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June 04, 2023 5 min read

Excessive alcohol consumption, referred to as alcohol use disorder, is a major risk factor for morbidity and mortality [1].

Alcohol use disorder is associated with a reduction in serum testosterone concentrations in men.

Evidence indicates that older men are associated with more frequent alcohol consumption in high-income countries [2] which may be a contributing factor contributing to the decrement in testosterone concentration with aging men. In addition, low testosterone is associated with several chronic diseases (e.g., obesity, type 2 diabetes, metabolic syndrome, and depression) [3].

Low testosterone is also associated with an enhanced risk of early mortality and a decrement in quality of life [4].

Therefore, elucidating the relationship between alcohol consumption and testosterone may impact the ability to identify strategies to attenuate testosterone reducing affects of alcohol use disorder.

In this article, we will investigate the effects of alcohol consumption on testosterone production and its potential mechanisms of action.

Alcohol consumption and testosterone concentrations

Although there is evidence that acute consumption of alcohol can increase testosterone, it seems to be due to biochemical changes. Most evidence indicates that consuming large amounts of alcohol, either acutely or chronically, decreases testosterone concentrations in men [5] with alcohol affecting each level of the Hypothalamus-Pituitary-Gonadal axis.

It is important to note that the normal hypothalamus-pituitary-gonadal axis is disrupted by alcohol.

The hypothalamus is susceptible to chronic alcohol administration via the effect of alcohol on gonadotropic releasing hormone gene expression. Essentially, chronic alcohol consumption suppresses the release of gonadotropic releasing hormone from the hypothalamus resulting in reduced Luteinizing hormone (LH) production and secretion form the pituitary gland [6].

Figure: Alcohol’s effects on hypothalamic neurons. GnRH, gonadotropin-releasing hormone; GABA, Gamma-aminobutyric acid.  [7]

Alcohol also appears to directly affect the testes based mainly on in vitro and animal research. Evidence indicates that alcohol negatively affects the synthesis of testosterone in the testes [8].

Figure: Alcohol’s effects on testosterone synthesis in the testes [7]


Another detrimental effect from alcohol in its activation of the hypothalamic-pituitary-adrenal (HPA) axis. In turn, the pituitary releases adrenocorticotropic hormone (ACTH) which travels in the systemic circulation and stimulates cortisol release from the adrenal cortex [9].  

Since elevated cortisol concentrations are associated with decreased testosterone concentrations, elevated cortisol concentrations, resulting from alcohol consumption, may lower testosterone concentrations [10].

Alcohol and inflammation

Alcohol consumption and inflammation have a complex association. Several lines of evidence indicate that an acute consumption of a low volume of alcohol is associated with low concentrations of pro-inflammatory markers, interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen compared to non-drinkers.

However, research also indicates that consuming a large volume of alcohol and/or alcohol use disorder is associated with elevated concentrations of inflammatory markers, such as lipopolysaccharide (LPS) and CRP.  

Since inflammation is associated with reduced testosterone concentrations, the testosterone-suppressing effects of cortisol appear to be replaced by pro-inflammatory cytokines during chronic consumption of a large volume of alcohol or alcohol use disorder.

Elevated inflammatory markers associated with consumption of a large volume of alcohol and/or alcohol use disorder appear to occur from three mechanisms:

  1. Translocation of LPS from the lumen and mucosa of the gastrointestinal tract into the systemic circulation.
  2. The production of reactive oxygen species (ROS) in the liver from the metabolism of alcohol
  3. The reduction of cortisol that occurs with reduced Hypothalamus-Pituitary-Adrenal (HPA) activity [11].


Excessive alcohol consumption has a negative effect on testosterone synthesis in men due to its effect on each level of the Hypothalamus-Pituitary-Gonadal (HPG) axis via the mechanisms of Hypothalamus-Pituitary-Adrenal (HPA) axis activity, inflammation, and oxygen species.

Since testosterone is such an important hormone, it is essential that strategies are identified to help attenuate alcohol’s effects on the Hypothalamus-Pituitary-Gonadal (HPG) axis.

Moreover, one of the most important lines of effort should be in providing men with evidence-based information about the impact excessive alcohol consumption has on their testosterone concentrations and overall health, as well as the impact it has on society in general.

This, in turn, may encourage more men to reduce their intake. Not only will this benefit them personally, but it will also benefit their family and the community by reducing the burden of health and societal issues associated with excessive alcohol consumption and alcohol use disorder.

Alcohol also negatively affects sleep, which is key to maintaining optimal testosterone levels and production. That means in order to ensure your body has the tools it needs to maintain optimal t-levels, you'll want to set your life up so that your daily routine supports your goals.

When you focus on getting good sleep (going to sleep and waking up at the same time each day), staying hydrated, eating nutrient-dense food, exercising regularly, and getting plenty of sunlight each day, you'll build a solid foundation from which to build muscle, get strong, and stay healthy. That way, if you do decide to drink every now and then, it won't wreck all of your hard work.

If you'd like to improve your sleep, RESTED-AF can help.

Rested-AF works to promote increased anabolic processes such as muscle breakdown recovery and promote higher rates of protein synthesis, in addition to improving daily cognitive function such as mental acuity and information retention.

1.    Griswold, M., E. Gakidou, and G.B.D.A. Collaborators, Alcohol and the global burden of disease - Authors' reply. Lancet, 2019. 393(10189): p. 2391-2392.
2.    Chaiyasong, S., et al., Drinking patterns vary by gender, age and country-level income: Cross-country analysis of the International Alcohol Control Study. Drug Alcohol Rev, 2018. 37 Suppl 2(Suppl Suppl 2): p. S53-S62.
3.    Gandhi, J., et al., The Role of Diabetes Mellitus in Sexual and Reproductive Health: An Overview of Pathogenesis, Evaluation, and Management. Curr Diabetes Rev, 2017. 13(6): p. 573-581.
4.    Laughlin, G.A., E. Barrett-Connor, and J. Bergstrom, Low serum testosterone and mortality in older men. J Clin Endocrinol Metab, 2008. 93(1): p. 68-75.
5.    Duca, Y., et al., Substance Abuse and Male Hypogonadism. J Clin Med, 2019. 8(5).
6.    Grattan, D.R., et al., Prolactin regulation of gonadotropin-releasing hormone neurons to suppress luteinizing hormone secretion in mice. Endocrinology, 2007. 148(9): p. 4344-51.
7.    Smith, S.J., A.L. Lopresti, and T.J. Fairchild, The effects of alcohol on testosterone synthesis in men: a review. Expert Rev Endocrinol Metab, 2023. 18(2): p. 155-166.
8.    Emanuele, M.A. and N. Emanuele, Alcohol and the male reproductive system. Alcohol Res Health, 2001. 25(4): p. 282-7.
9.    Rachdaoui, N. and D.K. Sarkar, Pathophysiology of the Effects of Alcohol Abuse on the Endocrine System. Alcohol Res, 2017. 38(2): p. 255-276.
10.    Stephens, M.A. and G. Wand, Stress and the HPA axis: role of glucocorticoids in alcohol dependence. Alcohol Res, 2012. 34(4): p. 468-83.
11.    Wang, H.J., S. Zakhari, and M.K. Jung, Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development. World J Gastroenterol, 2010. 16(11): p. 1304-13.



Dr. Paul Henning

About Dr. Paul

I'm currently an Army officer on active duty with over 15 years of experience and also run my own health and wellness business. The majority of my career in the military has focused on enhancing Warfighter health and performance. I am passionate about helping people enhance all aspects of their lives through health and wellness. Learn more about me