Does stress cause low testosterone in men? What science really shows

Chronic stress can quietly push testosterone down and make it harder for your body to recover, focus, and stay lean. Here is how stress and testosterone interact, what symptoms to watch for, and what actually helps break the cycle.

The relationship

Many men ask a simple question: does stress cause low testosterone? The honest answer is that stress and testosterone form a loop. Short, intense stress can cause a small, temporary rise in testosterone. Long-term, chronic stress is linked to lower levels in many human studies.^,[2]

Testosterone is the main male sex hormone. It supports libido, erections, muscle mass, red blood cell production, mood, and energy. Cortisol is the body’s main stress hormone. It helps you respond to danger but, in high doses over time, can disrupt other hormones, including testosterone.^[1]

Large population studies show that men who report higher psychological stress or job strain often have lower morning testosterone, even after adjusting for age and weight.^,[4] At the same time, men with low testosterone report more fatigue, irritability, and low resilience to stress. That means stress can lower testosterone, and low testosterone can make stress feel heavier, creating a feedback loop that is hard to spot until symptoms stack up.

How it works

Fight-or-flight hormones and quick testosterone changes

The sympathetic-adreno-medullary (SAM) system is the body’s fast “fight-or-flight” network. It is a nerve and hormone system that raises heart rate and blood pressure to respond to sudden threats. During brief stress, the SAM system releases adrenaline and noradrenaline. These can cause small, short-lived increases or no meaningful change in testosterone in healthy men.^,[2]

In other words, a hard workout, cold plunge, or pre-game nerves will not usually cause low testosterone. The problem appears when stress is frequent, intense, and unrelenting, which brings slower hormone systems into play.

The HPA axis: cortisol versus testosterone

The hypothalamic-pituitary-adrenal (HPA) axis is the body’s main long-term stress system. It links the brain and adrenal glands to control cortisol. The hypothalamus is a brain region that coordinates hormones. The pituitary is a small gland under the brain that sends hormone signals to other organs. With chronic stress, the HPA axis stays switched on, keeping cortisol elevated for long stretches.^[1],[2]

High cortisol can blunt the signals that normally tell the testes to make testosterone. It interferes with hormone-releasing cells in the brain and with testosterone-producing cells in the testes themselves.^[1],[2] Clinical studies show that giving men high doses of cortisol or steroid medications like prednisone can reduce blood testosterone significantly within days.^[1] Over months or years, this stress-related suppression can contribute to chronically low testosterone.

Brain signaling to the testes: the HPG axis

The hypothalamic-pituitary-gonadal (HPG) axis controls reproductive hormones. It is the hormone pathway from the brain to the testes. The hypothalamus releases gonadotropin-releasing hormone (GnRH), a brain hormone that tells the pituitary to act. The pituitary sends luteinizing hormone (LH), which is a signal that tells the testes to make testosterone.

Chronic stress and high cortisol can reduce GnRH and LH pulses, so the testes receive a weaker “make testosterone” signal.^[2] Over time this can shift a man from normal levels to borderline or frankly low levels. Meta analyses suggest that symptomatic men are most likely to benefit from treatment when total testosterone is below about 350 ng/dL (around 12 nmol/L) or free testosterone is below 100 pg/mL (around 10 ng/dL).^,[9]

Sleep, stress, and daily testosterone rhythms

Circadian rhythm is the body’s 24-hour internal clock that affects sleep and hormone release. Testosterone normally peaks in the early morning and falls through the day. Deep sleep is when much of the daily testosterone surge happens.

Chronic stress often disrupts sleep quantity and quality. Studies in healthy men show that restricting sleep to 4–5 hours per night for just one week can lower daytime testosterone by 10–15 percent, even in young men in their 20s.^[3] When poor sleep is added to psychological stress, weight gain, and inactivity, the combined effect on testosterone is larger, helping explain why “burned out” men often test low or borderline low.

Conditions linked to it

So does stress cause low testosterone on its own, or does it act through other health problems? In real life, stress almost always travels with partners like poor sleep, overeating, or heavy drinking. Together, they connect chronic stress and low testosterone to several common conditions.

Metabolic syndrome and type 2 diabetes. Metabolic syndrome is a cluster of conditions that includes large waistline, high blood pressure, high blood sugar, high triglycerides, and low HDL cholesterol. Men with low testosterone are more likely to have metabolic syndrome and to go on to develop type 2 diabetes, and men with these conditions tend to have lower testosterone.^[4],[5] Chronic stress and high cortisol promote abdominal fat and insulin resistance, which feed into this loop.

Obesity. Obesity is having an unhealthy amount of body fat, often measured with body mass index or waist size. Obese men have lower average testosterone, and higher stress and poor sleep make weight loss harder.^[6],[8] Fat tissue also converts testosterone into estrogen, further lowering levels.

Mood disorders. Depression and anxiety are strongly linked with both chronic stress and low testosterone. Men with low testosterone are more likely to report low mood, irritability, and poor motivation, and testosterone treatment can modestly improve depressive symptoms in men with clear deficiency.

Sexual dysfunction and fertility issues. Long-term stress and low testosterone are both associated with reduced libido, erectile dysfunction, and lower sperm counts.^[7] Stress hormones can affect sperm production directly and indirectly through testosterone reduction.

Overtraining in athletes. In endurance athletes and men who train hard without enough recovery, a state sometimes called “overtraining syndrome” can involve high perceived stress, fatigue, and lower testosterone.^[2]

Limitations note. Most of these links come from observational studies. That means they show associations but cannot fully prove that stress causes low testosterone, or that low testosterone causes the condition. However, the patterns are consistent across many studies and fit with what we know about hormone biology.

Symptoms and signals

Because stress and testosterone interact, it can be hard to tell what is causing what. These are common signs that chronic stress may be pushing testosterone down:

• Low sex drive or fewer sexual thoughts than you are used to
• Weaker or less frequent morning erections
• Trouble getting or keeping an erection during sex
• Feeling tired most of the day despite enough time in bed
• Reduced strength, slower gains at the gym, or loss of muscle mass
• More belly fat or overall weight gain, especially when diet has not changed much
• Low mood, irritability, or feeling “flat” and unmotivated
• Difficulty concentrating or a sense of brain fog
• Poor sleep, frequent waking, or feeling “tired but wired” at night
• Feeling overwhelmed by stressors you previously handled well

These symptoms are not specific to low testosterone. Burnout, depression, thyroid disorders, sleep apnea, and other conditions can look very similar. That is why lab testing and a full medical evaluation are essential before assuming stress is the sole cause of low testosterone.

What to do about it

If you are wondering “does stress cause low testosterone for me personally?”, the next step is to move from guessing to testing, and then to targeted action. A simple 1–2–3 plan can help.

1. Get properly tested. Ask your clinician for a morning, fasting total testosterone test, ideally between 7 a.m. and 10 a.m. Testosterone is highest then and falls during the day. If the first result is low or borderline, it should be repeated on a different day because levels can fluctuate. When total testosterone is borderline, measuring free testosterone can clarify the picture. Levels below about 350 ng/dL for total or 100 pg/mL for free in a man with clear symptoms support a diagnosis of hypogonadism, or clinically low testosterone.^,[9]
2. Address stress and lifestyle drivers. In many men, chronic stress combines with poor sleep, extra weight, and inactivity to lower testosterone. Tackling these factors can raise levels without or alongside medication.
3. Consider medical treatment and long-term monitoring. If testosterone is clearly low, symptoms are significant, and lifestyle steps are not enough, testosterone replacement therapy (TRT) may be appropriate under specialist guidance. Ongoing monitoring of blood counts, prostate markers, and symptoms is essential.^,[7]

Myth vs Fact

• Myth: All stress kills testosterone. Fact: Short bursts of stress, like a hard workout or big presentation, usually have little impact and can even give a small short-term boost. It is chronic, unrelenting stress that is linked to low testosterone.
• Myth: If you feel tired and stressed, you definitely need testosterone shots. Fact: Many conditions mimic low testosterone. You need proper testing and a full evaluation before starting TRT.
• Myth: Supplements can “fix” stress hormones and boost testosterone overnight. Fact: Most over-the-counter testosterone boosters have weak or no human data. Basic habits like sleep, strength training, and weight loss have far stronger evidence.
• Myth: Testosterone therapy always causes heart attacks or prostate cancer. Fact: Current large studies and guidelines suggest that, in appropriately selected men, TRT is generally safe with proper monitoring, though long-term data are still evolving.^,[9]
• Myth: If you just relax more, severe low testosterone will fix itself. Fact: Managing stress helps, but men with very low levels often need medical treatment on top of lifestyle changes.

Beyond the myths, here are practical, evidence-informed ways to improve both stress and testosterone:

1. Fix the daily basics that stress and low T share.

• Sleep 7–9 hours most nights. Set a fixed bedtime and wake time, use a dark, cool bedroom, and limit screens before bed. Even one week of short sleep can reduce testosterone in healthy men.^[3]
• Lift weights 2–4 times per week. Resistance training increases muscle mass, improves insulin sensitivity, and can modestly increase testosterone over time, especially when starting from inactivity.^[5]
• Move more on non-gym days. Light activity like walking reduces stress and improves metabolic health without risking overtraining.
• Dial in nutrition. Aim for a diet rich in whole foods, lean protein, vegetables, fruits, and healthy fats. Large studies show that losing excess weight, especially around the waist, can raise testosterone by 100–300 ng/dL in obese men.^[5],[6]
• Limit alcohol and nicotine. Heavy drinking and smoking are both linked with lower testosterone and poorer sexual function.

2. Use targeted stress management, not just “relaxation”.

• Structured breathing. Slow, deep breathing for 5–10 minutes can quickly lower heart rate and stress feelings and may reduce cortisol peaks.
• Cognitive-behavioral strategies. Cognitive-behavioral therapy (CBT) is a form of talk therapy that helps reframe unhelpful thoughts. CBT has strong evidence for reducing anxiety and stress, which may indirectly help hormonal balance.
• Boundaries around work and devices. Constant email and notifications keep your stress system activated. Setting clear work hours and screen-free time supports recovery.
• Social connection. Strong relationships buffer stress and are linked to better hormonal and cardiovascular health.

3. Decide on medical treatment with a specialist.

If, after several months of solid lifestyle and stress work, total testosterone remains below about 350 ng/dL or free testosterone below 100 pg/mL and you still have symptoms, it is worth discussing further options with a urologist or endocrinologist.^,[7]

• Evaluate the full hormone picture. Depending on your history, your clinician may check LH, follicle-stimulating hormone (FSH), prolactin, thyroid function, and sometimes cortisol. This helps distinguish primary testicular problems from brain-level hormone issues.
• Testosterone replacement therapy (TRT). For men with confirmed hypogonadism and bothersome symptoms, guidelines from major societies support TRT using gels, injections, or other forms, provided there are no major contraindications like certain prostate or breast cancers.^,[9]
• Fertility considerations. TRT can lower sperm production. Men who want future fertility may use other medications, such as clomiphene citrate or hCG, to stimulate their own testosterone and sperm production instead of taking external testosterone.^[7]
• Ongoing monitoring. Regular follow-up usually includes testosterone levels, blood counts, prostate-specific antigen (PSA) in appropriate age groups, and tracking of symptoms and side effects.

Bottom line

So does stress cause low testosterone? Evidence from human studies and hormone biology says that chronic, unrelenting stress can contribute to lower testosterone by raising cortisol, disrupting sleep, and interfering with the brain’s signal to the testes. In turn, low testosterone can make stress feel heavier by sapping energy, drive, and resilience. Breaking this loop starts with proper testing, then tackling sleep, weight, movement, and stress skills, and finally considering targeted hormone treatment when it is truly needed. You cannot remove all stress from life, but you can make sure it is not quietly draining your hormones in the background.

References

1. Cumming DC, Quigley ME, Yen SS. Acute suppression of circulating testosterone levels by cortisol in men. The Journal of clinical endocrinology and metabolism. 1983;57:671-3. PMID: 6348068
2. Hardy MP, Gao HB, Dong Q, et al. Stress hormone and male reproductive function. Cell and tissue research. 2005;322:147-53. PMID: 16079965
3. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet (London, England). 1999;354:1435-9. PMID: 10543671
4. Laaksonen DE, Niskanen L, Punnonen K, et al. Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes care. 2004;27:1036-41. PMID: 15111517
5. Corona G, Monami M, Rastrelli G, et al. Testosterone and metabolic syndrome: a meta-analysis study. The journal of sexual medicine. 2011;8:272-83. PMID: 20807333
6. Kelly DM, Jones TH. Testosterone and obesity. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2015;16:581-606. PMID: 25982085
7. Salonia A, Bettocchi C, Boeri L, et al. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. European urology. 2021;80:333-357. PMID: 34183196
8. Grossmann M. Hypogonadism and male obesity: Focus on unresolved questions. Clinical endocrinology. 2018;89:11-21. PMID: 29683196
9. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine. 2017;14:1504-1523. PMID: 29198507