Hair testosterone and cortisol interactively predict problematic pornography use in a male sample

Burkardt, Tom Malte and Stark, Rudolf and Stalder, Tobias and Wolf, Oliver T. and Klucken, Tim and Brand, Matthias and Muller, Silke M. (2026) Hair testosterone and cortisol interactively predict problematic pornography use in a male sample. JOURNAL OF BEHAVIORAL ADDICTIONS, 15 (1). pp. 459-470. ISSN 2062-5871

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Abstract

Background and aims Steroid hormones, such as testosterone and cortisol, may play a role in addictive behaviors, such as problematic pornography use (PPU). According to the dual-hormone hypothesis, their effects are probably interactive and may influence specific behavioral tendencies, like risk taking and impulsivity, which may, in turn, contribute to PPU. To examine these relationships, the present research utilizes endocrine hair analyses, providing a robust index of long-term hormone secretion. Methods The sample (N = 252) was part of a multi-center study (FOR2974), including male participants who consume pornography at least occasionally. Testosterone and cortisol concentrations were determined from a proximal 3 cm hair sample via Liquid Chromatography-Tandem Mass Spectrometry. Additionally, decision-making paradigms (i.e., Delay-Discounting Task, Game of Dice Task) and questionnaires assessing impulsivity and symptoms of PPU were used. Results Testosterone was positively related to PPU, but showed no significant associations with impulsivity and risk taking in a moderated mediation model. Furthermore, cortisol and testosterone interacted with a significant positive effect of testosterone on PPU severity for participants with low cortisol levels, and a non-significant effect in case of high cortisol levels. Discussion and conclusion This study delivers novel evidence for an association between basal testosterone and cortisol levels in PPU for males. However, the assumed association between hormonal levels, risk taking and impulsivity could not be supported.

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