Psychological stress and testicular function: a cross-sectional study of 1,215 Danish men

Fertil Steril. 2016 Jan;105(1):174-87.e1-2. doi: 10.1016/j.fertnstert.2015.09.016. Epub 2015 Oct 23.


Objective: To study the associations between self-reported psychological stress, semen quality, and serum reproductive hormones among young Danish men.

Design: Cross-sectional study.

Setting: University hospital-based research center.

Participant(s): Danish men (median age 19 years) from the general population were investigated from 2008 to 2012.

Intervention(s): Participants completed a questionnaire on health and lifestyle, including a four-item questionnaire about self-rated stress, had a physical examination performed, delivered a semen sample, and had a blood sample drawn.

Main outcome measure(s): Semen parameters (semen volume, sperm concentration, and percentages of motile and morphologically normal spermatozoa) and serum levels of reproductive hormones (LH, FSH, T, calculated free T, sex hormone-binding globulin, and inhibin B).

Result(s): Poorer semen quality was detected among men with self-reported stress scores above an intermediate stress level, in a dose-response manner. For example, men with the highest stress levels had 38% (95% confidence interval [CI] 3%; 61%) lower sperm concentration, 34% (95% CI 59%; 106%) lower total sperm count, and 15% (95% CI 1%; 27%) lower semen volume than men with intermediate stress levels. No significant associations between self-reported stress and levels of reproductive hormones were detected.

Conclusion(s): A negative association between self-reported stress and semen quality was detected. If causal, stress may be a contributing factor for suboptimal semen quality among otherwise healthy men.

Keywords: Stress; normal men; reproductive hormones; semen quality; sperm concentration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Fertility
  • Follicle Stimulating Hormone, Human / blood*
  • Humans
  • Infertility, Male / diagnosis
  • Infertility, Male / epidemiology*
  • Infertility, Male / physiopathology
  • Infertility, Male / psychology
  • Luteinizing Hormone / blood*
  • Male
  • Risk Factors
  • Sex Hormone-Binding Globulin / analysis
  • Sperm Count
  • Sperm Motility
  • Spermatozoa / pathology*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / physiopathology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Testosterone / blood*
  • Young Adult


  • Biomarkers
  • Follicle Stimulating Hormone, Human
  • Sex Hormone-Binding Globulin
  • Testosterone
  • Luteinizing Hormone