The effects of alcohol on testosterone synthesis in men: a review

ABSTRACT

Introduction

Testosterone concentrations in men decline with advancing age, with low testosterone concentrations being associated with multiple morbidities, an increased risk of early mortality, and a reduced quality of life. The purpose of this study was to examine the effects of alcohol on testosterone synthesis in men by investigating its effects on each level of the hypothalamic-pituitary-gonadal axis.

Areas covered

Acute consumption of a low-to-moderate amount of alcohol increases testosterone concentrations in men, while consumption of a large volume of alcohol is associated with a reduction in serum testosterone concentrations. Elevated testosterone concentrations result from the increased activity of detoxification enzymes in the liver. Conversely, the primary mechanisms of action involved in the reduction of testosterone are increased hypothalamic–pituitary–adrenal axis activity, inflammation, and oxidative stress. When alcohol is consumed in excess, particularly chronically, it negatively affects testosterone production in men.

Expert opinion

Since testosterone is an important component of men’s health and wellbeing, current levels of alcohol consumption in many countries of the world require urgent attention. Elucidating the relationship between alcohol consumption and testosterone may be useful in identifying strategies to attenuate the testosterone-reducing effects of excessive or chronic alcohol consumption.

KEYWORDS:

• Testosterone
• alcohol
• oxidative stress
• inflammation
• cortisol

Article highlights

• Low-to-moderate alcohol consumption may increase testosterone concentrations in men

• Excessive alcohol consumption, alcohol use disorder, has a significant negative effect on steroidogenesis in men

• Alcohol affects each level of the hypothalamus-pituitary-gonadal axis via the mechanisms of increased hypothalamus–pituitary–adrenal axis activity, increased inflammation, and increased oxidative stress

• Since testosterone is such an important hormone for men, it is essential that strategies are identified to help attenuate alcohol’s effects on it

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper received PhD research funding through Murdoch University.