A study evaluated the dose-response relationship between workplace psychological stress and erectile dysfunction (ED), along with the mediating role of hormone levels, in 826 full-time working men aged 22 to 40 years. Researchers developed the Workplace Psychological Stress Accumulation Index (WPSAI), incorporating workload and social support. The study found a nonlinear dose-response relationship between workplace stress and erectile function, with a threshold effect at WPSAI values above zero.

ED prevalence reached 54.37% in the high-stress group, with an adjusted odds ratio of 10.26. Cortisol elevation preceded testosterone decline by 2 to 4 weeks, while testosterone changes preceded impaired erectile function by 4 to 6 weeks. Longer working hours were associated with impaired erectile function through elevated cortisol, whereas supervisor support appeared protective by helping…