Testosterone Test

Testosterone is one of the most important male hormones. Healthy testosterone functioning is important for the development of male reproductive organs, secondary sexual characteristics, and fertility. It is also present in women in smaller amounts. In both men and women, it helps control sex drive, as well as maintain muscle and bone strength.

A Testosterone test measures the level of testosterone in the blood. In men, testosterone is responsible for changes during puberty (a biological process in which a child’s body attains physical maturity) such as a deeper voice, growth of body hair, an increase in height, and sperm production. It also helps build muscles and supports the production of red blood cells in both men and women.

Testosterone levels may decrease with age, which may lead to low sex drive, reduced muscle mass, weaker bones, increased body fat, and sometimes anaemia (low red blood cell count). Thus, doctors usually order this test to check hormone levels and understand related health issues.

You may need this test if you show signs of abnormal testosterone levels.

In men (after puberty), the Testosterone test is usually done for symptoms of low testosterone, such as:

• Low energy or fatigue
• Low sex drive
• Mood changes (low mood, irritability)
• Reduced facial or body hair
• Erectile dysfunction (difficulty getting or maintaining an erection)
• Enlarged breasts
• Unexplained anaemia
• Loss of muscle mass
• Infertility (difficulty getting a partner pregnant)
• Hot flashes (in severe cases)

Note: In boys (before puberty), low testosterone may present as delayed puberty, small testes or underdeveloped genitalia, and lack of facial or body hair development.

The Testosterone test for females is mainly done for symptoms of high testosterone, which include:

• Acne
• Excess hair growth on the face or body
• Hair thinning or male-pattern baldness (which refers to hair loss starting at the temples and/or thinning at the crown/top of the head)
• Voice changes
• Irregular or missed menstrual periods
• Infertility (difficulty getting pregnant)
• Unexplained weight changes

The frequency of Testosterone testing depends on the individual’s health condition, symptoms, and treatment status, as outlined below:

A Testosterone test helps identify possible causes of abnormal hormone levels (when combined with symptoms).

In men, low testosterone levels may indicate:

• Chronic diseases (e.g., liver or kidney disease): Long-term illnesses that can reduce hormone levels.
• Testicular disorders: Problems in the testes that affect testosterone levels and sperm production.
• Testicular injury: Physical damage that impacts testosterone production.
• Alcohol use disorder (AUD): Long-term alcohol use that can affect hormone levels.
• Klinefelter syndrome: A genetic condition that causes low testosterone.
• Pituitary gland disorders: Issues with the gland that controls hormone production.
• Benign tumours: Non-cancerous growths that affect hormone balance.

In men, high testosterone levels may indicate:

• Steroid use: External hormone use that increases testosterone levels.
• Adrenal disorders (disorders affecting the adrenal glands located above the kidneys): Conditions like congenital adrenal hyperplasia that cause excess hormone production.
• Testicular tumours: Abnormal growths that increase testosterone production.

In women, high testosterone levels may indicate:

• Polycystic ovary syndrome (PCOS): A common hormonal disorder that causes irregular periods and excess androgens (male sex hormones, including testosterone).
• Adrenal disorders: Conditions that lead to excess androgen production.
• Ovarian tumours or disorders: Abnormal growths that affect hormone levels.
• Pituitary gland disorders: Problems that affect hormone control and production.

In women, very low testosterone may indicate:

• Adrenal gland disorders: Problems in the glands that produce the hormones.
• Pituitary gland disorders: Conditions that affect hormone regulation.
• Ovarian disorders: Issues with the ovaries that affect hormone production.

What to Expect Before the Testosterone Test

No fasting is required for a standalone Testosterone test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise fasting for 8-12 hours. Avoid strenuous exercise for 24 hours before the test, as intense physical activity can temporarily raiseTestosterone levels and affect interpretation. Always inform your doctor about any ongoing medications.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein; you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the Testosterone Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes.

For the Testosterone test, the main parameter measured is:

Total testosterone: This measures the overall amount of testosterone in the blood, which includes both:

• Bound testosterone: Testosterone that is attached to proteins like sex hormone-binding globulin (SHBG) and albumin. This form is not easily available to be used by the body.
• Free testosterone: This is the unbound form of testosterone that is available for the body to use for functions like building muscles and bones.

Note: Most testosterone in the blood is bound to proteins, which helps regulate how much active hormone the body can use. The total testosterone test combines both forms and is the most commonly used test to assess testosterone levels.

The Testosterone test normal range is indicated in the table below.

Note:

• Normal ranges may vary slightly depending on the laboratory and clinical context.
• Testosterone levels are usually highest in the morning. Thus, testing is often recommended between 7 AM and 10 AM for accurate results.
• Results should always be interpreted along with symptoms and other hormone tests if needed.

The table below provides a general interpretation of Testosterone test results based on whether levels are high or low.

Note:

• Test results may vary depending on the type of test, age, symptoms, and overall health condition.
• Testosterone levels normally decrease with age. So, abnormal results do not always indicate a medical condition that requires treatment.
• Always consult your doctor to understand your results properly.

The Testosterone blood test is a simple and commonly performed blood test. While it is generally safe, there are minimal risks and certain limitations to consider.

Risks 

• You may feel slight pain or a prick when the needle is inserted.
• Mild bruising, swelling, or bleeding at the needle insertion site may occur.

Limitations

• Testosterone levels vary throughout the day (highest in the morning), which may affect the results.
• A single test may not be enough. So, repeat testing may be required for confirmation.
• Results can be influenced by age, stress, illness, and medications.
• Biotin supplements may affect test results. Thus, avoid high-dose biotin supplements (>5 mg/day) for at least 8 hours before your test.
• Different laboratories and testing methods may have slightly different reference ranges.

Depending on your symptoms and results, your doctor may recommend additional tests to understand your condition better:

• Free testosterone
• Sex hormone-binding globulin (SHBG)
• Luteinizing hormone (LH)
• Follicle-stimulating hormone (FSH)
• Prolactin
• Estradiol (Estrogen)
• Dehydroepiandrosterone sulfate (DHEA-S)
• Thyroid function tests (T3, T4, TSH)
• 8 AM cortisol test
• Iron and ferritin test

Pro Tip: For the most stress-free experience, book a Testosterone test on PharmEasy. Enjoy professional service and accurate results without stepping out of your house.