PTSD and Hypogonadism

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Post traumatic stress disorder (PTSD) is a mental condition that may cause low testosterone, also known as hypogonadism.

The body's response to testosterone is blunted by the hormone's response to stress.

This result is abnormality in the stress response, a hallmark of PTSD. In this article, we'll explore the role of PTSD in causing low testosterone and how to address the issue.

But first, we'll briefly examine the relationship between PTSD and hypogonadism.

Hypogonadism Explained

Hypogonadism is a condition characterized by decreased function of the testes, which results in insufficient hormonal stimulation from the brain.

The signs and symptoms of hypogonadism usually develop gradually over time, so that they may go unnoticed for some time.

The signs and symptoms of hypogonadism differ from individual to individual, and they may be more noticeable in certain age groups.

Ibuprofen and other drugs can cause a condition known as compensatory hypogonadism in males.

Regular use of these drugs can lead to the condition, which causes low testosterone levels and all of its associated symptoms. The effects of ibuprofen use go beyond just symptoms.

It also affects other aspects of testicular function, such as sperm count. The effects of ibuprofen on sperm production are far-reaching.

In both men and women, the hormones in their sex organs fail to produce enough testosterone to maintain a healthy life cycle.

This condition results in decreased energy levels, decreased sex drive, erectile dysfunction, and mental changes.

Fortunately, there are therapies which can help many sufferers. It may be the only treatment that is effective for your specific condition. 

There are two main types of testosterone therapy. In the first form, testosterone therapy is aimed at increasing the levels of testosterone in the body.

Increasing testosterone levels through this procedure has been shown to be effective for improving libido, reducing the effects of other treatments, and improving mood and fatigue.

There are other non-invasive procedures such as diet and lifestyle changes which can be employed.

While traumatic experiences such as war or a car crash are not the most likely causes of hypogonadism, they may affect the condition.

For example, hypogonadism can result from the use of corticosteroids or long-term opioid use.

The abrupt cessation of these medications can also cause hypogonadism.

Traumatic experiences such as childbirth or physical abuse can also lead to hypogonadism. HIV infection and other diseases can also cause hypogonadism.

Hypogonadism can be the result of sleep dysregulation. Traumatic events that cause PTSD can disrupt sleep cycles and interfere with the production of testosterone.

Symptoms can also include sleep problems, such as impaired concentration, mood disturbance, and altered body composition.

Because of these common symptoms, clinicians should seek a thorough blood test to identify possible secondary causes of hypogonadism.

Secondary hypogonadism occurs when the hypothalamic-pituitary axis malfunctions, leading to low levels of testosterone and sperm.

Secondary hypogonadism may also be a result of hyperprolactinemia or other medical conditions that inhibit the release of hormones.

Some medications, such as glucocorticoids, hypothalamic tumors, and testosterone-producing hormones, can cause hypogonadism. 

PTSD and Testosterone

There is growing evidence that chronic anxiety, including PTSD, can lower testosterone levels. Low levels of testosterone are known to amplify the symptoms of PTSD.

While testosterone levels in individuals can fluctuate, the research suggests that they are not caused by an abnormality of the adrenal glands.

Instead, a low testosterone level is a result of the abnormal response of the body to stress. This abnormal response is linked to many symptoms of PTSD, including erectile dysfunction, depression, and anxiety.

This relationship has implications for men who suffer from PTSD. For example, they may be at risk for low testosterone if they are exposed to traumatic experiences.

Because trauma affects many aspects of life, low testosterone levels may also be a symptom of PTSD. However, this relationship may not be permanent. Moreover, it can cause long-term relationship problems. In such cases, psychological counseling may be helpful.

Psychologists can teach survivors and their partners how to cope with the trauma and improve communication and intimacy in their relationships.

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While the cause of PTSD is unclear, studies have shown that low testosterone levels can negatively affect one's executive functions.

The hypothalamic–pituitary–gonadal axis (HPG axis) plays an important role in the regulation of the body's stress response.

Low levels of testosterone can disrupt the function of the hypothalamus-pituitary axis, leading to moodiness and other psychological problems.

Low levels of testosterone may affect cognitive functions, including episodic memory, working memory, and processing speed.

Visual-spatial processing helps people understand images and scenery. This skill helps us see depth and realism.

A study published in the journal Psychoneuroendocrinology in 2017 discussed the link between testosterone levels and PTSD.

This study enrolled 120 soldiers who were exposed to stressful situations before and during their deployment. Stress increases cortisol levels, and soldiers with abnormal levels of cortisol were more likely to develop PTSD.

This research is important because it may provide new insights into the causes of PTSD and how it can be prevented.

Stress and Cortisol

Research has shown that the effects of stress on testosterone levels are not entirely clear. However, there are numerous factors that influence testosterone levels.

One of these is the way in which we respond to stress. For instance, the body responds to stress by producing more cortisol, the hormone associated with stress. The body then produces less testosterone and the effects of stress are felt in various ways. 

In addition to affecting the levels of testosterone, stress also affects sleep. We tend to produce most of our testosterone during sleep.

Moreover, if you're not getting enough sleep, you're putting your body's performance at risk

Furthermore, elevated levels of cortisol are associated with higher levels of glucose in the bloodstream which can be dangerous for those suffering with diabetes.

Medications such as opioid pain meds and steroids can interfere with the function of the pituitary gland.

In addition to these factors, prolonged periods of emotional stress can disrupt the normal hormonal processes in the body, resulting in low testosterone levels.

Physical injury or disease

Other factors that can lead to low testosterone include physical injury to the testicles or treatments for other medical compications.

Also, the pituitary gland or hypothalamus, which controls testosterone production in the testes, can be damaged by a disease, resulting in secondary hypogonadism.

Low testosterone levels are associated with a variety of symptoms, including decreased strength and muscle mass, reduced mobility, and fatigue.

Low levels can also affect medication compliance and motivation. Additionally, men suffering from spinal cord injuries may suffer from decreased sexual interest. 

Some medicines, such as steroid pain meds and opioids, can also affect these glands. Other factors, such as extreme emotional stress, can lead to low levels of testosterone.

Other causes of low testosterone include trauma, radiation, and testicular cancer. Males are supposed to have one X chromosome and one Y chromosome.

These chromosomes are what determine gender. Certain genetic conditions such as Klinefelter syndrome may result in abnormal testicle development, which can lead to low testosterone.

While males should have one of each of the sex chromosomes, some males may be born with only one.


There is evidence that associates sufferers of PTSD with hypogonadism, furthermore, those already suffering from low testosterone levels are at a higher risk of experiencing PTSD.

These conditions can lead to further health complications.

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