Medical summary
Current evidence does not show that masturbation causes a sustained reduction in a man’s baseline testosterone or causes testosterone deficiency. Small laboratory studies have reported short-lived hormonal changes around sexual arousal, orgasm or abstinence, but they do not establish a clinically important long-term effect.[1][2]
MYTRT treatment eligibility
MYTRT treats men only when they have compatible symptoms and meet both biochemical limits: total testosterone of 15 nmol/L or below, and free testosterone of 0.35 nmol/L or below.
The widely repeated claim that seven days without ejaculation raises testosterone to 145.7% of baseline came from a 2003 paper that was retracted in 2021. It should not be used to recommend abstinence, diagnose low testosterone or promise performance benefits.[3]
If you have persistent symptoms associated with testosterone deficiency, the appropriate next step is a clinical assessment and properly collected repeat blood tests—not a prescribed masturbation frequency or a “semen-retention” programme.[4]
The short answer
Masturbation may be followed by brief changes in prolactin and other hormones involved in sexual response, but available studies do not demonstrate a lasting fall in testosterone after ejaculation. The evidence base is small, usually involves healthy young men, and does not show that abstinence treats hypogonadism, improves fertility through testosterone, or produces sustained muscle or performance gains.
That distinction matters. A temporary laboratory fluctuation is not the same as a persistent deficiency, and a result from a small experimental study is not a treatment instruction.
What the small studies actually found
| Study | What was measured | Finding | What it cannot show |
|---|---|---|---|
| Exton et al., 2001 | Ten healthy men were studied during masturbation-induced orgasm before and after three weeks of abstinence. | Orgasm increased prolactin and cardiovascular measures, while plasma testosterone was unaltered by orgasm. Testosterone concentrations were higher after the abstinence period.[1] | The study was very small, did not test men with hypogonadism and did not show that abstinence improves symptoms, muscle, fertility or long-term testosterone. |
| Isenmann et al., 2021 | Eight healthy young strength-trained men completed masturbation, visual-stimulus and passive conditions in a cross-over pilot study. | Masturbation and visual stimulus appeared to attenuate the daytime fall in free testosterone, but testosterone-to-cortisol and related ratios did not change significantly.[2] | The study did not demonstrate a sustained increase in baseline testosterone or improved training outcomes, and the authors called for larger studies. |
| Jiang et al., 2003 | Twenty-eight men were reportedly followed during abstinence after ejaculation. | The paper reported a day-seven value equal to 145.7% of baseline.[3] | The article was retracted in 2021. Its result must not be presented as reliable evidence or a treatment recommendation. |
The two non-retracted studies do not point to a simple rule that “more masturbation lowers testosterone” or “abstinence raises testosterone”. Their designs, sample sizes and outcomes are too limited for that conclusion.
Why the seven-day claim is misleading
The retracted Jiang paper is often described online as showing a “145% increase”. The original abstract said 145.7% of baseline, which would represent a 45.7% rise rather than more than doubling the baseline value. More importantly, the publication is formally labelled as retracted by PubMed, with a 2021 retraction notice.[3]
A retracted finding should not be used as proof that testosterone peaks after a week, as the basis of an abstinence schedule, or as evidence that ejaculation suppresses testosterone. The previous version of this article repeated the figure in several places without clearly identifying the retraction; those passages have been removed.
What happens around orgasm
Sexual arousal and orgasm involve short-term nervous-system and endocrine responses. In the Exton study, prolactin rose after orgasm, while plasma testosterone did not change as a result of the orgasm itself.[1] The 2021 pilot study suggested that sexual stimulation and masturbation might alter the way free testosterone declines across the day, but it did not show a meaningful change in the measured hormone ratios or prove a long-term effect.[2]
These studies were performed under controlled conditions and involved very small groups. They do not justify predicting what an individual blood result will do after a particular ejaculation frequency.
Does abstinence increase baseline testosterone?
Three weeks of abstinence was associated with higher testosterone concentrations in the ten participants studied by Exton and colleagues.[1] That is an observation from a small experimental sample, not evidence that abstinence reverses a clinical testosterone deficiency. The study did not establish an optimal duration, assess symptom improvement or compare abstinence with medical treatment.
The more recent pilot study examined short-term hormone kinetics and likewise did not establish a lasting baseline increase.[2] Overall, current evidence is insufficient to recommend abstinence as a testosterone-raising intervention.
Masturbation, NoFap and symptoms
Some people choose to reduce pornography use or masturbation because they feel it is compulsive, interferes with relationships or affects their wellbeing. Those are valid reasons to seek support, but they should be considered separately from claims about testosterone.
Research on commercial ejaculation-training and semen-retention programmes has found that they commonly make health claims without adequate scientific evidence.[5] Feeling better after changing a habit does not prove that testosterone increased; sleep, anxiety, attention, relationship factors and behaviour may all change at the same time.
If pornography or masturbation feels difficult to control or causes distress, speak to a GP or appropriately qualified psychosexual or mental-health professional. A hormone test cannot diagnose a behavioural problem.
Should you avoid masturbation before a testosterone blood test?
There is no established clinical rule requiring a specific period of ejaculation abstinence before a diagnostic testosterone test. The more important requirements are the timing, fasting state, sample quality, repeat confirmation and whether you are acutely unwell.
Current EAU guidance recommends total testosterone sampling between 07:00 and 10:00, under fasting conditions, using a reliable assay. A low result should be confirmed on a separate morning before testosterone therapy is considered.[4] Follow the instructions supplied by the laboratory or clinician arranging your test.
Do not try to manipulate a result through dehydration, extreme exercise, sleep deprivation, supplements or prolonged abstinence. The aim is to measure a representative baseline.
When symptoms need a broader assessment
Persistent low sexual desire, fewer spontaneous erections, erectile difficulties, unexplained loss of strength or other symptoms may justify a medical review. Tiredness, low mood and poor concentration are less specific and can also relate to sleep, mental health, thyroid disease, anaemia, medicines, weight change or chronic illness.
A clinician will consider symptoms alongside repeat hormone results and relevant health history. Depending on the result, additional tests may include SHBG, calculated free testosterone, luteinising hormone, follicle-stimulating hormone and prolactin.[4]
Masturbation frequency alone does not diagnose testosterone deficiency. If you want to understand the assessment process, read our guide to TRT eligibility and our explanation of low-testosterone symptoms.
Frequently asked questions
Does ejaculation lower testosterone the next day?
Small experimental studies do not show a reliable, clinically important next-day fall in testosterone caused by ejaculation. Normal day-to-day and within-day variation, sleep, food intake, illness and sample timing can all affect a result.[2][4]
Does seven days of abstinence raise testosterone?
The widely quoted day-seven result came from a paper that was retracted in 2021. It should not be treated as reliable evidence or used to prescribe a seven-day abstinence schedule.[3]
Can NoFap cure low testosterone?
There is no good evidence that NoFap or semen retention treats clinically confirmed testosterone deficiency. If symptoms persist, use properly collected repeat blood tests and a clinician-led assessment.[4][5]
Does masturbation affect muscle growth?
The available masturbation studies have not demonstrated that masturbation reduces muscle growth or that abstinence improves training adaptation. The 2021 pilot study was small and found no significant change in the measured testosterone-to-cortisol ratios.[2]
Should I abstain before a testosterone test?
No standard diagnostic abstinence period is established. Follow the laboratory’s instructions and prioritise a fasting morning sample, adequate sleep and repeat confirmation of a low result.[4]
Can frequent masturbation cause hypogonadism?
Current evidence does not show that frequent masturbation causes persistent biochemical hypogonadism. Persistent symptoms require a broader medical assessment rather than an assumption based on sexual frequency.
References
[1] Exton MS, Krüger THC, Bursch N, et al. Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence. World J Urol. 2001;19(5):377–382. View source
[2] Isenmann E, Schumann M, Notbohm HL, Flenker U, Zimmer P. Hormonal response after masturbation in young healthy men: a randomised controlled cross-over pilot study. Basic Clin Androl. 2021;31:32. View source
[3] Jiang M, Xin J, Zou Q, Shen JW. A research on the relationship between ejaculation and serum testosterone level in men. Retracted in 2021. View source
[4] European Association of Urology. Male Hypogonadism. EAU Guidelines on Sexual and Reproductive Health. 2026. View source
[5] Prause N. Online ejaculation training programs promote non-evidence-based treatment of male sexual dysfunction. Int J Impot Res. 2024;36:759–764. View source
