Horm Metab Res 2014; 46(13): 905-910
DOI: 10.1055/s-0034-1387797
© Georg Thieme Verlag KG Stuttgart · New York

Salivary Cortisol Levels in Athletes and Nonathletes: A Systematic Review

T. Cevada
1   Federal University of Rio de Janeiro, Center for Alzheimer Disease and Related Disorders, Institute of Psychiatry of the Federal University of Rio de Janeiro, Fundos – Campus da Praia Vermelha, Rio de Janeiro/RJ, Brazil
P. E. Vasques
1   Federal University of Rio de Janeiro, Center for Alzheimer Disease and Related Disorders, Institute of Psychiatry of the Federal University of Rio de Janeiro, Fundos – Campus da Praia Vermelha, Rio de Janeiro/RJ, Brazil
H. Moraes
1   Federal University of Rio de Janeiro, Center for Alzheimer Disease and Related Disorders, Institute of Psychiatry of the Federal University of Rio de Janeiro, Fundos – Campus da Praia Vermelha, Rio de Janeiro/RJ, Brazil
A. Deslandes
1   Federal University of Rio de Janeiro, Center for Alzheimer Disease and Related Disorders, Institute of Psychiatry of the Federal University of Rio de Janeiro, Fundos – Campus da Praia Vermelha, Rio de Janeiro/RJ, Brazil
› Author Affiliations
Further Information

Publication History

received 20 March 2014

accepted 06 August 2014

Publication Date:
17 September 2014 (online)


High performance athletes are constantly facing different situations involving stress. Salivary cortisol has been used as a physiological measure to verify high performance athlete and mental health, in spite of research that has shown that comparisons between cortisol levels in athletes and nonathletes are inconclusive. The purpose of this study was to review articles that investigated salivary cortisol levels at rest in high performance athletes in comparison to physically active or sedentary nonathlete individuals. PubMed, ISI Web of Knowledge, SciELO, LILACS, and Scopus databases were searched for studies on salivary cortisol in athletes and the size effect was calculated. Although 3 articles reported higher salivary cortisol levels in female athletes compared to a control group, the results showed homogeneity among baseline groups or groups in resting conditions, suggesting a lack of discriminative capacity. These results should be interpreted with caution, due to the presence of substantial methodological bias.

  • References

  • 1 Dedovic K, Duchesne A, Andrews J, Engert V, Pruessner JC. The brain and the stress axis: the neural correlates of cortisol regulation in response to stress. Neuroimage 2009; 47: 864-871
  • 2 Stranahan AM, Lee K, Mattson MP. Central mechanisms of HPA axis regulation by voluntary exercise. Neuromolecular Med 2008; 10: 118-127
  • 3 McEwen BS, Gianaros PJ. Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease. Ann N Y Acad Sci 2010; 1186: 190-222
  • 4 Viru A, Viru M. Cortisol – essential adaptation hormone in exercise. Int J Sports Med 2004; 25: 461-464
  • 5 Duclos M, Corcuff JB, Arsac L, Moreau-Gaudry F, Rashedi M, Roger P, Tabarin A, Manier G. Corticotroph axis sensitivity after exercise in endurance-trained athletes. Clin Endocrinol (Oxf) 1998; 48: 493-501
  • 6 Duclos M, Gouarne C, Bonnemaison D. Acute and chronic effects of exercise on tissue sensitivity to glucocorticoids. J Appl Physiol (1985) 2003; 94: 869-875
  • 7 Papacosta E, Nassis GP. Saliva as a tool for monitoring steroid, peptide and immune markers in sport and exercise science. J Sci Med Sport 2011; 14: 424-434
  • 8 Urhausen A, Gabriel HH, Kindermann W. Impaired pituitary hormonal response to exhaustive exercise in overtrained endurance athletes. Med Sci Sports Exerc 1998; 30: 407-414
  • 9 Moreira A, Franchini E, de Freitas CG, Schultz de Arruda AF, de Moura NR, Costa EC, Aoki MS. Salivary cortisol and immunoglobulin A responses to simulated and official Jiu-Jitsu matches. J Strength Cond Res 2012; 26: 2185-2191
  • 10 Moreira A, McGuigan MR, Arruda AF, Freitas CG, Aoki MS. Monitoring internal load parameters during simulated and official basketball matches. J Strength Cond Res 2012; 26: 861-866
  • 11 Moreira A, Freitas CG, Nakamura FY, Drago G, Drago M, Aoki MS. Effect of match importance on salivary cortisol and immunoglobulin A responses in elite young volleyball players. J Strength Cond Res 2013; 27: 202-207
  • 12 O’Connor PJ, Morgan WP, Raglin JS, Barksdale CM, Kalin NH. Mood state and salivary cortisol levels following overtraining in female swimmers. Psychoneuroendocrinology 1989; 14: 303-310
  • 13 Cook CJ, Crewther BT, Smith AA. Comparison of baseline free testosterone and cortisol concentrations between elite and non-elite female athletes. Am J Hum Biol 2012; 24: 856-858
  • 14 Gouarné C, Groussard C, Gratas-Delamarche A, Delamarche P, Duclos M. Overnight urinary cortisol and cortisone add new insights into adaptation to training. Med Sci Sports Exerc 2005; 37: 1157-1167
  • 15 Minetto MA, Paccotti P, Borrione P, Massazza G, Ventura M, Termine A, Di Luigi L, Pigozzi F, Angeli A. Effects of the training status on the hormonal response and recovery from high-intensity isokinetic exercise: comparisons between endurance-trained athletes and sedentary subjects. J Sports Med Phys Fitness 2006; 46: 494-500
  • 16 O’Connor PJ, Corrigan DL. Influence of short-term cycling on salivary cortisol levels. Med Sci Sports Exerc 1987; 19: 224-228
  • 17 Reardon CL, Factor RM. Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Med 2010; 40: 961-980
  • 18 Hughes L, Leavey G. Setting the bar: athletes and vulnerability to mental illness. Br J Psychiatry 2012; 200: 95-96
  • 19 Lightman SL. The neuroendocrinology of stress: a never ending story. J Neuroendocrinol 2008; 20: 880-884
  • 20 Matta Mello Portugal E, Cevada T, Sobral Monteiro-Junior R, Teixeira Guimarães T, da Cruz Rubini E, Lattari E, Blois C, Camaz Deslandes A. Neuroscience of exercise: from neurobiology mechanisms to mental health. Neuropsychobiology 2013; 68: 1-14
  • 21 Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009; 62: e1-e34
  • 22 Minetto MA, Lanfranco F, Baldi M, Termine A, Kuipers H, Ghigo E, Rainoldi A. Corticotroph axis sensitivity after exercise: comparison between elite athletes and sedentary subjects. J Endocrinol Invest 2007; 30: 215-223
  • 23 Rudolph DL, McAuley E. Cortisol and affective responses to exercise. J Sports Sci 1998; 16: 121-128
  • 24 Georgopoulos NA, Rottstein L, Tsekouras A, Theodoropoulou A, Koukkou E, Mylonas P, Polykarpou G, Lampropoulou E, Iconomou G, Leglise M, Vagenakis AG, Markou KB. Abolished circadian rhythm of salivary cortisol in elite artistic gymnasts. Steroids 2011; 76: 353-357
  • 25 Paccotti P, Minetto M, Terzolo M, Ventura M, Ganzit GP, Borrione P, Termine A, Angeli A. Effects of high-intensity isokinetic exercise on salivary cortisol in athletes with different training schedules: relationships to serum cortisol and lactate. Int J Sports Med 2005; 26: 747-755
  • 26 Roupas ND, Mamali I, Armeni AK, Markantes GK, Theodoropoulou A, Alexandrides TK, Leglise M, Markou KB, Georgopoulos NA. The influence of intensive physical training on salivary adipokine levels in Elite Rhythmic Gymnasts. Horm Metab Res 2012; 44: 980-986
  • 27 Rimmele U, Zellweger BC, Marti B, Seiler R, Mohiyeddini C, Ehlert U, Heinrichs M. Trained men show lower cortisol, heart rate and psychological responses to psychosocial stress compared with untrained men. Psychoneuroendocrinology 2007; 32: 627-635
  • 28 Rimmele U, Seiler R, Marti B, Wirtz PH, Ehlert U, Heinrichs M. The level of physical activity affects adrenal and cardiovascular reactivity to psychosocial stress. Psychoneuroendocrinology 2009; 34: 190-198
  • 29 Kim KJ, Chung JW, Park S, Shin JT. Psychophysiological stress response during competition between elite and non-elite Korean junior golfers. Int J Sports Med 2009; 30: 503-508
  • 30 Cohen J. Statistical Power Analysis for the Behavioral Sciences. Second Edition ed New Jersey: Lawrence Erlbaum Associates; 1988
  • 31 Moreira A, Crewther B, Freitas CG, Arruda AF, Costa EC, Aoki MS. Session RPE and salivary immune-endocrine responses to simulated and official basketball matches in elite young male athletes. J Sports Med Phys Fitness 2012; 52: 682-687
  • 32 Salvador A, Suay F, González-Bono E, Serrano MA. Anticipatory cortisol, testosterone and psychological responses to judo competition in young men. Psychoneuroendocrinology 2003; 28: 364-375
  • 33 Herman JP, Figueiredo H, Mueller NK, Ulrich-Lai Y, Ostrander MM, Choi DC, Cullinan WE. Central mechanisms of stress integration: hierarchical circuitry controlling hypothalamo-pituitary-adrenocortical responsiveness. Front Neuroendocrinol 2003; 24: 151-180
  • 34 Uusitalo AL, Huttunen P, Hanin Y, Uusitalo AJ, Rusko HK. Hormonal responses to endurance training and overtraining in female athletes. Clin J Sport Med 1998; 8: 178-186
  • 35 Kudielka BM, Hellhammer DH, Wüst S. Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge. Psychoneuroendocrinology 2009; 34: 2-18