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Sound travels much further than light in the marine environment. As a result, marine mammals, especially cetaceans, rely heavily on sound for many important life functions, including breeding and foraging. This reliance on sound means it is quite likely that exposure to noise will have some detrimental effects on these life functions. However, there has been little application to marine mammals of the knowledge available in other species of stress responses to noise and other stressors. In this paper we begin to integrate what is known about marine mammals with the current knowledge gained in terrestrial mammals about stress physiology, specifically considering physiological and psychological context and thus also cumulative and synergistic impacts. We determined that it is reasonable to extrapolate information regarding stress responses in other species to marine mammals, because these responses are highly conserved among all species in which they have been examined to date. As a result, we determined that noise acts as a stressor to marine mammals. Furthermore, given that marine mammals will likely respond in a manner consistent with other species studied, repeated and prolonged exposures to stressors (including or induced by noise) will be problematic for marine mammals of all ages. A range of issues may arise from the extended stress response including, but not limited to, suppression of reproduction (physiologically and behaviorally), accelerated aging and sickness-like symptoms. We also determined that interpretation of a reduction in behavioral responses to noise as acclimation will be a mistake in many situations, as alternative reasons for the observed results are much more likely. We recommend that research be conducted on both stress responses and life-history consequences of noise exposure in marine mammals, while emphasizing that very careful study designs will be required. We also recommend that managers incorporate the findings presented here in decisions regarding activities that expose marine mammals to noise. In particular, the effects of cumulative and synergistic responses to stressors can be very important and should not be dismissed lightly.