Plasma and Salivary Measures of Testosterone and Cortisol Levels in Basketball Players Under Various Games / Training Conditions, and Nutritional Strategies: An updated Systematic Review

Seifeddine Brini^1*Cain Craig Truman Clark^2,3Ibrahim Ouergui¹Anne Delextrat⁴Fatma Hilal Yagin⁵Antonella Muscella⁶Georgian Badicu⁷Anissa Noussa Bouassida¹Filipe Manuel Clemente⁸Sameer Badri AL-Mhanna^10,9Abedelmalek Kalefh Tabnjh^11,12,13*Hadi Nobari¹⁴Julio Calleja-Gonzalez¹⁵

• ¹Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef, Tunisia
• ²School of Life and Health Sciences, Birmingham City University, Birmingham, United Kingdom
• ³Centre for Movement, Occupation and Rehabilitation Services, Oxford Brookes University, Oxford, United Kingdom
• ⁴Department of Wellbeing, Nutrition and Sport; Pegaso Telematic University, Naples, Italy
• ⁵Department of Biostatistics, Faculty of Medicine, Malatya Turgut Ozal University, Malatya, Türkiye
• ⁶Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, Viana do Castelo, Portugal
• ⁷Department of Physical Education and Special Motricity, University Transilvania of Brasov, Brasov, Romania
• ⁸Sport Physical Activity and Health Research and Innovation Center, Viana do Castelo, Portugal
• ⁹Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
• ¹⁰Department Of Higher Studies, AlQasim Green University, Babylon, Iraq
• ¹¹Department of cariology, Institute of odontology, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
• ¹²Department of Applied Dental Sciences. Faculty of Applied Medical Sciences, Jordan University of Science and Technology,, Irbid, Jordan
• ¹³Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
• ¹⁴LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
• ¹⁵Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Vitoria, Spain

Background: In basketball research, hormonal monitoring has focused almost exclusively on plasma and salivary testosterone and cortisol, as these methods are more practical and accessible for applied sport settings than alternative approaches. Yet, no systematic review recapitulates these two methods together among Basketball players under various (games / training) conditions, and different nutritional strategies. Objectives: This systematic review synthesized the existing literature on testosterone and cortisol measurements in basketball players using salivary and blood samples under various (games / training) conditions, and different nutritional strategies, and discussed implications for practical monitoring. Methods: A comprehensive search of electronic databases (PubMed, Scopus, Web of Science, Google Scholar) was conducted for studies published between 1999 and 2025. Eligible studies involved basketball players and assessed testosterone and cortisol via salivary or blood sampling during training, matches, or recovery. Data were extracted and narratively synthesized due to heterogeneity and the absence of direct comparison studies. Results: Forty-two studies met the inclusion criteria. Salivary cortisol consistently reflected acute stress responses post-match, aligning closely with blood cortisol measures. Testosterone responses were more variable; salivary testosterone sometimes diverged from blood levels, indicating methodological sensitivity differences. The testosterone-to-cortisol ratio decreased following matches, highlighting a shift toward a catabolic state. Salivary sampling showed practical advantages for field monitoring but requires standardized protocols for testosterone assessment. Conclusions: Salivary sampling is a promising, non-invasive alternative for monitoring cortisol in basketball players, with practical benefits for field use. However, discrepancies in salivary testosterone measurements compared to blood samples suggest cautious interpretation. The current literature lacks direct comparative studies in basketball, underscoring the need for future research to validate and standardize hormone monitoring methods to optimize training and recovery strategies.