Male Stress

Male Stress and Healthy Hormones

Stress is your hormones’ biggest enemy. Here are five ways to combat it. By Dr. Monica Lascar

Reading time: 5 minutes

The stress hormone, commonly known as cortisol, is for many people the hormones' biggest enemy, yet it is so common in today’s world. Scientists have published research over the years proving that elevated cortisol levels interfere with learning and memory, lower immune function and bone density, increase weight gain, blood pressure, cholesterol and heart disease — to name just a few. Therefore, the importance of reducing your stress levels to promote healthy hormones in men is paramount.

What is a stress response?

When we are faced with a threat (real or imagined) a signal gets sent to a part of the brain (hypothalamus), which then sends a messenger (hormone) to the pituitary — this then sends a message to the adrenals that produce adrenaline and cortisol, which forms your HPA axis. Extensive research highlights the role of the HPA axis in maintaining physical and mental health with disruptions in its functioning being acknowledged in most mental health conditions including chronic pain and fatigue related conditions. Yet little of this knowledge is applied in a pharmacological-based model of practice of medicine; there is no quick fix or pill to alleviate an overdriven and overstimulated stress axis. However, lifestyle changes are often helpful.

The stages of stress

The first stage of stress is known as the alarm stage, when the body mobilises cortisol and adrenaline to help survival. The heart beats faster and more blood is being pumped around the body to enable us to flee danger. Remember when the Covid 19 pandemic was announced, and we all mobilised and built a new hospital site within weeks? This was a helpful stress response. Also remember the panic buys? Decision-making in the alarm stage of stress is not always the wisest. The alarm stage is meant to be short lived and it is a helpful stress response to adapt to danger (fight/flight).

Resilience and growth can be defined by this successful adaptation to stress. You are able to mount a good stress response but also, once the perceived danger or emergency is over, you are able to reset your nervous system to a state of calmness and safety, where you feel connected to yourself and others and replenished enough to face the next challenge.

However, sometimes the danger does not go away, or our HPA axis remains overstimulated, on a repeat loop, and a host of hormonal changes ensue. This can include an increase in overall 24-hour cortisol production over time, known as the adaptation stage. However, this is not sustainable long term, despite many people sustaining chronic stress for 10-15 years.

It’s also important to note that stress can be cumulative over time. We all have an individual ability to cope with stress; this is defined as an allostatic stress load, a metaphorical boat which we load as the years go by. Beyond that capacity, the boat tips and the effects of chronic stress can become more apparent.

The final stage of stress is exhaustion. Many conditions have been associated with ongoing chronic stress; from high-blood pressure, heart disease, stomach ulcers and according to some research, decreasing cognitive function and even cancer.

What about hormones and cortisol?

Hormones work together as a finely-tuned orchestra. The sex hormone pathway includes oestrogens, testosterone, progesterone, cortisol, DHEA (di[1]hydroepiandrosterone) and several metabolites in between. Both men and women share the same hormones but in different ratios and amounts. Sex hormones are also neuro-steroids, with specific effects on the brain through their interaction with neurotransmitters. Cortisol is therefore part and parcel of the sex neuro-steroid hormone pathway.

Male Stress and Healthy Hormones image

Cortisol, as the survival hormone, is the king of all hormones

Hormones are tiny molecules that travel from the place where they are made (endocrine glands) to many tissues, where they bind to receptors and create a specific effect. Testosterone works with androgen receptors (AR), which are found in many tissues like bone, muscle, prostate, adipose (fat) tissue and the reproductive, cardiovascular, immune, neural and blood cell systems.

When testosterone levels are low, many effects can occur, such as loss of muscle mass (or inability to build it despite exercise), low libido and erectile dysfunction to name a few. Sex hormones interact with our neurotransmitters also, and low testosterone may be associated with anxiety, mood swings or memory and concentration problems. But this lock and key mechanism of testosterone can also be influenced by cortisol. A system flooded in cortisol may down regulate testosterone receptors, although more research is needed to understand the implications of this.

There is also human research showing that the administration of cortisol can reduce testosterone levels in a blood test. While too much cortisol in the system can affect testosterone levels, the interplay between hormones is complex and varies during the day. More research is needed to fully understand the interplay between cortisol and testosterone.

What can men do to manage stress levels and maintain balanced hormones?

Recognise how you handle stress in your body and use movement to help reset your nervous system
Stress can affect us all slightly differently and one can build an increased awareness to recognise the specific patterns of how your body reacts to stress. Pay attention to your body’s patterns of stress. Do you tense your jaw muscles and grind your teeth? Do you hold the world’s worries on your shoulders and get a tense neck or headaches? Are your thoughts faster or more anxious? Do you feel hyper vigilant?

Experiment with what may work for you to change your state. For example, you could go for a walk outdoors, connect with a friend, explore one of the many mindfulness and meditation apps, or try a Qi Gong class or yoga. Too much prolonged or sustained exercise can also increase cortisol (and decrease testosterone in some studies) and can backfire, especially if you are already under chronic stress. Resistance training and building muscle mass can often be helpful.

Learn abdominal breathing techniques, diaphragmatic breathing or box breathing (breathe in counting to four, hold for four, breathe out to four and hold to four before taking in the next breath). Deep breathing stimulates the vagus nerve, which is the main ’feeling safe’ system of the autonomic nervous system and will take you out of the fight and flight response.

Restorative sleep has many benefits for optimal hormones, your immune system and maintaining good energy and sharp thinking. It often starts with a good sleep routine. Obstructive sleep apnoea is an increasingly common condition that not only causes interrupted sleep but also is a known contributor to low testosterone levels.

Anyone hangry?

Minimise blood sugar fluctuations Cortisol is also involved in blood sugar regulation and as the fight and flight hormone it also helps to rapidly release glucose in the blood stream in service of survival. But blood sugar fluctuations can also lead to sugar cravings and worsen anxiety and mood swings. It can be helpful to aim for a diet rich in protein and healthy fats (nuts, seeds, olive oil) and to avoid sugar, processed foods and simple carbohydrates (have more complex carbs instead).

Connection and a sense of purpose
This has emerged as a common theme in longevity studies. It is easy to end up feeling disconnected in all the busy-ness of life. Take time to remember what brings you joy and makes you feel recharged, and dare I say, what is your deepest longing? Connect with it and honour it.

Remember: some stress is helpful to help us grow and to learn, but ongoing stressors that end in hyper vigilance can be detrimental. With the above steps, men can begin to manage their stress levels and maintain balanced hormones.

Dr Monica Lascar is a specialist in integrative women's health and bioidentical hormone balancing for the Marion Gluck Clinic (

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