).

Cortisol vs. Testosterone

Since this article is about how can stress affect testosterone specifically, you may be wondering why are we talking about cortisol so much. Well, this is because all of your hormones are interconnected! Increased cortisol levels due to stress can negatively impact your testosterone production.

What is Testosterone?

Testosterone is the major male sex hormone. It plays a critical role in both the male and female body. In males, testosterone is produced in the testes, and in females—though in smaller amounts—it is made in the ovaries and adrenal glands.

In males, testosterone plays a role in the development of the penis and testes, the appearance of facial and pubic hair, balding, the deepening of the voice during adolescence, bone growth and bone strength, muscle size and muscle strength, sperm production, and libido. In females, it plays a role in ovarian function, bone strength, and libido. It also helps the brain to function and to create a balanced mood.

The Impact of Cortisol on Testosterone

Your cortisol levels increase when you are under stress and “flight mode” is triggered. When your cortisol levels spike under stress, your body blocks testosterone as a response. This happens because testosterone-related actions, such as mating or aggression, are not essential when your body is in flight mode, trying to escape potential harm.

Historically, the fight-or-flight response, including the release of adrenaline and cortisol, was crucial for our ancestors’ survival. When faced with immediate dangers like predators or other threats, this quick hormonal response would prepare them either to fight the threat or flee to safety. However, in modern times, this same stress response is triggered by everyday non-life-threatening situations—like work deadlines, traffic, or social pressures that can lead to chronic stress (5).

This can also happen if you are dealing with increased cortisol due to an ongoing health issue. According to a 2023 study published in Clinical Medicine Insights, high cortisol levels due to type 2 diabetes may decrease testosterone levels (6).

If you are experiencing chronic stress, you may end up with ongoing elevated cortisol and decreased testosterone levels, which can significantly impact your body and result in chronic symptoms and health issues.

The Impact of Chronic Stress on Testosterone

As you can see, high cortisol levels due to chronic stress are not good news for your testosterone levels. So how can stress affect testosterone? What are the long-term effects of chronic stress-related, low testosterone levels on your hormone balance and overall health?

Long-Term Effects on Hormone Balance

Prolonged stress can have significant effects on both your physical and mental health. It disrupts your hormonal balance, including your normal testosterone levels. As you learned earlier, extended periods of stress can result in elevated cortisol and adrenaline levels. Your body simply can’t relax if it’s always in fight-or-flight mode.

Excess cortisol can lead to a decrease in testosterone. Chronically high cortisol levels due to chronic stress can lead to constantly low testosterone levels (5, 6).

High cortisol levels due to chronic stress may also decrease estrogen levels, which can result in irregular periods, fatigue, night sweats, hot flashes, mood imbalances, and more, in females. It may also cause low progesterone levels, which may also contribute to irregular periods, anxiety, depression, fatigue, migraines, weight gain, fibroids, breast tenderness, low libido, and more (7).

Besides your sex hormones, chronic stress can also impact other hormones, including your thyroid hormones, leptin, ghrelin, melatonin, and insulin (8, 9, 10, 11). Thyroid hormone imbalance may result in hypothyroidism or hyperthyroidism. Ghrelin and leptin both regulate your appetite and hunger, thus imbalances may affect your weight and diet. Melatonin supports sleep and low levels may cause insomnia and poor sleep. Insulin imbalances can result in type 2 diabetes.

Symptoms of Low Testosterone

Common signs and symptoms of low testosterone levels related to chronic stress may include:

• Low libido
• Erectile dysfunction, in males
• Shrinking testicles, in males
• Hot flashes
• Low to zero sperm count, in males
• Ovarian dysfunction, in females
• Infertility
• Loss of armpit and pubic hair
• Increased body fat
• Reduced muscle mass and strength
• Lower endurance
• Enlarged male breast tissue (gynecomastia)
• Difficulty concentrating
• Poor memory
• Low mood
• Poor energy levels

Stress-Induced Health Issues Related to Testosterone

Clearly, low testosterone levels can significantly affect your health. Because testosterone is such an important hormone, stress-induced low testosterone levels can result in various health issues, including concerns with your sexual health, libido, and mental health.

Effects on Sexual Health and Libido

Testosterone is the key hormone responsible for sex drive and sexual health in males. It’s not surprising that low testosterone can affect sexual health and libido in both males and females.

Stress-induced low testosterone levels are a common reason behind low libido. For men, it may result in fewer spontaneous erections during sleep and erectile dysfunction, as well. As a 2013 review published in The World Journal of Men’s Health explains, as men age, testosterone levels drop which may result in low libido, erectile dysfunction, sexual dysfunction, metabolic disease, and cardiovascular disease (12). Coupling aging-related low testosterone with chronic stress and related testosterone deficiency is not great news.

Improving testosterone may help. According to a 2018 paper published in Current Opinions in Urology, improving testosterone levels with testosterone therapy may help to improve libido and erectile dysfunction in men (13). 

Low testosterone levels may affect sexual health and libido in women, too. It may also contribute to poor bone density and irregular periods. However, according to current research, there doesn’t seem to be a benefit of testosterone therapy for sexual function in women (14).

Mental Health Implications

Stress-related low testosterone levels may also have mental health implications. Chronic stress itself can increase the risk of depression, anxiety, and other mental health conditions. Testosterone deficiency and hormonal imbalances only add to the psychological pressure and the increased risk of mental health issues.

Besides sexual health, testosterone is critical for emotional regulation. It shouldn’t come as a surprise that low testosterone levels can lead to fatigue, low energy, irritability, concentration troubles, poor memory, anxiety, depression, and other mood imbalances (15).

A 2011 study published in Aging Men has found that low levels of testosterone were associated with symptoms of anxiety in male participants, but not with serious mental health issues (16). Improving testosterone may help to improve low testosterone-related mood imbalances. A 2019 study published in JAMA Psychiatry has found that testosterone therapy may help to reduce symptoms of depression (17).

On the other hand, excessive testosterone is not good either. In fact, psychosocial stress increases testosterone in patients with serious mental health conditions such as borderline personality disorder. It can increase the risk of irritability, anger, hypomania, and depression (18). Thus, optimal hormonal balance and normal testosterone levels are critical for mental health.

Managing Stress to Support Healthy Testosterone Levels

Fortunately, you can support healthy testosterone levels and reduce stress-related deficient testosterone levels with a few simple and natural strategies.

Stress Reduction Techniques

Stress and testosterone levels are connected, so reducing your stress levels is critical. Here are some of our recommendations to lower stress and reduce the risk of stress-induced testosterone deficiency.

Sleep

Getting enough sleep is critical for reducing your stress levels (19). We recommend getting 7 to 9 hours of restorative sleep every night. Try to go to bed around the same time, this supports your sleep cycle.

Develop a relaxing bedtime routine. Stay away from blue lights, electronic use, heavy meals, sugar, and alcohol the last few hours before bedtime. Reading, journaling, coloring, listening to relaxing music, and taking a bath can help to unwind. Having a supportive bed and bedding, blackout curtains, and an eye mask can all help you sleep.

Exercise

Moving your body can also help to reduce your stress levels, anxiety, irritability, anger, or depression (20). Make it a point to stay active throughout the day. Simple actions like stretching regularly, taking the stairs instead of the elevator, or going for a walk in the park can make a significant difference. Aim to exercise at least five days a week, spending 20 to 30 minutes per session at a minimum. Mix up cardiovascular workouts with strength and resistance training.

Jogging, biking, swimming, dancing, and hiking are great for cardio. Body weight exercises, weight lifting, kettlebell training, and TRX workouts are fantastic for muscle strength. Yoga, pilates, and barre workouts are great low-impact options.

Relaxation and Stress Management Strategies

Using relaxation and stress management strategies can help you respond to stress better and lower your stress levels. Thus, it may improve stress-induced low testosterone levels.

Meditation is a fantastic option for managing stress better (21). Other effective techniques include mindfulness, breathwork, guided relaxation, and maintaining a gratitude practice (22, 23). If you’re facing depression, anxiety, or other mental health challenges, working with a therapist can also be highly beneficial. A therapist can help you learn additional strategies to manage your stress and address mental health concerns more effectively.

Diet and Supplements

Just like regular exercise, healthy eating and good nutrition are just as important for reducing stress and supporting testosterone levels (24).

Whole-Foods Diet

Remove inflammatory and processed foods from your diet. This includes refined sugar, refined oil, foods with artificial ingredients, sodas, and sugary drinks, overly processed foods, and foods you are allergic to. Choose a whole foods diet instead with lots of greens, vegetables, fruits, spices, herbs, sprouts, fermented food, pasture-raised eggs, grass-fed meat, pasture-raised turkey, wild-caught fish and seafood, and wild game (25).

Specific foods that may boost testosterone levels include healthy fats. Low-fat diets may reduce testosterone levels (26). Omega-3-rich fatty fish and seafood and healthy fats, such as extra virgin olive oil, coconut oil avocados, and olives may help.

Oysters are not only a great source of fat but are also rich in zinc which may help your testosterone levels (27). Leafy greens, such as kale and spinach, are high in magnesium which may help testosterone production (28). They are also rich in plant-based steroids which may help (29, 30). Onion and ginger may also help to increase your testosterone levels (31, 32).

Supplements for Testosterone

Certain supplements can be beneficial for boosting testosterone and enhancing sexual health. Zinc, for example, is known to potentially raise testosterone levels and improve semen qualityC (27). Magnesium may also help to improve your testosterone markers (28, 33). Vitamin D, ashwagandha, fenugreek, and ginger supplements are great options that may contribute to better hormonal health and overall sexual well-being. (34, 35, 36, 32).

When to Seek Medical Advice

You now understand how stress may affect testosterone levels. And you now know how to improve your stress to support healthy testosterone levels. But how do you know when to seek medical advice?

Recognizing the Need for Professional Help

If you are experiencing symptoms of low testosterone levels, it’s worth seeking medical advice, especially if your symptoms are chronic. You may develop low testosterone due to many reasons, not just chronic stress and high cortisol levels. Low testosterone levels can also be due to:

• hypopituitarism
• hyperprolactinemia
• iron overload (hemochromatosis)
• Cushing’s syndrome
• cirrhosis of the liver
• kidney failure
• obesity
• poorly managed diabetes
• obstructive sleep apnea
• certain medications

It is important to find out the reason and the underlying causes of your low testosterone-related symptoms in order to find the right treatment strategy.

What to Expect at Your Doctor’s Visit?

When you visit your doctor with concerns related to symptoms of low testosterone, they will first go over your medical and family history, symptoms, and medications, and perform a physical exam. Then they will likely order some blood tests, including:

• Total testosterone level blood test to look at your testosterone levels between 8 a.m. and 10 a.m., when they should be at their highest
• Luteinizing hormone (LH) blood test to check for issues with your pituitary gland as a potential cause of low testosterone
• Prolactin blood test to test for signs of pituitary gland issues or tumors

Possible Treatments

Your treatment for low testosterone levels depends on the causes of your hormonal imbalance, your medical history, and your overall health.

Treatment in Conventional Medicine

Testosterone hormone replacement therapy is the most common treatment strategy for low testosterone levels. Testosterone replacement therapy has several different forms, including testosterone skin gels, intramuscular testosterone injections, testosterone patches, testosterone pellets, buccal testosterone tablets, testosterone nasal gel, and oral testosterone.

If you have prostate cancer, breast cancer, an unevaluated lump on your prostate, untreated obstructive sleep apnea, or uncontrolled heart failure, testosterone replacement therapy is not recommended. Along with testosterone replacement therapy, you may receive recommendations for a healthy diet, exercise, controlling weight, and other lifestyle strategies.

How About Functional and Integrative Medicine?

If you are working with a functional or integrative medicine practitioner, the main focus will be natural strategies, including improving your diet, stress reduction, exercise, improving gut microbiome health, and supplementation. They may recommend bioidentical hormone therapy as well.

Reduce Stress and Improve Your Overall Health

Can stress affect testosterone levels? Yes, it can! Chronic stress can result in chronically elevated cortisol levels which can lead to depleted testosterone levels. This can lead to all kinds of health issues, including hormonal imbalance, sexual health complaints, and mood imbalances.

Reducing your stress is critical not only for your testosterone levels but for your overall health as well. Along with stress management strategies, diet, nutrition, and lifestyle play a role too.

If you need further information to address the root causes of your low testosterone-related symptoms and to find the right support strategy, please set up an appointment with us here.