Underlying mechanisms of observed hormonal changes might be explained by changes in psychological state and alteration at both central and peripheral levels, which will be discussed in the following paragraphs. Coaches should consider holding the friendly competitions in the morning (between 10 a.m. and 12 noon) whenever they seek to decrease the stress response and to have specific training purposes. They concluded that the effect of competition for increasing testosterone levels appears to be specific to men. Typically, the steroid hormone responses to physical stress are influenced by numerous variables, e.g. (a) individual characteristics (i.e., genes, age, gender), (b) physiological (i.e., nutrition, body composition) or pathological (i.e., obesity factors), (c) psychological conditions, and (d) the nature of physical activity performed . This contradiction could be due to (a) the importance of the competition for the subject, (b) blood compared with salivary hormonal sample collection, (c) the body mass index (BMI) and technical ability, and (d) the type of martial art (i.e., judo being characterized by more intense body contact compared with karate). Previous studies on sports activities have confirmed the differences in T and C responses according to the outcome of the contest (i.e., victory or defeat) 9,39. Consequently, the results of the latter studies support the findings that kickboxing bouts could generate considerable acute stress and amplify the hormonal response by the activation of the central nervous system, typically with greater sympathetic nerve activity. Further studies can lead to practical conclusions regarding the psychological training of combat sport athletes. Other data also point out that the anger level in karate sportsmen is connected with the state rather than a trait when compared to nonathletes. It seems that in karate, the high level of hormones connected with aggression does not reflect the everyday behavior of the athletes but rather serves the situational, competitive aggression required for the stressful fight. Only two studies (three ESs) aimed at investigating the effect of noradrenaline levels immediately following combat events. Based on two studies’ results (four ESs), alterations in T levels following the two different forms of karate (i.e., kumite and kata) were analysed. Based on two studies’ results (four ESs), alterations in C levels following the two different forms of karate (i.e., kumite and kata) were analysed. Hormonal responses between pre- and post-kickboxing competition (mean ± SD or relative effect %). All studies were cross-sectional with pre- and post-combat hormonal analysis (Table 1, 2, 3). Furthermore, possible mediator variables, such as self-confidence, anger, mood state, and anxiety, have been shown to influence the hormonal stress to competition and were therefore included in the study. Typically, measuring psychological variables, which are also called mediator factors, could help researchers and coaches understand why and how the increase or decrease of stress in the competition was achieved. All these factors stimulate the response of the sympathetic system and the hypothalamic-pituitary-adrenal axis, and its intensity can be affected by the diversity of rules and styles of individual disciplines. Combat sports are characterized by relatively short duration ranging from a few seconds to several minutes when the interval exercise involves large muscle groups performing both static and dynamic contractions. Cortisol and Epi increased similarly for both winners and losers, whereas the Tes/Cort ratio was unaltered at any time. An official website of the United States government In addition, the different variables studied, such as nature of the competition, age, gender, and time of day, in all the studies reviewed allowed this review to provide some basic data that will allow future studies to build on and improve the knowledge in this specific field. In conclusion, these findings may help to explain the already evident connection between psychological state and the activation of the endocrine systems, in which the psychological skills are the mediator variable of win-loss in competition. A previous study also reported that C is not strictly linked to an agonistic activity but is affected by the cognitive and emotional perception of the event . For instance, Parmigiani et al. suggest that in a symmetric type of contest the karatekas with more anxious and defensive personality traits have higher probability of losing the competition. However, it has been shown that the endocrine responses to the competitive setting varied significantly by gender . Specifically, it has been shown that after the early twenties, resting T levels begin to decline slowly . 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 research related to hormonal changes in official kickboxing competition, female athletes, participant levels, and for different kickboxing styles (full-contact, low-kick, light contact) are needed to support the knowledge in the field. Another study by Ouergui et al. showed that simulated combat is not different to official combat in terms of stress response, with similar values pre- to post-combat to the results of Ouergui et al. . Self-confidence, anger, motivation and competitive anxiety were the mediator variables of hormonal change-competition/outcomes relationship in striking combat sports athletes. Testosterone responses to striking combat sports competitions relative to different moderator variables. Cortisol responses to striking combat sports competitions relative to different moderator variables.