Testosterone is a critical hormone necessary for both men and women, though it’s often considered a male hormone. Without it, the body doesn’t function properly. However, testosterone levels sometimes fluctuate and become too low or too high. About 40% of men older than 45 have low testosterone.
Understanding testosterone levels is vital to detecting hormone imbalances and achieving optimal health and well-being. This article explores what a testosterone test is, why it’s done, and what the results may mean.
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What Is Testosterone?
Testosterone is a chemical messenger and an important sex hormone men and women need in specific quantities to maintain exceptional health without bothersome symptoms and complications. This hormone travels through the bloodstream to various other areas of the body and is essential for growth, development, and masculine characteristics.
Brain signals to the pituitary gland control testosterone production. The body closely regulates hormones, but levels can become unbalanced for numerous reasons.
Testosterone’s roles in the human body include:
- Growth and development
- Muscle and bone health
- Sexual functioning
- Sex drive
- Sperm production in men
- Masculine features
- Mood regulation
- Cognitive function
- Ovarian function in women
Testosterone is produced in the testes in men and the ovaries and adrenal glands in women. The balance of testosterone with estrogen and other hormones is crucial for proper sexual and overall bodily functioning.
What Is a Testosterone Test?
A testosterone test measures the levels of testosterone circulating in the body. Such tests can show free testosterone, which isn’t attached to anything, and bound testosterone attached to proteins. The body uses free testosterone more easily.
Testing For Total And Free Testosterone
Testosterone tests measure:
- Total testosterone (most common): measures free and bound testosterone
- Free testosterone: measures the active form of testosterone
- Bioavailable testosterone (less common): measures free testosterone levels and testosterone that is loosely attached to albumin
Free testosterone and bioavailable testosterone tests may be more useful for diagnosing certain medical problems.
Testosterone tests evaluate testosterone in the saliva, blood, or urine.
Other tests that may help determine the cause of low testosterone include:
- Prolactin blood test: screens for pituitary gland problems or tumors.
- Luteinizing hormone (LH) blood test: determines if pituitary gland problems are the cause of low testosterone.
- Estrogen tests: screens for estrogen imbalance and helps determine testosterone: estrogen ratios.
The type of tests that are most appropriate vary from patient to patient.
How Is the Test Conducted?
A blood test is a common way to measure testosterone (free and total), though saliva and urine tests are also available.
Blood tests are often the gold standard of testosterone testing. Providers should take blood samples between 7:00 am and 10:00 am in the morning, as testosterone levels are often the highest during this time period. Fasting may be necessary to obtain the most accurate results. It’s important for patients to tell their providers if they’ve been sick, as this can also affect results.
Saliva testosterone tests are noninvasive but typically only measure free testosterone and its bioavailability. Oral hygiene and other outside factors could affect the results.
Urine tests are another simple testosterone testing option that may offer insights into testosterone metabolism. However, kidney function, hydration status, and several other factors could influence urine testosterone test results.
Reasons for Testing Testosterone Levels
The reasons for testosterone tests include having symptoms of hormone imbalance or health concerns. These tests can also monitor the effectiveness of hormone replacement therapy (HRT).
Any unusual symptoms may warrant hormone testing, as certain medical conditions (diabetes, STDs, tumors, kidney failure, liver problems, etc.) may be the underlying causes of hormone imbalance. Some medications can also lead to low or high testosterone levels.
Symptoms of Low Testosterone
The following symptoms may indicate low testosterone levels:
Men
- Erectile dysfunction (ED)
- Reduced sex drive
- Thinning hair
- Fatigue
- Hot flashes
- Shrinking testicles
- Reduced sperm count
- Infertility
- Increased body fat
- Reduced strength and muscle mass
- Lower endurance
- Enlarged breast tissue
- Depression
- Problems with memory and concentration
Symptoms of low testosterone in male children and teenagers include slowed growth (height), reduced body hair, less of a deep voice than their peers, and lower-than-normal endurance and strength.
Women
- Low sex drive
- Infertility
- Fatigue
- Vaginal dryness
- Thinning hair
- Brittle, dry skin
- Reduced muscle tone and strength
- Irregular menstruation
- Trouble sleeping
- Mood changes
Reasons for low testosterone in men and women include aging, stress, congenital conditions, and chronic diseases like poorly managed diabetes. Carrying excess weight, taking certain medications, radiation therapy, sleep disorders, and alcohol misuse can contribute to low T.
Disorders of the pituitary gland, adrenal gland, or ovaries may also play a role in testosterone imbalance.
Symptoms of High Testosterone
Symptoms and conditions associated with high testosterone, particularly among women, include:
- Excess body or facial hair
- Acne
- Irregular or no menstrual periods
- Weight gain
- Deepening voice
- Male pattern baldness in women
- Infertility
- Congenital adrenal hyperplasia (CAH)
Tumors, steroid use, polycystic ovary syndrome (PCOS) in women, ovarian cancer, and adrenal or pituitary conditions may contribute to high testosterone levels.
Interpreting Testosterone Test Results
An abnormal testosterone test result could indicate unhealthy lifestyle habits or an underlying medical problem requiring treatment.
Normal TOTAL testosterone levels for different ages and sexes include:
Males
- 0 to 5 months: 75-400 ng/dL
- 6 months to 9 years: <7-20 ng/dL
- 10 to 11 years: <7-130 ng/dL
- 12 to 13 years: <7-800 ng/dL
- 14 years: <7-1,200 ng/dL
- 15 to 16 years: 100-1,200 ng/dL
- 17 to 18 years: 300-1,200 ng/dL
- 19 years and older: 240-950 ng/dL
Females
- 0 to 5 months: 20-80 ng/dL
- 6 months to 9 years: <7-20 ng/dL
- 10 to 11 years: <7-44 ng/dL
- 12 to 16 years: <7-75 ng/dL
- 17 to18 years: 20-75 ng/dL
- 19 years and older: 8-60 ng/dL
What’s considered normal for free testosterone varies significantly within the various age ranges.
Low Testosterone Results
Low testosterone may cause unpleasant side effects or have potential health implications, such as:
- Chronic illnesses
- Infertility
- Pituitary gland problems
- Thyroid diseases
- Hypothalamus abnormalities
- Testicular cancer, infections, injuries, or trauma
- Iron overload
- Delayed puberty
- Obesity
- Tumor
- Chronic stress
- Excessive exercise
- Sleep problems
- Pituitary gland disorder
- Genetic diseases
- Alcohol use disorder
- Adrenal gland disorders
- Ovarian disorders
Solutions for low testosterone include treating the underlying cause, testosterone replacement therapy, and healthy lifestyle changes.
High Testosterone Results
Possible health issues related to high testosterone include:
- Tumor
- Congenital adrenal hyperplasia (CAH)
- Other adrenal gland disorders
- Steroid use
- Ovarian or testicular cancer
- Polycystic ovary syndrome (PCOS)
- Pituitary gland disorders
- Androgen resistance
- Some medications and supplements
Further testing may be necessary. Treating high testosterone could include taking medications, treating the underlying cause (such as tumor removal), and making healthy lifestyle adjustments.
Impact of Testosterone Levels on Health
Abnormal testosterone levels can affect overall health, mood, and physical capabilities when left untreated. Potential long-term effects of unmanaged low testosterone include lower bone density, reduced muscle mass and strength, depression, and poor ability to focus.
High testosterone in women can cause masculine features. In men, artificially high testosterone can lead to testicle shrinking, low sperm count, infertility, heart damage, and a higher risk of a heart attack.
Abnormally high levels of testosterone may also increase the risk of liver disease, high blood pressure, high cholesterol, insomnia, and headaches. It can stunt growth in adolescents, cause aggressive behavior or mood swings, and increase the risk of blood clots.
Testosterone Therapy
Treatments for testosterone imbalances typically consist of making healthy lifestyle changes and/or testosterone replacement therapy. This therapy may involve the use of gels, injections, skin patches, oral testosterone, subdermal hormone pellets, buccal tablets, or testosterone nasal gels. However, not everyone is a candidate for hormone therapy.
Lifestyle changes associated with hormone balance include eating a nutritious diet, exercising regularly, getting enough sleep, limiting alcohol, not smoking, and minimizing stress. It’s also helpful to take all medications and supplements exactly as directed and maintain an ideal body weight.
Frequently Asked Questions(FAQs)
The following are common questions regarding testosterone testing:
#1. Does Masturbating Reduce Testosterone?
No, masturbating does not affect long-term testosterone production. In fact, studies show that masturbation appears to counteract natural drops in testosterone throughout the day but doesn’t alter the ratios between free testosterone, total testosterone, and cortisol.
#2. How Do I Know If I Have Low Testosterone?
A testosterone test is the only way to know for sure if you have low testosterone. However, signs of low testosterone include fatigue, thinning hair, reduced muscle mass, depression, erectile dysfunction (ED) in men, and a low sex drive in men and women.
#3. Does Low Testosterone Mean I Have A Medical Condition?
Not necessarily, but some medical conditions (tumors, diabetes, other chronic diseases, HIV/AIDS, malnutrition, etc.) may contribute to low testosterone. That’s why routine testosterone testing and determining potential underlying causes of low T are important for individuals with risk factors.
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Key Takeaways
Testosterone imbalance is a common problem with multiple causes that affects both men and women.
- Keeping testosterone levels within a healthy range is important to enhance overall health and well-being.
- If needed, total and free testosterone tests, as well as additional diagnostic testing, can detect hormone imbalances and any underlying causes.
- Treatment for low testosterone or its cause includes healthy lifestyle changes, hormone replacement therapy (HRT), medications, or other medical interventions.
- It is vital to recognize the symptoms and risk factors for low and high testosterone and make lifestyle adjustments or receive medical treatment to ensure balance.
- Individuals with a history of low or high testosterone should follow up with their provider routinely for testosterone testing.
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