About Our Testosterone Test
Purpose of the test
The purpose of testosterone testing is to evaluate the amount of the hormone in the blood. Testosterone levels outside the normal range can affect health and physical appearance. Measuring testosterone can help diagnose medical conditions or monitor your response to hormone therapy, pituitary disorders, or certain cancers.
Diagnosis
Doctors may check testosterone levels to determine the cause of your symptoms. Testing can help identify a deficiency or an elevated level of testosterone. Tests may be part of assessing whether you have health conditions that can affect hormone levels.
Doctors may also order testosterone testing when evaluating medical conditions that can affect hormone levels. Low testosterone may be linked to conditions such as hypogonadism, pituitary disorders, chronic illnesses, or certain medications. High testosterone levels can sometimes be associated with conditions such as polycystic ovary syndrome (PCOS), adrenal gland disorders, or, in rare cases, hormone-producing tumors. Measuring testosterone levels can help doctors better understand the cause of symptoms and determine whether additional testing is needed.
Monitoring
This is how doctors follow your health over time. If you have had abnormal testosterone tests, follow-up testing may be used to track your testosterone levels.
Testosterone tests can also monitor the health of transgender men who were assigned female at birth but identify as male. Some transgender men may take hormone therapy to change their physical appearance to match their gender identity. Doctors may monitor testosterone levels in this group of men to ensure testosterone levels are maintained at a certain level.
What does our Testosterone test measure?
A testosterone test measures the level of the hormone testosterone in the blood.
In men or anyone with a penis, testosterone is produced by the testes, as well as small amounts in the adrenal gland, controlling the development of sperm and male sex characteristics. In women and others with ovaries, testosterone is produced by the ovaries, adrenal glands, and other tissues, and it aids overall growth and development.
In females, testosterone is produced in the ovaries at much lower levels and is converted to the female sex hormone, estradiol. Low testosterone levels may result in low energy levels, loss of muscle mass and strength, diminished sex drive, irregular menstrual cycle, and insomnia.
Testosterone in the blood can be either bound or free:
- Bound testosterone is attached to proteins such as albumin or sex hormone-binding globulin (SHBG). Most testosterone is bound to SHBG.
- Free testosterone, the active form, is all the remaining testosterone that is not bound to other substances.
- Bioavailable testosterone consists of free testosterone and testosterone that is bound to proteins other than SHBG.
A total testosterone test measures both bound and free testosterone in a blood sample. This is the most common type of testosterone test. While testing for free testosterone or bio-available testosterone is performed less frequently, it may be useful in diagnosing certain medical conditions.
When should I get a Testosterone test?
Your doctor may order a testosterone test if you are experiencing symptoms that suggest hormone levels outside of a normal range.
In men or anyone with a penis, a testosterone test may be performed if you have symptoms that suggest a low testosterone level, such as:
- Early or late onset of puberty
- Erectile dysfunction
- Fertility problems
- Osteoporosis or thinning of the bones
- Decrease in sex drive
- Accidental damage to testicles
- Removal of the testicle due to cancer
- Chemotherapy/radiation therapy
- Pituitary gland disease
- Infection
- Autoimmune disease
Even if you don’t have symptoms, doctors may also evaluate your testosterone levels if you have a health condition that can affect hormone levels. For example, testosterone testing may be performed if you have HIV/AIDS, unexplained bone density loss, infertility, or anemia. If you have undergone certain types of cancer treatment, such as chemotherapy or radiation to the testicles, you may also have your testosterone levels checked.
Doctors may check testosterone levels as part of a diagnostic work-up in women or anyone with ovaries if physical changes suggest a higher-than-normal testosterone level. Changes may include the following:
- Irregular or loss of periods
- Infertility
- Changes in hair growth patterns (dark, coarse hair on face, back, chest)
- Voice changes
- Skin changes, such as oily skin or acne
- Enlarged clitoris
- Fatigue
- Depression
- Reduced muscle mass
- Increased body fat
Testosterone testing may also be used as part of a fertility evaluation. In men or people with testes, testosterone plays an important role in sperm production. Abnormal hormone levels may contribute to infertility, so doctors sometimes include testosterone testing along with other hormone tests when investigating difficulty conceiving.
You may also have testosterone testing if you are a transgender man on masculinizing hormone therapy intended to induce and maintain male sex characteristics. Testing is recommended every three months during the first year of therapy as your dose is adjusted. After that, your doctor may suggest monitoring your testosterone levels one to two times per year.
If you have questions about testosterone testing, talk with your health care provider, who can discuss whether this testing is appropriate in your situation.
Finding a Testosterone Test
Several at-home collection test kits for checking testosterone levels are available without a prescription. These test kits may be sold at your local pharmacy and are available online.
Self-collection kits contain all the materials needed to obtain a blood sample and mail it to a laboratory for testing. Results from at-home testosterone tests are usually available within a few days. Note that saliva testing is not commonly used, as most clinicians prefer serum blood tests.
If you have concerns about your testosterone levels, it is important to talk with a health care provider. At-home testosterone testing doesn’t replace talking with a doctor, especially if you have a change in your health.
If the results of an at-home test are abnormal or if you are having symptoms, your doctor might want to order another testosterone test. They may also suggest a physical exam or other types of tests to assess your overall health.
How much does the test cost?
Costs for testosterone testing may include charges for an office or clinic visit, a technician’s fee for drawing your blood, and laboratory fees for analyzing the sample.
If your doctor recommended testing, the costs of measuring your testosterone level are generally covered by health insurance. Depending on your insurance plan, you may be responsible for some out-of-pocket costs like copays or a deductible. If you have questions about the cost of testing, you can speak with your doctor and insurance plan for more information.
Taking a Testosterone Test
Testosterone levels are checked by drawing a blood sample from a vein in the arm. The sample is usually taken in a doctor’s office, medical clinic, laboratory, or hospital.
Before the test
Testosterone testing should be performed in the early morning, since testosterone follows a circadian rhythm, and that’s when levels are normally the highest. You may need two separate morning tests to confirm low testosterone.
Fasting is not typically required for testosterone testing, though doctors may request it mainly for standardization or if other tests are drawn simultaneously. If fasting is suggested, it means avoiding eating or drinking anything but water for a few hours before the test.
Check with your doctor about how to prepare for your testosterone test, and carefully follow any instructions before the test.
During the test
Your doctor or another health professional will draw a sample of blood using a small needle. The blood is normally drawn from a vein inside your elbow.
An elastic band, called a tourniquet, will be placed around your upper arm so more blood is in the vein. The inside of your elbow will be cleaned with an antiseptic wipe to prevent infection. A needle will be inserted into the vein to fill a small vial with blood.
During the test, you might feel a slight sting as the needle is inserted or removed. The entire process usually lasts less than a minute or two.
After the test
Once the blood draw is complete, you may be asked to apply pressure around where the needle was inserted using gauze or cotton. This can help reduce swelling, bleeding, and bruising. You may also be given a cotton swab or bandage to cover the area.
The type of blood draw used to gather a sample for a testosterone test is routine. It is usually done on an outpatient basis, and you can resume your normal activities following testing. If you were told to fast before testing, you may wish to bring a light snack to eat once the test is complete.