It's possible you don't admit to it, but you probably like watching fights. According to the law and social rules, fighting is not necessary. They are suppressed, however, by social and familial inhibitions. This is a vital aspect of survival, and it helps to preserve species by ensuring that they reproduce. All of these behaviors are crucial in combat - it's the ultimate test for dominance. Research shows that testosterone is a key factor in determining these traits. Training programmes have to be tailored to the particular requirements of each form of karate. With regards to C concentrations, no significant differences were observed between pre- (752.5 ± 52 nmol/l) and post-exercise in either the kumite or kata form (759.1 ± 46 and 711.1 ± 87 nmol/l, respectively) . Karate is a striking combat sport including two main forms (i.e., kata and kumite) (for more details see Chaabène et al., ). In summary, this evaluation highlighted a number of areas in need of improvement to reduce the risk of bias and provide evidence for the generalization of findings, which would increase the quality of research in this field. Furthermore, studies should also state participants’ specific characteristics, such as age and gender. Future research needs to control nutrition status, sleep quality, health and psychological states of each participant. Two of the included studies 17,34 were of high quality, three investigations 16,24,25 were of moderate quality, and the remaining three studies were of low quality 15,35,36 (Table 1, Table 2, Table 3). Testosterone helps maintain bone density, which reduces the risk of stress fractures and joint issues over time. On the other hand, Low T (low testosterone) can lead to decreased muscle mass, slower recovery times, and plateaued strength gains. In athletic contexts, testosterone becomes especially important because it affects how efficiently the body builds muscle, repairs tissue, and maintains energy. In the same contest, Capranica et al. showed that sA-A and sC increased post-bout, with lower pre- and post-bout values than those of Chiodo et al. . A typical taekwondo competition contains three 2 min rounds with a 1 min recovery in-between . The sC values recorded at post-combat 2 would be considered the highest compared to those recorded at post-combat 1. We did not use this study in the quantitative synthesis because the authors presented the same data in the study of Ouergui et al. . The I2 measure of inconsistency was used to examine between-study variability; values of 25, 50 and 75% represent low, moderate and high statistical heterogeneity, respectively . Hormonal measurements methods using blood, urine or saliva samples were included in the present study. Whereas, to date, limited studies on this topic were reported, researchers are encouraged to examine the psychological mechanisms of the hormonal response-competitive situation/outcome relationship. This suggests that humans’ hormonal response to competition is not a direct consequence of winning and losing but rather is mediated by complex psychological processes that could even contribute to the competition outcome. However, some psychological variables (e.g., mental toughness, mood state) have been strongly linked with optimal performance and outcome in combat sports 10,48,49. Furthermore, psychobiological studies of martial arts can increase our understanding of the "power of mind" to modulate neurochemical responses. The meta-analyses were performed using Comprehensive Meta-analysis software (Version 2.0, Biostat Inc., Englewood, NJ, USA). Therefore, it would be useful to investigate the effects of these moderator variables on competition events and hormone-changes relationship. Moderator and mediator variables whose hormonal concentrations changed were recorded when applicable. Twenty-seven items were used to determine the Methodological Quality Checklist of each study. Two reviewers (MS and AP) conducted a methodological quality assessment on each included article using the modified Downs and Black scale , which is appropriate for nonrandomized control trials (NRCTs) and case–control study designs. The potentially relevant studies were screened for eligibility by two reviewers (MS and AP) by examining the titles, abstracts and full texts. This controversy may be due to differences in age, gender, and the nature of the competition. These findings highlight the catabolic hormonal responses that occurred, particularly during the second karate bout. Particularly, during two consecutive bouts, salivary cortisol (sC) increased progressively and significantly from pre-combat 1 to post-combat 1 and from pre-combat 1 to post-combat 2. Recently, Chaabène et al. showed that simulated karate competition could be considered as a challenging situation and a very-high intensity and stressful activity in male elite level karateka. The authors reported that both forms produced significant increases in glucose, T and catecholamine levels, without appreciable changes in insulin and C concentrations . Forest plot of insulin-like growth factor 1 changes induced by striking combat sports competitions. Another study showed that Polish wrestlers were more aggressive than karate fighters. Litwic-Kamińska suggests that taekwondo and judo athletes from the Polish population are characterized by high resiliency, which makes them more resistant to stress. It seems likely that differences in the increase of noradrenaline level between the groups do not reflect the physical load of the exercise itself but rather the different emotional engagement/aggression levels in the respective disciplines. These hormonal changes reflect the neuroendocrine adaptation to competition-related exercise as well as aggression level and cognitive functioning. We found a rise in the blood BDNF level following the fight, similar for all the combat sport disciplines studied. To the best of our knowledge, our study is the first to investigate the effect of a short but very intense exercise during a combat sport fight on BDNF concentration. In this paper, the T/C indices were similar in all groups, which indicates a similar physical load in all combat sports analyzed. Future studies including psychological variables in conjunction with the assessment of hormonal responses in simulated and official combat sports competition are important to understand the mechanisms of a positive or negative relationship. For instance, the present review showed a higher increase in stress response in female fighters than males in an official combat contest, whereas in a simulation combat contest, male fighters presented a higher increase of C levels than female athletes. A synthesis of the literature about hormonal responses related to striking combat sports athletes may be helpful and of great applicable importance towards understanding the level of effort, stress per se and the real physiological demands of such an activity. Accordingly, several studies have reported that striking combat sports competition is a very high intensity and stressful activity that results in increased C levels 5,16,24. The relatively short bout of exercise in combat sports evokes an enormous activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis manifested by a major increase of plasma catecholamine, cortisol, and testosterone levels.