First Responders and Low Testosterone: The Truth about Compassion Fatigue

As the backbone of our society, first responders belong to a group of essential personnel that work around the clock, 24/7, rain or shine. But because of the high demands of the job and long work hours, it comes as no surprise that rates of first responder burnout are soaring. Are their hormones equally affected, given stress and testosterone go hand-in-hand?

We all remember the COVID-19 pandemic and how it shut down our whole world — but that wasn’t quite the case for all of us. In fact, first responders, nurses, and doctors had to ramp up their work hours to meet the increasing needs of a world thrown into panic mode.

But compassion fatigue and working night and day have led many first responders to burn out. It’s a rewarding career, crippled by many risk factors adversely affecting the health of staff. Chronic stress, in particular, can unleash many unpleasant health effects, including potentially plummeting your testosterone levels. 

First Responders’ High Demands on the Job

As a first responder, no day is the same and will depend mainly on the type of calls you’re dispatched to. However, at times it can be challenging to be surrounded by so much trauma — which led to the term compassion fatigue being coined.

As a paramedic, you could be administering CPR to a patient in cardiac arrest and as a firefighter, you may have to go into a burning building and make your way through smoke and rubble trying to look for survivors — all while being very much aware that the clock is ticking.

Being a first responder requires not only physical strength but also the ability to, at least to some extent, detach yourself emotionally for the sake of your mental health. Being surrounded by the sick and witnessing another person take their last breath is not for the faint of heart.

But truth be told, compassion fatigue can eventually drain you and can explain the high rate of first responder burnout.

First Responder Burnout

According to a survey conducted by the American Psychological Association, 3 in 5 workers expressed feeling negative mental health and physical effects as a result of work-induced stress. But first responder burnout can be particularly profound as the consequences can affect both the first responder and the patient they’re responsible for.

A study that investigated the well-being of 1,101 EMS workers, found that up to 40% reported feeling burnt out and experienced high dissatisfaction with their jobs — which could potentially lead to behavior that’s safety compromising.

Acknowledging first responder burnout is the first step towards understanding the many health risks EMS personnel are exposed to, especially in regards to the high levels of stress they’re under every single day.

Compassion Fatigue

One of the main reasons why first responder burnout is soaring and their mental, physical, and emotional health consistently compromised, is compassion fatigue — a term used to convey the exhaustive physical and psychological challenges that come with helping others.

Compassion fatigue mainly develops as a result of chronic stress on the job, working under high pressure, and in life-or-death situations. It’s frequently the result of traumatic events like trying to save patients or experiencing a near-death situation yourself.

While first responder burnout is similar and also leads to fatigue, compassion fatigue mainly addresses challenging work situations and a lack of resources.

Stress and Testosterone: How Common is Low T in First Responders & Why?

Testosterone deficiency, which is medically referred to as hypogonadism, affects roughly 10% to 40 % of men worldwide. Several factors have been identified as being capable of worsening your levels. These include stress, which can impair testosterone synthesis — in addition to lifestyle and environmental circumstances, such as your occupation.

We can all agree that first responder burnout is heavily linked to excessive levels of stress at work, but stress and testosterone are also interconnected. A non-clinical study found chronic stress to impair the production of testosterone in the Leydig cells, leading to a significant reduction in testosterone levels.

Another analysis evaluating the complex relationship between stress and testosterone showed that in patients with higher cortisol levels — also known as the stress hormone, testosterone levels were considerably lower. The study also suggested that spiking cortisol levels, triggered by stress, can decrease testosterone production.

Stress is one of the most prominent factors affecting testosterone levels in first responders. Research that investigated the prevalence of testosterone deficiency in first responders found 10.6% of career firefighters to have low testosterone levels and a whopping 26.4% presenting with borderline levels.

The reason why stress can have such a large impact on first responders and their testosterone levels is because environments causing excessive stress, can lead to inflammation in your body and result in an altered hormonal balance. But it doesn’t stop here.

As healthy testosterone levels promote a normal BMI and lean muscle mass, they also keep your body fat in check. This, in turn, supports cardiovascular health — but changing one variable, say testosterone, and the whole structure collapses. This means that low testosterone output can adversely affect your heart health too.

Another noteworthy factor is poor diet, which can be responsible for excess body weight and a lack of vital nutrients. With first responders constantly on the go and preparing for the next call, it’s hard to consistently follow a healthy and well-balanced diet. Nonetheless, healthy dietary patterns are necessary to help maintain normal testosterone levels.

When Compassion Fatigue is Wearing You Down

While it’s honorable to care about and help others, sometimes it’s time to focus on just you and ensure your health is on the right track. After all, compassion fatigue can drain your energy and wear you down: physically, mentally, and emotionally.

And while it’s hard to avoid stress as a first responder, finding healthy ways to cope with it can help reduce its impact on your overall well-being.

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