Cortisol, Testosterone and Erectile Dysfunction

cortisol testosterone and erectile dysfunction

Cortisol is a steroid hormone made in the adrenal glands and then released into the blood. Most cells have receptors for this hormone, which works in your body in several ways. This hormone helps control your body’s blood sugar levels and metabolism and influences water and salt balance, blood pressure, memory, and the ability to fight infection. Like many other hormones, cortisol affects the circadian rhythm (sleep and wake cycle), with the highest levels in the morning and lowest around midnight.

Cortisol is also known as the ‘stress hormone’ because your body releases it during stressful or dangerous situations. As the adrenal glands release cortisol into your bloodstream, your body automatically produces a surge of glucose into your larger muscles enabling you to react quickly. Also, while narrowing your arteries, your body produces another hormone called epinephrine (adrenaline), which increases your heart rate. 

This reaction enables you to face any threat with a sense of heightened alertness and energy. Everybody will be familiar with that surging feeling when you narrowly avoid a thrown punch, your child breaks a bone, or you receive a large utility bill; this is cortisol at work. Also known as “fight or flight,” this sensation of increased stimulation and perception is what has kept us one step ahead of predators for millennia and essentially helped us survive. It allows you to jump into action at the drop of a hat.

What does cortisol do?

Cortisol plays an important role in many bodily functions, such as.

  • Helps your memory
  • Helps regulate your sleep cycle
  • Helps reduce inflammation
  • Regulates bloody pressure
  • Manages your body’s use of fats, carbohydrates, and protein
  • Helps boost alertness in stressful situations and calm you down afterward
  • Regulates glucose levels

What if your Body Produces too Much Cortisol?

In these modern times, everybody is under more pressure than your body is designed to cope with. Stress from work, busy lifestyles, and constant high-stress levels can wreak havoc on your levels. In turn, this can cause unpleasant symptoms, which can be very damaging in the long term. These symptoms include:

  • Fatigue
  • headaches
  • Short temper and irritability
  • Constipation, diarrhea, and bloating
  • Poor sleep
  • Weight gain, especially around the midsection and face
  • High blood pressure
  • Erectile dysfunction and low libido
  • Menstrual problems
  • Ovulation issues
  • Slow recovery time after exercise
  • Easily bruised
  • Increased risk of bone fractures and osteoporosis
  • Lack of concentration
  • Flushing and acne

What Causes high Cortisol Levels?

Several different conditions can cause high cortisol. While stress is the most obvious, other conditions can cause an imbalance. 

Stress

Life in the fast lane….work hard, play hard….plenty of time to sleep when you are dead, all phrases that many of us can relate to. Modern life is relentless, and unless we learn to relax, cortisol pumps through your system continuously. Long term high levels can increase the risk of heart disease, obesity, anxiety, and depression. So unless you are a yoga teacher living in a Yurt by a gentle river, you probably will experience the negative symptoms of stress multiple times during your life.

Cushing’s Syndrome

Cushing’s Syndrome is a hormonal disorder where your adrenal glands produce too much cortisol into your body for too long. Cushing’s Syndrome may be caused by a pituitary tumor, causing the pituitary gland to overproduce this hormone. An adrenal gland tumor, a tumor elsewhere in the body, or a result of long-term use of certain drugs. These include cortisone medications and Prednisone, a medicine used to suppress the immune system and ease inflammation in asthma, COPD, and rheumatologic diseases.

Cushing’s syndrome symptoms are similar to symptoms of high cortisol, but some are unique.

  • Obesity in the upper body
  • Skinny arms and legs
  • Muscle weakness
  • Camel like fatty bulge between the shoulder at the base of the neck
  • Purple stretch marks on the sides of the abdomen, hips, and underarms
  • Round reddish face
  • Fatigue
  • Erectile dysfunction and or lack of libido
  • Irregular periods or they stop altogether
  • Excessive body hair on women

Cortisol, Testosterone and Erectile Disfunction

The relationship between cortisol, testosterone, and erectile dysfunction is not widely studied. However, there are plenty of studies linking the stress hormone and erectile dysfunction. However, living in a constant state of stress can also play havoc on your testosterone production. Cortisol pushes down testosterone levels. When you are is in a stressful or dangerous situation, the last thing your body needs is testosterone. 

In one study (1), 109 trainee soldiers had hormone levels monitored undertaking intense military training to see the human response to acute, realistic military stress, and the findings were pretty conclusive.

“Cortisol significantly increased during the captivity experience and was greatest after subjects’ exposure to interrogations. Cortisol remained significantly elevated at recovery. Testosterone was significantly reduced within 12 hours of captivity. Reductions of both total and free T4 and of total and free T3 were observed, as were increases in thyrotropin” (Wang S, Mason J, Southwick SM, Fox P, Hazlett G, Charney DS, Greenfield G).

One other study (2)  looked at 105 men between 35 and 72 and compared cortisol, testosterone levels, and erectile dysfunction incidence. Testosterone levels start to decline as a male reaches around 35 years old, but cortisol does not. In the study, they determined that men with high cortisol levels were more likely to suffer from E.D.

“One reason why E.D. occurred in patients with high levels of cortisol is because cortisol is increased by stress. It is known that the blood cortisol level increases at the same time as the blood norepinephrine level when sympathetic nervous activity is dominant. Sympathetic nervous activity has a restraining effect on erection, and sexual function is thought to be reduced under stress. Our results indicate that increases in plasma and salivary cortisol may play causative roles in E.D. induced by social stress.” (Kobori Y, Koh E, Sugimoto K, et al. 2009)

So, one can conclude that high cortisol levels can reduce testosterone levels and, both low T and high cortisol negatively impact erectile function.

What if your Body Produces too Little Cortisol?

If your body doesn’t produce enough cortisol without medical intervention, you will eventually die. Addison’s disease is an uncommon condition where the adrenal glands don’t make enough cortisol and aldosterone.

Addison’s disease usually happens when your immune system starts to attack the adrenal glands. This type of autoimmune disease tricks your body into attacking an organ, thinking it is a harmful invader, such as a virus or bacterial infection.

Other Causes of Addison’s Disease

  • Infections: Caused by AIDS or fungal infection
  • Hemorrhage: Bleeding in the adrenal gland caused by Meningitis or other types of severe sepsis
  • Cancer: Cells can spread from different areas of the body
  • Amyloidosis – a disease where protein produced in bone marrow builds up, damaging the adrenal glands
  • Adrenal gland removal: Due to severe infection or cancer
  • Medicines used to treat Cushing’s Syndrome such a Prednisone 
  • Damage caused by accidents: Trauma from car accidents, for example
  • Severe shock
  • Severe dehydration

Low cortisol levels can cause extreme fatigue, weakness, and low blood pressure, and if levels fall too low, you will have an Addisonian crisis, a life-threatening event with a long list of symptoms.

  • Extreme weakness
  • Confusion
  • Dizziness
  • Stomach pains
  • Sickness and vomiting
  • High fever
  • Pain in the legs and lower back
  • Low blood pressure
  • Chills
  • Dark skin rash
  • Sweating
  • increased heart rate
  • Loss of consciousness

During an Addisonian crisis, you desperately need a hydrocortisone injection. Once given, you will recover fairly quickly. Many people who suffer from this disease are unaware until they have a crisis and will require hormone therapy for the rest of their lives.

Fortunately, medication can control this condition. Because the adrenal glands are no longer producing cortisol and aldosterone, corticosteroid medication tablets, usually taken 2-3 times a day.

Most people who have Addison’s disease go on to lead a healthy life. However, they may suffer periods of severe fatigue, which can be challenging to manage. Many people who have to rely on daily medication suffer from feeling restricted and feel frustrated, affecting mental health.

After a super stressful situation such as a car crash, healthy people feel a surge of cortisol. This hormone rush helps you cope with the stress and any injuries you may have incurred. People living with Addison’s cannot produce cortisol. In this situation, they will need to replace the natural cortisol that they lack to avoid being overwhelmed by adrenaline and prevent an adrenaline crisis. Therefore, people with Addison’s carry hydrocortisone medication with them at all times and usually wear medical bracelets indication their condition. 

How Can You Maintain Healthy Cortisol Levels?

  • Maintain a good circadian rhythm: Go to bed and get up and at the same time every day. This routine helps maintain a healthy hormone balance. Lack of sleep can drop testosterone and raise stress hormones.
  • Avoid caffeine before bed: Caffeine is a stimulant and will keep you awake.
  • Exercise: But, don’t go overboard; overtraining can increase cortisol and decrease testosterone. Your muscles need glucose during recovery, and this can add chronic stress to your body. Try yoga, pilates, swimming, and walking, which can help you get fit and relax.
  • Try meditating: Meditation slows down your mind and allows your body to relax, reducing cortisol levels. Meditation is proven to reduce the harmful risks of extreme stress, such as high blood pressure, psychiatric disorder, and even migraines.
  • Medication: Medication to slow cortisol production include ketoconazole, mitotane (Lysodren), and metyrapone (Metopirone). These drugs are mainly for those with Cushing’s Syndrome.

Maintaining health hormone levels can be tricky as a man’s testosterone levels inevitably drop with age, and the associated negative symptoms can start to creep in. Weight around the middle, loss of libido, brain fog, inability to gain muscle, and general lethargy can all start to creep in. All these negative symptoms can lead to a guy losing confidence and losing their lust for life. This added negativity can cause excessive physical and psychological stress, which causes the stress hormone to kick in, hammering testosterone even more.

Testosterone replacement (TRT) therapy is now an excellent option for guys who want to tackle the overall picture. TRT has so many benefits that can, in the long run, help reduce stress from your life and get things back in your control. By optimizing your testosterone level and getting fit and healthy, you can rewind the clock and grab claim back your youthfulness with both hands.

Unsurprisingly, testosterone replacement therapy can significantly reduce stress levels. This list of benefits is closely related.

  • A better night’s sleep means you will wake up more rested and less stressed.
  • More muscle, less fat, and a healthier body all will improve self-image and reduce stress.
  • Improved drive, motivation, and reduced symptoms of depression. All will give you an energy boost and the ability to deal with stressful situations more capably.
  • Improved red blood cell count, some studies show testosterone treatment can increase red blood cell production, so oxygen is delivered more efficiently from your lungs to your organs.
  • Better cardiovascular health, a healthy heart and lungs are central to you being fit and healthy. If your engine runs without stress, so will you!

So, in conclusion, you are not a machine; to be put through the mill daily. Stress gets to everybody in the modern world we live in, but you can do plenty to avoid burnout. Whether it be keeping fit, eating well, meditation, or hormone therapy, there is usually an answer. There is no ‘one shoe fits all’ approach, and if you are feeling anxious, and this all rings alarm bells, talk to your doctor; help is available. The answer is often just a call away. 

(1) Morgan CA 3rd, Wang S, Mason J, Southwick SM, Fox P, Hazlett G, Charney DS, Greenfield G. Hormone profiles in humans experiencing military survival training. Biol Psychiatry. 2000 May 15;47(10):891-901. doi: 10.1016/s0006-3223(99)00307-8. PMID: 10807962.

(2) Kobori Y, Koh E, Sugimoto K, et al. The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function. Int J Impot Res. 2009;21(4):207-212. doi:10.1038/ijir.2009.14