COMMENTS: We wrote this article to highlight possible mechanisms behind the benefits of rebooting. Below I address the most common misconceptions related to testosterone, abstinence and ejaculation. The preponderance of human and animal research points to neither abstinence nor ejaculation having any significant long-term effects on blood testosterone levels – other than a spike around day 7 of abstinence. That said, there’s been no study examining the effects of porn addiction on hormone levels. It is not unreasonable to assume that hormones are altered by brain changes associated with porn addiction (i.e. in the hypothalamus). I caution readers (especially r/nofap) to not conflate the effects of ejaculation with the effects of a severe porn addiction.

1) As stated, the preponderance of animal & human studies suggest that neither abstinence nor “too much ejaculation” have any effect on blood testosterone levels. However, there’s evidence that ejaculation to the point of sexual satiation triggers multiple brain changes – including a decline in androgen receptors. and increases in estrogen receptors and dopamine-blocking opioids in several brain regions. Full recovery takes about 15 days and is quite apart from addiction-related brain changes. More below.

2) There is no consistent correlation between sexual activity, or abstinence, and plasma testosterone levels – other than a one-day transient spike (46% above baseline) following seven days of abstinence. Wide fluctuations in male testosterone levels (10-40%) are normal.

3) There is no evidence for abstinence raising testosterone levels. Only two studies have measured T levels during a long-term abstinence (16 & 21 days), and both found no change:

The “famous” Chinese study measured testosterone levels every day for 16 days, and found little change until around day 7, when a spike occurred. After the one day spike Testosterone returned to baseline or slightly lower from day 8 through day 16 when the experiment ended.

The study in #4

4) This abstract – Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence, where subjects didn’t ejaculate for 3 weeks, is often cited as evidence that abstinence leads to increased testosterone. It doesn’t. This sentence from the abstract is poorly worded and misleading: “although plasma testosterone was unaltered by orgasm, higher testosterone concentrations were observed following the period of abstinence“. In the full study, testosterone levels are the same in both groups. Examine the testosterone graph C on page 379. Notice testosterone levels at the start of the film (10-minute mark) were identical in both groups. End of story. The confusing language in the abstract refers to testosterone differences while masturbating. While watching the erotic film and masturbating, T-levels dropped for the pre-abstinence masturbation session. After 21 days of abstinence, T-levels stayed closer to the 10 minute baseline during masturbation. The statement – “higher testosterone concentrations were observed following the period of abstinence” – means that testosterone levels did not fall as much during the stimulus: masturbation & porn viewing. The authors suggest anticipation of watching a porno (perhaps augmented by the anticipation of finally masturbating) caused testosterone to remain elevated throughout the viewing.

5) Rodent studies consistently find that ejaculation to “sexual exhaustion” has no effect on testosterone levels. These studies follow the animals for up to 15 days. However, they do find multiple changes within the limbic system, including a decline in androgen receptors, and increase in estrogen receptors & opioids (which block dopamine), and alterations in gene expression.

6) Long-term studies on primates have shown no reliable correlation between ejaculation and blood testosterone levels.

7) Many studies report similar testosterone levels in healthy men and men with chronic ED (1, 2, 3, 4). From these studies alone we can conclude that 1) low testosterone is rarely a cause of ED, 2) frequency of ejaculation has no effect on T levels.

8) In fact, the authors of these two ED studies (study1, study2) suggest that abstinence may lead to chronically low testosterone levels . This 2014 ED study found higher testosterone/DHT after penile implant surgery led to increased sexual activity.

9) Many men with porn-induced erectile dysfunction have seen doctors. Virtually all have reported normal testosterone levels.

10) Many human and animal studies show that low testosterone has no effect on erections achieved through stimulation. See this discussion by a professor of reproductive endocrinology – Hypogonadal men and erections and Testosterone and Erectile Dysfunction

11) This single study from 1976 reported less sexual activity correlating with higher testosterone – for some subjects, but not all. However, the study also found that higher levels of testosterone were associated with periods of sexual activity. A bit contradictory. Let’s place this study in context: It has never been replicated and contains countless uncontrolled variables. All other animal and human studies examining testosterone and high ejaculation frequency, abstinence, various levels of sexual activity, along with erectile dysfunction refute its findings.

12) The evidence points to addiction processes or sexual conditioning as the primary cause of porn-induced ED, porn-induced loss of libido, or what is euphemistically called “sexual exhaustion”.

13) Some men with porn-induced ED have tried testosterone supplementation, with no success. When these same men rebooted, their ED was cured.

14) By the way, most studies that involve porn viewing report it has little or no effect on testosterone levels. For example, The endocrine effects of visual erotic stimuli in normal men. (but some do)

15) Reward circuitry dopamine is behind sexual desire, motivation, and erections. In short, the many improvements guys see in libido and confidence as they reboot are probably coming from changes in their brains, not their testosterone levels.

Men experience myriad benefits as they unhook from porn and compulsive masturbation. It’s natural to assume positive changes such as more confidence, better mood, less anxiety, and greater motivation must have something to do with blood testosterone levels. However, neither human or animal research supports the testosterone hypothesis. While a few men have reported abstinence associated with higher T, the vast majority of men who are tested (before & during) report no significant change. Since many factors (stress, exercise, diet) can affect T levels and lab results, we need to be cautious with an occasional anecdote. On the other hand, it is quite possible that brain changes associated with porn addiction can affect hormones via the hypothalamus. Examples include: alteration in the autonomic nervous system and the HPA axis (CRF, cortisol, norepinephrine), along with any number of steroid hormones derived from the gonads or adrenal glands. Longitudinal research on porn addicts and “rebooted” porn addicts would help clarify the mechanisms behind claimed physical benefits such as, deeper voice, better response to exercise, hair growth, clearer skin, etc.

For the science behind the benefits guys experience see – Porn, Masturbation and Mojo: A Neuroscience Perspective – Ex-porn users usually get their mojo back. Why?

STUDIES

LOWER T RELATED TO ABSTINENCE. HIGHER T WITH RESUMED SEXUAL ACTIVITY:

Sexual inactivity results in reversible reduction of LH bioavailability.

Int J Impot Res. 2002 Apr;14(2):93-9; discussion 100.

Carosa E, Benvenga S, Trimarchi F, Lenzi A, Pepe M, Simonelli C, Jannini EA.

Abstract

We have recently documented significantly reduced serum testosterone (T) levels in patients with erectile dysfunction (ED). To understand the mechanism of this hypotestosteronemia, which was independent of the etiology of ED, and its reversibility only in patients in whom a variety of nonhormonal therapies restored sexual activity, we measured serum luteinizing hormone (LH) in the same cohort of ED patients (n=83; 70% organic, 30% nonorganic). Both immunoreactive LH (I-LH) and bioactive LH (B-LH) were measured at entry and 3 months after therapy. Based on outcome (ie number of successful attempts of intercourse per month), patients were categorized as full responders (namely, at least eight attempts; n=51), partial responders (at least one attempt; n=20) and non-responders (n=16). Compared to 30 healthy men with no ED, baseline B-LH (mean+/-s.d.) in the 83 patients was decreased (13.6+/-5.5 vs 31.7+/-6.9 IU/L, P<0.001), in the face of a slightly increased, but in the normal range, I-LH (5.3+/-1.8 vs 3.4+/-0.9 IU/L, P<0.001); consequently, the B/I LH ratio was decreased (3.6+/-3.9 vs 9.7+/-3.3, P<0.001).

Similar to our previous observation for serum T, the three outcome groups did not differ significantly for any of these three parameters at baseline. However, outcome groups differed after therapy. Bioactivity of LH increased markedly in full responders (pre-therapy=13.7+/-5.3, post-therapy=22.6+/-5.4, P<0.001), modestly in partial responders (14.8+/-6.9 vs 17.2+/-7.0, P<0.05) but remained unchanged in non-responders (11.2+/-2.2 vs 12.2+/-5.1). The corresponding changes went in the opposite direction for I-LH (5.2+/-1.7 vs 2.6+/-5.4, P<0.001; 5.4+/-2.2 vs 4.0+/-1.7, P<0.05; 5.6+/-1.2 vs 5.0+/-1.2, respectively), and in the same direction as B-LH for the B/I ratio (3.7+/-4.1 vs 11.8+/-7.8, P<0.001; 4.2+/-4.3 vs 5.8+/-4.2, P<0.05; 2.1+/-0.7 vs 2.6+/-1.3, respectively).

We hypothesize that the hypotestosteronemia of ED patients is due to impaired bioactivity of LH. This reduced bioactivity is reversible, provided that resumption of sexual activity is achieved regardless of the therapeutic modality. Because biopotency of pituitary hormones is controlled by the hypothalamus, LH hypoactivity should be due to the hypothalamic functional damage associated to the psychological disturbances which unavoidably follow sexual inactivity.

COMMENTS: Authors suggest that successful sexual activity increases LH and testosterone in men treated for ED. None of the men were treated with hormones, and low testosterone was not the cause of their ED. If true in healthy men, this suggests that sex/ejaculation may prevent a decline in testosterone levels.

Lack of sexual activity from erectile dysfunction is associated with a reversible reduction in serum testosterone.

Int J Androl. 1999 Dec;22(6):385-92.

Jannini EA, Screponi E, Carosa E, Pepe M, Lo Giudice F, Trimarchi F, Benvenga S.