Purpose: Although acute exercise has been demonstrated to modulate endogenous testosterone levels, existing studies have reached conflicting conclusions regarding the pattern of response of testosterone levels after exercise. The objective of this study was to examine the dynamic effects of acute exercise on testosterone levels and to analyze the differences in the role of factors such as exercise mode, intensity, sample source, and gender.
Methods: A comprehensive search of articles published up to March 2025 was conducted in five database systems, including PubMed and Web of Science, in accordance with the PRISMA guidelines. A total of 15 randomized controlled trials assessing the effect of acute exercise on testosterone levels were included, with a total sample size of 251 participants.
Results: (1) Testosterone levels demonstrate a greater increase following resistance training, with a delayed return to baseline levels; in contrast, testosterone levels typically recover within 1 h after aerobic exercise. (2) Moderate to high-intensity exercise stimulates the hypothalamic-pituitary-gonadal axis (HPG), leading to a transient rise in testosterone, but extended high-intensity exercise causes testosterone suppression during recovery due to cortisol antagonism for up to 72 h. The testosterone concentration during the active phase exceeds that during the recovery period. (3) A significant disparity in baseline testosterone levels exists between males and females, with males exhibiting higher levels. Additionally, males demonstrate a more pronounced response to exercise compared to females. (4) Blood tests exhibit greater sensitivity than saliva tests, although the latter is more reactive to high-intensity exercise; (5) The response is more pronounced in younger males compared to older adults, with negligible response observed in adolescents.
Conclusion: Variations in testosterone level modulation due to acute exercise are predominantly influenced by exercise mode, intensity, sample source, and subject characteristics (gender and age). While resistance training and high-intensity exercise might temporarily increase testosterone levels, it is essential to consider the potential for hormonal imbalance after recovery; age and sex variations, along with assay standardization, are critical areas for further investigation. This review was registered PROSPERO with registration number CRD420251007222.
Keywords: Acute exercise; Recovery period; Testosterone.
© 2026 Tu et al.