Psychological stress and testicular function: a cross sectional study of 1215 Danish men

A negative association between self-rated stress and sperm concentration, total sperm count, and semen volume was detected in a cross-sectional study of 1,215 young Danish men.


Loa Nordkap, M.D., Tina Kold Jensen, Åse Marie Hansen, Tina Harmer Lassen, Ph.D., Anne Kirstine Bang, M.D., Ulla Nordström Joensen, Ph.D., Martin Blomberg Jensen, Ph.D., Niels Erik Skakkebæk, Niels Jørgensen, Ph.D.

Volume 105, Issue 1, Pages 174-187



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


Cross-sectional study.


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


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).


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.


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.

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