Wired for stress: Advances in electrochemical biosensors for monitoring of cortisol and catecholamines via wearable and point-of-care platforms

Stress hormones including cortisol and catecholamines (epinephrine, norepinephrine, and dopamine) play cruical roles in regulating physiological responses to emotional, physical, and metabolic challenges. Their dynamic secretion patterns characterized by pulsatility, diurnal variation, and rapid concentration changes make timely monitoring essential for accurate assessment of stress-related conditions including adrenal disorders, mental health imbalances, cardiovascular dysfunction, and performance stress in athletes. Conventional diagnostic techniques, while precise, rely on invasive sampling, centralized laboratory infrastructure, and delayed feedback, limiting their utility for point-of-care (PoC) applications. Recent research has shown that electrochemical biosensors can meet the practical requirements of stress hormone analysis, offering both high sensitivity and adaptability for integration into wearable formats using sweat, saliva, or interstitial fluid as sample media. This review critically examines the current landscape of electrochemical biosensor technologies tailored for stress hormone detection, with a focus on sensor architecture, biorecognition strategies, signal amplification techniques, and the role of functional nanomaterials. Emphasis is placed on the integration of these sensors into wearable and PoC platforms, enabling rapid or near-continuous monitoring and supporting remote health assessment. Furthermore, key clinical applications, existing limitations, and the translational potential of these technologies within personalized and digital endocrinology are discussed. While several emerging wearable and microfluidic electrochemical systems demonstrate fast or semi-continuous operation, the majority of reported cortisol and catecholamine biosensors remain single-use or endpoint devices. Accordingly, this review highlights advances that enable rapid, on-demand electrochemical monitoring while outlining future directions toward fully continuous stress sensing.