Will quitting smoking increase testosterone?

However, there was no difference in free testosterone levels between the two groups. After quitting smoking, SHBG levels were found to decrease, while no change was observed in bioavailable testosterone levels (PJ Pugh, et al. 2023). This further supports the notion that quitting smoking does not significantly alter testosterone levels.

To reinforce this evidence, another trial even showed a slight (insignificant) decrease in total testosterone levels following smoking cessation (H Hruškovičová, et al. 2012).

This suggests that the body does not instantly recover or regenerate upon quitting smoking. On the contrary, while smoking might temporarily raise some hormone levels or alter SHBG, quitting does not lead to a dramatic or rapid increase in testosterone.

In fact, some individuals have reported subjective experiences of declining testosterone after quitting. For example, one user on Reddit shared:

“I've just quit smoking a week ago, and I'm feeling very severely the drop in testosterone. Zero libido, feeling of weakness, flaccid penis, low energy, depression... These symptoms were not present before quitting…”*

In other words, the endocrine system which includes the pituitary gland and testes is complex and influenced by numerous factors such as nutrition, sleep, and stress.

When someone quits smoking, the body enters a detoxification phase and slowly begins to adjust. If nicotine previously stimulated certain hormonal responses, its absence can lead to a temporary hormonal shift that takes time to rebalance.

How does tobacco affect testosterone and fertility?

Overall, it can be said that smoking severely impairs fertility in both men and women. However, in men, despite having a reproductive system that is generally less sensitive than that of women, smoking still causes significant damage.

Notably, several studies have identified specific mechanisms by which tobacco negatively impacts male fertility.

First, cigarette smoke contains over 4,000 harmful chemicals, including nicotine, carbon monoxide, and heavy metals that create oxidative stress in the body’s cells. This oxidative process elevates free radicals, damaging sperm DNA and cells in the gonads (Qiao et al. 2015).

These reactions reduce sperm quality and sperm count, reflected in lowered sperm concentration, reduced motility, and higher rates of morphological abnormalities.

For example, a large-scale study in Pakistan revealed that smoking significantly decreased sperm count and the percentage of normal sperm, primarily due to oxidative damage (Rehman et al. 2019).

Additionally, nicotine has a disruptive impact on the endocrine system. Specifically, it directly affects Leydig cells in the testes, which are responsible for producing testosterone.

In one animal study, both smoking and nicotine injection significantly reduced testosterone levels. This finding is based on a single animal study, so its relevance to humans remains uncertain. Moreover, tobacco damages the vascular function of the testes.

Nicotine and other toxins circulating in the bloodstream trigger vasoconstriction, reducing blood flow to the testes. This organ is particularly sensitive to oxygen deficiency, and long-term smoking diminishes testicular function resulting in impaired spermatogenesis and lower sperm production (Qiao et al. 2015).

Furthermore, another review noted that testosterone levels tend to increase with the number of cigarettes smoked per day. However, this rise may be a compensatory response or related to alterations in SHBG (sex hormone-binding globulin) levels (Johan et al. 2006).

While debates continue regarding the effects of tobacco on male steroid hormones, past literature remains inconsistent, and post-cessation data is limited. Therefore, this article does not further elaborate on that aspect.

In summary, tobacco simultaneously damages sperm quality and fertility, negatively affects the testes, and alters hormone levels leading to unstable testosterone concentrations.

How to recognize low testosterone after quitting smoking

When you quit smoking, your body undergoes a variety of physiological changes, including shifts in hormone levels. Common symptoms that may emerge include fatigue, low libido, erectile dysfunction, reduced muscle strength, sleep disturbances, and mood swings, all of which are classic signs of low testosterone.

However, some symptoms such as irritability, fatigue, poor concentration can be harder to distinguish. These signs may result from nicotine withdrawal rather than directly from low testosterone. Therefore, if these symptoms persist, it is advisable to consult a physician and get your blood testosterone levels tested.

One major factor to consider is cortisol, the so-called “stress hormone.” The stress of quitting and its physiological turbulence can increase both psychological and physical strain. Chronically elevated cortisol suppresses the HPA/HPT axis (hypothalamus-pituitary-testes), which in turn reduces testosterone production (Cumming et al. 1983).

For this reason, alongside testosterone tests, measuring cortisol levels is also recommended. If both cortisol is high and testosterone is low, your doctor will likely consider balancing both hormones together.

Lastly, remember that low testosterone symptoms may be caused by multiple factors, including poor sleep, stress, or inadequate nutrition.

When in doubt, it is crucial to evaluate additional markers such as pituitary hormones (LH, FSH) and SHBG. Relying solely on total testosterone could lead to misleading conclusions. A comprehensive hormonal profile will help identify the root cause and guide appropriate treatment.

Can you smoke while on testosterone?

If you are undergoing testosterone replacement therapy (such as injections, gels, or patches), the short answer is: you should not smoke. This is because testosterone therapy stimulates red blood cell production, which can thicken the blood.

When combined with smoking, a known risk factor for vascular problems, you may face serious complications like thrombosis or blood clots.

Moreover, smoking reduces respiratory function and increases the risk of pulmonary conditions such as chronic obstructive pulmonary disease (COPD), lung cancer, and other respiratory illnesses (American Lung Association).

From a pulmonary health perspective alone, there is no justification for smoking while on testosterone therapy.

To maximize the benefits of hormone replacement therapy and reduce associated risks, the best approach is to quit smoking as soon as possible. Doing so will improve blood circulation and oxygen levels, both of which are essential for optimizing treatment outcomes.

Lifestyle changes to support testosterone balance

One of the most effective ways to support and maintain healthy testosterone levels is by adopting a healthier lifestyle. You can start with small, consistent habits such as:

• Exercising regularly, especially endurance training and resistance exercises. These activities help maintain a healthy weight, limit obesity, and improve male hormonal balance.
• Optimizing your diet with testosterone-friendly foods rich in zinc, vitamin D, healthy fats, and green vegetables. Avoid fast food, sugary products, trans fats, and alcohol.
• Getting enough sleep, ideally 7–8 hours per night, which helps restore hormonal balance naturally.
• Managing stress and keeping a positive mental state. Regular relaxation practices like meditation, walking, yoga, or strengthening social connections can effectively reduce stress levels.

In summary, regular physical activity, a nutritious and balanced diet, adequate sleep, and stress management are key to optimizing testosterone. These habits not only boost your hormonal health but also improve your overall physical and mental well-being.

Conclusion

Quitting smoking is undeniably one of the smartest decisions you can make for your health, it reduces the risk of heart disease, cancer, and numerous other serious conditions. However, increasing testosterone after quitting smoking is not straightforward and doesn’t happen immediately.

Hormonal improvements depend on various factors such as individual endocrine function, stress levels, diet, and lifestyle. Therefore, it's crucial to adopt a healthy lifestyle and seek regular check-ups if you're concerned about your testosterone levels.