How does stress affect testosterone levels?

Here’s a shocking statistic. Nearly three-quarters of UK adults in 2018 felt so stressed at some point that they felt unable to cope [1]. While it’s normal to feel stressed from time to time, chronic stress can significantly impact your hormone levels, including testosterone.  

In this article, we look at the body’s stress response and its link to low testosterone levels, which are sometimes behind symptoms of low libido, fatigue, and loss of muscle mass.  

• What happens to your body when you’re stressed? 
• Acute versus chronic stress 
• How do I know if I’m stressed? 
• How does stress affect testosterone levels? 
• Does testosterone affect how you respond to stress? 
• What should you do if you’re struggling with stress? 
   

What happens to your body when you’re stressed?

When you’re faced with a threat, your body prepares itself by undergoing changes. These changes are driven by the release of hormones from the brain and adrenal glands. You may be familiar with adrenaline, which is released immediately and in short bursts by the adrenal glands. Adrenaline causes many changes in the body that prepare you to take action, such as increasing your heart rate, dilating the pupils, and opening up the airways.  

But adrenaline (and noradrenaline) are broken down in a matter of minutes. To sustain the stress response, the body needs to engage the HPA (hypothalamic-pituitary-adrenal) axis.  
 

What is the HPA axis and how does it work? 
 

The HPA axis describes the interaction between the hypothalamus, pituitary gland, and adrenal glands, which help to regulate our response to stress. Before it’s activated, the body must establish something as a threat. If you were to step out into oncoming traffic, your eyes and ears would send this sensory information to the amygdala, an area of the brain that processes emotions. The amygdala interprets these images, sounds, and thoughts. If it perceives danger, it sends a stress signal to the hypothalamus. 

The three parts of the HPA axis are:  

1. The hypothalamus — When the hypothalamus receives a distress signal it releases corticotropin-releasing hormone (CRH).  
2. The pituitary gland — CRH reaches the pituitary gland, causing it to release adrenocorticotropic hormone (ACTH) into the bloodstream.  
3. The adrenal glands — ACTH finds its way to the adrenal glands which sit on top of the kidneys. When ACTH binds to their receptors, they release cortisol, the primary stress hormone.  

To prevent this axis from spiralling out of control, it has its own trip switch. This is known as a negative feedback loop — high levels of cortisol actually inhibit the hypothalamus and pituitary gland from releasing more CRH and ACTH. You can read more about stress hormones here.  

Once the threat has passed, the stress response begins to return to its normal state, and stress hormones are broken down.  

Importantly, the HPA axis isn’t just triggered by physical threats, but also psychological stressors, for example, a deadline at work, or an argument with a partner. Often psychological stressors last longer than physical threats, which can lead to chronic stress.  
 

Acute versus chronic stress

The stress response is designed to be temporary. Prolonged activation of the HPA axis leads to persistently raised cortisol levels which can have negative effects on your health. Chronic stress is generally defined as something that lasts for many weeks or months.  

Common causes of chronic stress include:  

• Personal stressors — e.g. bereavement, moving house, or other major life changes  
• Work-related stress — e.g. long hours, high workloads, and unrealistic deadlines 
• Financial stress — e.g. debt, unemployment, or low income  
• Relationship problems — e.g. troubled relationships with family, friends, or a partner 
• Health problems — e.g. chronic illness, disability, or chronic pain 

Read more about the ten most common causes of stress. 
 

How do I know if I’m stressed?

When you become accustomed to a busy lifestyle, sometimes stress is difficult to spot. The symptoms of stress are wide-ranging and it’s easy to put them down to other causes. It’s worth taking a stress questionnaire to assess whether life might be getting on top of you.  Alternatively, you can measure your levels of stress hormones with our at-home Cortisol Saliva Stress Test.  

If you are chronically stressed, there’s a good chance it’s already started to affect your overall health, as well as your hormone levels, like testosterone.

Check your testosterone levels with our testosterone test kit.
 

How does stress affect testosterone levels?

While it’s clear that stress affects testosterone levels, the relationship is a complex one.  

Chronic stress and testosterone 

Generally speaking, chronic stress is likely to lower your testosterone levels. There are a few possible reasons for this. Firstly, as well as the HPA axis to regulate stress hormones, the body also has a hypothalamic-pituitary-gonadal (HPG) axis to regulate sex hormones. Both axes are controlled at the top end by the hypothalamus and pituitary gland. Because of this, and the negative feedback loops we discussed earlier, persistently high cortisol can dampen the HPG axis too, preventing testosterone release [2]. Cortisol is also thought to reduce testosterone production directly by acting on the Leydig cells (found in the testes) [3].  

This makes sense in evolutionary terms: if you encounter a life-or-death situation, reproductive hormones like testosterone become less important than your fight-or-flight stress response. But, your body can’t distinguish acute stress from chronic stress, which is where this becomes a problem. 

Chronic stress is also more likely to lead to bad habits, like comfort eating, smoking, drinking alcohol, or exercising less. These types of unhealthy coping mechanisms can lead to conditions like obesity, diabetes, and mental health problems, all of which are associated with lower testosterone levels. 

One theory that often pops up but has been debunked is “pregnenolone steal”. Pregnenolone is a building block for both testosterone and cortisol. The theory suggests that if the body uses up the body’s store of pregnenolone to make cortisol, there will be less available to make other hormones like testosterone. But this theory assumes that the body makes hormones from a single pool of pregnenolone, which isn’t true. So, this doesn’t explain how raised cortisol levels may lower testosterone levels.   

Acute stress and testosterone

Some short-term stressors, like exam stress, may temporarily increase testosterone levels up to a certain threshold [4–6]. One explanation is that acute stress makes the testes more sensitive to hormones like luteinising hormone (LH), which trigger testosterone production [7,8]. This is true for most contexts but varies according to different factors, like age and type of stress. 

Generally, exercise (which is a form of physical stress) has beneficial effects on testosterone levels. Resistance training, especially, has been shown to boost testosterone levels both in the long and short term [9]. We’ve not mentioned the difference between total and free testosterone, but this is important. Some studies have found that while total testosterone didn’t increase with exercise, free testosterone (the bioactive form) did [10,11].  
 

Can overtraining affect testosterone levels? 
 

Of course, there is such thing as too much. Overtraining, that is training excessively without allowing enough time to recover, is a form of chronic stress. The body is put under long-term strain, and it’s a well-recognised cause of low testosterone [12]. Low testosterone in itself affects the body’s ability to put on muscle which is one of the reasons overtraining may lead to a plateau in training, or affect your gains.  
 

Does testosterone affect how you respond to stress?

We know that stress can affect testosterone levels, but what about the other way around?  

It seems that our baseline testosterone levels play a role in how we deal with stress, but it highly depends on the social context. For example, there’s evidence that testosterone can decrease social anxiety and reduce the effects of stress in socially challenging situations [13]. It’s thought that testosterone dampens the HPA axis (stress response) and decreases overall cortisol levels [14]. 
 

What should you do if you’re struggling with stress?

Daily stresses are inevitable, but if you’re feeling constantly overwhelmed by work, relationships, or life in general, it’s time to start looking for a solution.  

Self-help techniques are a great place to start. We’ve put together five ways to reduce your stress levels. And you can find more related articles in our stress hub. If you’ve tried these approaches and they’re not helping, it’s worth speaking to someone. Mind has a useful helpline that can guide you to the right place, or alternatively, the NHS has a free talking therapies service anyone can access. Your GP can also help you with stress and mental health issues.  

References 

1. Stressed nation: 74% of UK ‘overwhelmed or unable to cope’ at some point in the past year [Internet]. [cited 2023 Feb 16]. Available from: https://www.mentalhealth.org.uk/about-us/news/survey-stressed-nation-UK-overwhelmed-unable-to-cope
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