How do they test your testosterone levels

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Both men and women make testosterone in their bodies, although men usually produce much more of it than women. A blood test for testosterone can show how much of this important sex hormone is in your body.

What is being tested?

Testosterone is the main sex hormone produced in men. It helps make sperm, and it influences men's sex drive. It also helps create facial and body hair, and plays a part in the development of muscles. Men make testosterone mainly in their testes, but also in their adrenal glands.

Women make a much smaller amount of testosterone in their ovaries, adrenal glands and other body tissues. Some of this breaks down to form a type of oestrogen called oestradiol.

Some testosterone is found in the blood both of men and women. A blood test for testosterone will show how much is in your body.

Why would I need this test?

Your doctor might suggest a blood test for testosterone if:

you are having problems conceiving a child – both men and women can be tested
you are a man with a low sex drive
you are a man with problems getting an erection
you are a woman with masculine features, such as a lot of body hair or a low voice
you are a boy and puberty has come very early, or is very late

Some diseases can also affect the amount of testosterone in your blood. These include diabetes, mumps and tumours on the testicles or ovaries. People who drink too much alcohol can also have low testosterone levels.

How to prepare for the test

You might be asked to have a fasting test early in the morning. In that case, you should stop eating by midnight, then only have sips of water in the morning. You can usually continue to take any medications you need but check with your doctor.

Understanding your results

Many things can affect your testosterone blood test results, including your age, your health and what’s happening with your body.

You will need to discuss the results with your doctor, what they mean, and what comes next.

More information

Read the healthdirect Guide to blood testing.
Pathology Tests Explained has more information on blood tests in general and testosterone in particular.
Pregnancy Birth and Baby has more information on blood tests during pregnancy.
Healthdirect's Question Builder can help you prepare for a doctor's appointment.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2020

Test Quick Guide

Testosterone tests are performed to determine the amount of testosterone in a sample of blood. You can order a testosterone test online, but it must be performed in person.

Testosterone is the hormone responsible for controlling fertility and the development of sperm in men or anyone with a penis. Testosterone also plays an important part in the development of male sex characteristics such as a deeper voice and certain patterns of muscle development and hair growth. In women or anyone with ovaries, testosterone impacts overall growth as well as development of muscle and reproductive tissue.

Testosterone tests can be used to help diagnose health conditions in children and adults. Doctors also use testosterone tests to monitor hormone levels in patients who are receiving testosterone replacement therapy and transgender men who are on hormone therapy.

Testosterone, Total

$64.00

This test measures the total level of testosterone in the body.

About the Test

Purpose of the test

The purpose of testosterone testing is to evaluate the amount of testosterone in the blood. Testosterone levels that are outside of a normal range can cause changes to health and physical appearance. Measuring testosterone can be helpful in diagnosing medical conditions or monitoring a patient’s response to therapy:

Diagnosis Doctors may check testosterone levels to determine the cause of a persons’ symptoms. Testing can help identify testosterone deficiency or an elevated level of testosterone. Testosterone tests may be part of assessing patients with health conditions that can affect hormone levels.
Monitoring Monitoring is how doctors follow a patient’s health over time. In people who have had abnormal testosterone tests in the past, follow-up testing may be used to track their testosterone levels.

Testosterone tests can also be used to monitor the health of transgender men. Transgender men are people who were assigned female at birth but identify as male. Some transgender men may choose to 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 the 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 testicles and the adrenal gland, and it controls the development of sperm and male sex characteristics. In women or anyone with ovaries, testosterone is produced by the ovaries, the adrenal gland, and other tissues, and it aids in overall growth and development.

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.

A total testosterone blood test measures both bound and free testosterone in a sample of blood. This is the most common type of testosterone test, and levels are commonly reported in nanograms per deciliter of blood (ng/dL). Less often, a free testosterone blood test may be performed, which is reported in picograms per deciliter of blood (pg/dL).

Another less common test is for bioavailable testosterone, which is testosterone that can be used more readily by the body. Bioavailable testosterone includes all testosterone that is not bound to SHBG, including free testosterone and albumin-bound testosterone. Bioavailable testosterone is also commonly reported in nanograms per deciliter of blood (ng/dL).

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

Doctors may also evaluate your testosterone levels even if you don’t have symptoms 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 level of testosterone. Changes may include the following:

Irregular periods
Loss of periods
Changes in hair growth patterns
Voice changes
Skin changes such as oily skin or acne
Enlarged clitoris

You may also have testosterone testing if you are a transgender man on masculinizing hormone therapy that is 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

How to get tested

Testosterone testing requires a blood draw that is ordered by a doctor. The blood sample is usually taken during a visit to a doctor’s office, clinic, lab, or hospital. The sample is then sent to a laboratory for analysis.

Can I take the test at home?

There are several at-home collection test kits for checking testosterone levels that are available without a prescription. These test kits may be sold at your local pharmacy and are also available online.

Self-collection kits contain all of the materials needed to obtain a blood or saliva sample and mail it to a laboratory for testing. Results from at-home testosterone tests are usually available within a few days.

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.

For more information about taking at-home tests, see our At-Home Tests page.

How much does the test cost?

Costs for testosterone testing may include charges for an office or clinic visit, a fee for the technician to draw your blood, and laboratory fees when the sample is analyzed.

If testing was recommended by your doctor, 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 sample of blood 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 between 7 a.m. and 10 a.m., which is around when levels are normally the highest. Some doctors may require you to prepare for the test by fasting, which means avoiding eating or drinking anything but water for a few hours before the test. Other doctors may not require you to fast before testosterone testing.

Check with your doctor about how to prepare for your testosterone test, and carefully follow any instructions for 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 on the inside of your elbow.

An elastic band, called a tourniquet, will be placed around your upper arm so there is more blood 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 and a bandage or a band-aid 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 out-patient basis, and you can plan to 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.

Testosterone Test Results

Receiving test results

You will generally receive results showing your testosterone levels within several days. Your results may be uploaded to an online health portal for you to view or be sent to you in the mail.

In some cases, your doctor may also contact you to discuss your results. They may suggest a follow-up appointment to review the results of your test and discuss next steps in your medical care.

Interpreting test results

There are several measures of testosterone, and the interpretation of test results depends on which kind of testosterone was measured.

Total testosterone is the most commonly used test for diagnostic and monitoring purposes. Total testosterone results are typically reported in nanograms per deciliter (ng/dL).

Each result on your report has a corresponding reference range. This range shows what the laboratory considers to be an expected total testosterone level for a healthy person. Reference ranges can vary from laboratory to laboratory, so it is important to speak with your doctor about your result and what it means for your health.

Levels outside of the reference range can indicate a health problem. While testosterone levels decrease with age, abnormally low levels that occur alongside symptoms can indicate testosterone deficiency. In addition, low levels of testosterone in men or anyone with a penis can be tied to other health issues including changes in thyroid function, genetic or chronic illness, benign tumors, problems with the testicles, obesity, or disturbed sleep.

In women or anyone with ovaries, abnormal testosterone levels can be an indication of excess testosterone being produced by the ovaries or other glands that produce hormones. For example, abnormal testosterone results may be caused by polycystic ovary syndrome (PCOS), cancer of the ovary or adrenal gland, or a disorder of the pituitary gland.

Total testosterone levels alone are not enough to make a diagnosis of any health condition. Test results are interpreted in the context of your specific health situation. Your doctor may recommend repeat testing or additional tests to learn more about what may be causing your symptoms and/or the change in your testosterone level.

If you have a test of free or bioavailable testosterone, it is important to talk with your doctor about what the test results mean. When prescribed, these tests are often interpreted in relation to total testosterone. In people who have certain health conditions or take some medications, free or bioavailable testosterone tests may provide more detailed information about whether hormone levels in the body are normal.

Are test results accurate?

Measuring testosterone in the blood is a routine procedure, and results are generally considered accurate when performed in an accredited laboratory that follows established testing methods.

One factor that may impact your testosterone level is the time of day when your blood is drawn. Testosterone levels are best evaluated from blood drawn in the morning when they are usually at their highest point. In addition, some drugs or medications may impact testosterone test levels.

If you have concerns about the accuracy of your test result, you can talk with your doctor. They can tell you about the laboratory that conducted the test, the reference range used, and the reliability of your test results.

Do I need follow-up tests?

Testosterone tests provide information about the level of testosterone in the blood, but they do not provide enough information to make a diagnosis. Therefore, follow-up tests may be recommended if your results suggest a testosterone level outside of a normal range.

Your doctor may want to order a repeat testosterone test to confirm your initial test result. If the repeat test confirms the results of your first testosterone test, a physical exam or other tests are used to help determine the underlying cause. Tests may include blood work, imaging tests, and/or biopsies.

Your doctor will tailor follow-up testing based on the results of your testosterone levels and your situation. Your doctor can explain the risks and benefits of the follow-up tests that are being recommended.

Questions for your doctor about test results

The following questions may be helpful when reviewing your testosterone test results with your health care provider:

What was the result of my testosterone test?
If the result of my test was abnormal, do I need any follow-up tests?
If follow-up tests are needed, what tests will be performed?

Albumin Blood Test (Serum Albumin) Learn More
Follicle Stimulating Hormone (FSH Blood Test) Learn More
Luteinizing Hormone (LH) Test Learn More
Prolactin Blood Test (PRL) Learn More
Sex Hormone Binding Globulin (SHBG) Learn More
CDC: Transgender Persons Learn More
National Library of Medicine: Polycystic Ovary Syndrome Learn More
National Library of Medicine: Hypogonadism Learn More
National Library of Medicine: Delayed Puberty Learn More
National Library of Medicine: Precocious Puberty Learn More

Sources

A.D.A.M. Medical Encyclopedia. Testosterone. Updated January 26, 2020. Accessed November 18, 2021. https://medlineplus.gov/ency/article/003707.htm

A.D.A.M. Medical Encyclopedia. Adrenal glands. Updated November 2, 2021. Accessed November 19, 2021. https://medlineplus.gov/ency/article/002219.htm

American Board of Internal Medicine. ABIM laboratory test reference ranges. Updated July 2021. Accessed November 18, 2021. https://www.abim.org/Media/bfijryql/laboratory-reference-ranges.pdf

Campbell M, Jialal I. Physiology, endocrine hormones. In: StatPearls. Updated October 1, 2021. Accessed November 29, 2021. https://www.ncbi.nlm.nih.gov/books/NBK538498/

Mayo Clinic Laboratory. Test ID: TTFB: Testosterone, total, bioavailable, and free, serum. Date unknown. Accessed December 3, 2021. https://www.mayocliniclabs.com/test-catalog/Overview/83686

MedlinePlus: National Library of Medicine. Testosterone levels test. Updated December 3, 2020. Accessed November 18, 2021. https://medlineplus.gov/lab-tests/testosterone-levels-test/

MedlinePlus: National Library of Medicine. SHBG blood test. Updated December 10, 2020. Accessed November 22, 2021. https://medlineplus.gov/lab-tests/shbg-blood-test/

Mulhall JP, Trost LW, Brannigan RE et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115

Nassar GN, Leslie SW. Physiology, testosterone. In: StatPearls. Updated January 9, 2021. Accessed November 23, 2021. https://www.ncbi.nlm.nih.gov/books/NBK526128/

Trangpricha V, Safer JD. Transgender men: Evaluation and management. In: Snyder PJ, Matsumoto AM, eds. UpToDate. Updated December 2, 2020. Accessed November 18, 2021. https://www.uptodate.com/contents/transgender-men-evaluation-and-management

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Send Us Your Question

How do I know if my testosterone is low?

What are the symptoms of low testosterone?.

Reduced sex drive..

Erectile dysfunction..

Loss of armpit and pubic hair..

Shrinking testicles..

Hot flashes..

Low or zero sperm count (azoospermia), which causes male infertility..

When should testosterone be tested?

The best time for the blood sample to be taken is between 7 a.m. and 10 a.m. A second sample is often needed to confirm a result that is lower than expected.

How do you prepare for a testosterone test?

How to prepare for the test. You might be asked to have a fasting test early in the morning. In that case, you should stop eating by midnight, then only have sips of water in the morning. You can usually continue to take any medications you need but check with your doctor.

Does masturbating reduce testosterone?

The short answer to this question? No. Masturbation and ejaculation haven't been shown to have any long-term or negative effects on testosterone levels, also known as T levels.