Alcohol and Testosterone: What the Evidence Shows

Does alcohol lower testosterone?

A meta-analysis published online in 2023 combined 21 studies involving 10,199 participants. It found lower total and free testosterone overall, but the association was evident in otherwise healthy men with chronic alcohol exposure. It was not demonstrated in the acute-intake or diagnosed alcohol use disorder subgroups.

That finding supports taking regular drinking seriously, while showing why a headline such as “alcohol cuts testosterone by X%” is too broad. A result averaged across different studies is not a prediction for your next drink or your blood test.

Most of the evidence discussed here concerns adult men. Findings from men cannot simply be applied to women, and hormone changes are not automatically health improvements.

Sources & further reading [1] [10]

How alcohol can affect testosterone production

Testosterone production depends on communication between the brain and testes. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which signals the pituitary gland to release luteinizing hormone (LH). LH stimulates testosterone production in the testes. This feedback system is called the hypothalamic-pituitary-gonadal axis.

Alcohol can interfere at more than one point: with hormonal signals, with processes involved in testosterone production, and with hormone metabolism. Alcohol-related liver disease can further complicate the picture. A NIAAA journal review describes several proposed mechanisms, drawing on both human and animal research.

These mechanisms explain why an effect is biologically plausible. They do not tell us exactly how much testosterone one person will lose after a particular amount of alcohol. Animal experiments also cannot supply a human recovery countdown.

Sources & further reading [2]

Short-term drinking and regular drinking are different questions

One small controlled experiment followed eight healthy men after a very large alcohol dose: 1.75 grams per kilogram of body weight over three hours. Testosterone fell, with a decrease still present at 24 hours. For an 80 kg person, that experimental dose would be 140 grams of alcohol, or ten US standard drinks. This was not a test of one beer.

In a separate randomized crossover study, ten middle-aged men consumed beer supplying 40 grams of alcohol daily for three weeks, and alcohol-free beer in another three-week period. Average testosterone was 6.8% lower after the alcohol period. The study also included nine postmenopausal women; no testosterone effect was detected in that small female group.

These are different exposures and small samples. The 6.8% result should not be described as the effect of one drink, a typical night out, or the increase someone will get by quitting.

Scroll horizontally to compare all columns.

Sources & further reading [3] [4] [11] [5]

Why some studies find higher testosterone

A 2014 cross-sectional study of 1,221 Danish men aged 18 to 28 found that recent alcohol intake was associated with higher free testosterone. Habitual intake was associated with poorer semen measures. Higher testosterone in a blood sample therefore did not amount to evidence of better reproductive health.

Cross-sectional studies compare people at a particular point in time. They cannot establish that alcohol caused a hormone difference or that changing alcohol intake would reverse it. Timing, participant characteristics and the measure used also matter when comparing studies.

Total testosterone and free testosterone are different measurements. Total includes testosterone bound to blood proteins; free testosterone is the unbound fraction. Your clinician may consider binding proteins and free testosterone when a total result is difficult to interpret.

Sources & further reading [5] [8]

Will testosterone recover after quitting alcohol?

It may improve, but research does not establish a universal recovery schedule. In a study of 29 men receiving detoxification treatment, testosterone and its binding protein rose by three weeks of sobriety. Initial testosterone values were generally within normal limits, and participants did not have severe signs of liver disease.

Another small study followed 18 men without cirrhosis through 127 days of abstinence. Testosterone and LH patterns remained different from those of healthy controls. Testosterone was higher, rather than lower, in that group, illustrating that recovery is more complicated than a steady rise from a low starting point.

Neither study tells an occasional drinker what will happen after a weekend, or guarantees that someone with diagnosed low testosterone will recover by day 7, 30 or 90. If symptoms persist, arrange an assessment instead of waiting for a promised hormone reset. Feeling better and confirming a hormone change are different outcomes.

Sources & further reading [6] [7]

When to ask a clinician about low testosterone

Persistent low sex drive, erection problems, reduced spontaneous erections, or fertility concerns deserve a medical conversation. Tiredness, low mood and reduced muscle mass can also occur with low testosterone, but symptoms alone cannot diagnose it.

The Endocrine Society recommends diagnosing hypogonadism only when compatible symptoms accompany consistently low testosterone. Confirmation involves repeating a morning fasting blood test. A single result, especially without information about timing and health, is not enough.

Bring your drinking history, medication and supplement list, and a note of when symptoms began. Other possible contributors include obesity, sleep disorders, certain medicines and testicular or pituitary conditions. Ask what else should be assessed and when a repeat test would be useful.

If you already use testosterone injections, gel or another prescribed treatment, discuss alcohol with the prescriber. Do not adjust your dose to compensate for drinking. Mention plans to have children: the Society advises against starting testosterone therapy when near-term fertility is planned.

Sources & further reading [9] [8]

Make your drinking history useful

Record what you actually drink: serving size, alcohol by volume (ABV), and the days you drink. In the US, a standard drink contains 14 grams of pure alcohol. A strong beer or generous wine serving can contain more than one, so counting glasses alone can be misleading.

For a useful appointment note, write something concrete: “I usually have two 16-ounce beers at 8% on Friday and Saturday.” Add when your symptoms started and whether your drinking changed around that time. This gives a clinician more to work with than “I drink socially.”

If you are making a change, decide which situation you will handle differently, such as ordering separately from a round or choosing an alcohol-free drink at dinner. If you keep exceeding your intended limits, discuss professional support. You do not need a low testosterone result to ask for help with drinking.

Freedom app lets you record days with or without alcohol and review an editable calendar. Use it to keep track of those days alongside a separate record of amounts and symptoms. It does not measure testosterone, diagnose hormone problems or provide testosterone treatment.

Sources & further reading [11] [12]

• Practical ways to slow down drinking ↗
• Consider cutting back versus quitting ↗
• Explore Freedom app features ↗
• Download Freedom app ↗

Questions about alcohol and testosterone