Sven Wombwell
Article by: Sven Wombwell
Estimated 10 minutes read

Cortisol is a hormone made in the adrenal glands. It affects your body in many ways. It helps control blood sugar levels, metabolism, water and salt balance, blood pressure, memory, and fighting infection. Cortisol also affects our sleep and wake cycle. It is highest in the morning and lowest at midnight.

You release cortisol in stressful situations, hence why it's called 'the stress hormone.' As the adrenal glands release cortisol into your bloodstream, your body produces a surge of glucose into your larger muscles enabling you to jump into action. Also, while narrowing your arteries, your body produces another hormone called epinephrine (adrenaline), which increases your heart rate. 

Also known as "fight or flight," this increased stimulation has kept us ahead of predators and essentially helped us survive. It allows you to jump into action when you need it most.

What does cortisol do?

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

  • Helps your memory
  • Helps regulate your sleep cycle
  • Helps reduce inflammation
  • Regulates blood 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?

Almost everybody is under more pressure than our bodies can cope with these days. Stress from work, busy lifestyles, and constant high-stress levels can wreak havoc on your hormone 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. 


Life in the fast lane: work hard, play hard are all phrases that many find relatable. Modern life is relentless; unless we learn to relax, cortisol pumps through our systems constantly. 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 may be at risk.

Situations that cause stress are called 'stressors,' which cause the release of cortisol. There are two categories of stressors: Physiological (physical) and Psychological Stressors.

Physiological (or physical) Stressors

Extreme temperature, injury, chronic illness, and pain can all be physical causes of stress. Your body is up against it and releases the stress hormone cortisol as a result.

Psychological Stressors

Situations that make you feel under threat or cause cortisol to surge. For example, an upcoming exam, high-pressure family situations, a near miss, or worrying about a sick child.

Cushing's Syndrome

Cushing's Syndrome is a hormonal disorder where your adrenal glands produce too much cortisol for too long. It could result from a pituitary tumor, causing excessive production of cortisol. An adrenal gland tumor, a tumor elsewhere in the body, or a result of long-term use of certain drugs. Examples include cortisone drugs and Prednisone, a medication that inhibits the immune system and alleviates inflammation in conditions like asthma and COPD.

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 Dysfunction

The relationship between cortisol, testosterone, and erectile dysfunction is not widely studied. However, plenty of studies link 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 in a stressful or dangerous situation, the last thing your body needs is testosterone. 

Study: Stress Affects Hormone Levels in Soldiers

In one study (1), 109 trainee soldiers had hormone levels monitored while 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 total and free T4 and 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).

Study: Men With High Cortisol are More Likely to Get ED

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

"One reason why E.D. occurred in patients with high cortisol levels 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.

Take our free hormone assessment to see if reduced testosterone may be causing your ED.

What if Your Body Produces Too Little Cortisol?

Without medical intervention, you will eventually die if your body doesn't produce enough cortisol. 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 autoimmune disease tricks your body into attacking an organ, thinking it is a harmful invader, such as a virus or 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 as Prednisone 
  • Damage caused by accidents: Trauma from car accidents, for example
  • Severe shock
  • Severe dehydration
  • Severe dehydration

Low cortisol levels can cause extreme fatigue, weakness, and low blood pressure. 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

Cortisol and Addinsonian Crisis

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

Fortunately, medication can control this condition. Because the adrenal glands no longer produce cortisol and aldosterone, corticosteroid medication tablets can rectify this, usually taken 2-3 times daily.

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 feel restricted and frustrated, affecting their mental health.

Healthy people feel a surge of cortisol after a super stressful situation such as a car crash. This hormone rush helps you cope with the stress and any injuries you may have incurred.

People living with Addison's cannot produce cortisol. They will need a hydrocortisone injection to replace the cortisol to avoid being overwhelmed by adrenalin and prevent an adrenalin crisis. Sufferers should wear medical bracelets indicating their condition, so anybody at the scene can identify any issues quickly.

How Can You Maintain Healthy Cortisol Levels?

  • Maintain a good circadian rhythm: Go to bed and get up at the same time every day; this helps maintain a healthy hormone balance. Lack of sleep can drop testosterone and raise stress hormones. 
  • Avoid caffeine before bed: Caffeine is a stimulant that keeps you awake.
  • Exercise: Don't go overboard; overtraining can increase cortisol and decrease testosterone. Your muscles need glucose during recovery, which 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. This method is proven to reduce the harmful risks of extreme stress, such as high blood pressure, psychiatric disorder, and even migraines.
  • Medication: Many medications are used to slow cortisol production in the adrenal glands, such as ketoconazole, mitotane (Lysodren), and metyrapone (Metopirone); these meds are mainly for those with Cushing's Syndrome. 

Maintaining healthy hormone levels can be tricky. As men age, testosterone levels inevitably drop, and the associated negative symptoms can start to creep in.

Weight around the middle, loss of libido, brain fog, inability to gain muscle, and low energy can all creep in. These symptoms can lead to a guy losing confidence, losing their lust for life, and causing excessive physical and psychological stress. Factors we now know cause the stress hormone to kick in, hammering testosterone even more.

Testosterone Therapy and Cortisol

Bioidentical hormone replacement therapy (BHRT) therapy is now an excellent option for guys who want to tackle the overall picture. BHRT has so many benefits that can help reduce stress from your life and get things back in your control.

By optimizing testosterone levels and getting fit and healthy, you can rewind the clock and grab 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, a healthier body, improved self-image and reduced stress.
  • Improved drive, motivation, and reduced symptoms of depression 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!
(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
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