Workplace Stress Tied to 54% ED Rate in Young Men via Cortisol-Testosterone Sequence

Investigators measured five workplace stress dimensions including hours, autonomy, supervisor support, colleague relations and promotion pressure alongside serum cortisol, testosterone and erectile function scores. Elevated cortisol preceded testosterone decline by 2-4 weeks, with testosterone changes preceding erectile impairment by another 4-6 weeks, outlining a potential 6-10 week window for intervention. Working hours drove effects through cortisol elevation while supervisor support protected testosterone levels. This temporal pattern aligns with known HPA-axis activation under chronic occupational demand and prior cohort data showing stress-related hypogonadism in men under 45. The design cannot establish causation or rule out reverse causality from preexisting erectile concerns amplifying perceived stress. Next steps require randomized trials of supervisor-support programs or cortisol-lowering interventions to test whether the observed 6-10 week sequence can be interrupted before erectile function declines.