Testosterone Test

What is a testosterone test?

A testosterone test is a blood test that measures your levels of testosterone, a hormone.

Your gonads (sex organs) mainly produce testosterone. More specifically, the testicles in people assigned male at birth (AMAB) and the ovaries in people assigned female at birth (AFAB) make testosterone. Levels of testosterone are naturally much higher in people AMAB than in people AFAB.

Your body functions best when your testosterone is in a certain range. A testosterone level that’s too low or high can cause health problems regardless of your sex assigned at birth. Your healthcare provider may recommend this test if you have symptoms that could point to high or low testosterone.

Types of testosterone tests

Testosterone in your body exists in free (not attached to anything) and bound (attached to proteins) forms. Free testosterone is easier for your body to use. A testosterone blood test may show:

• Total testosterone, which measures both free and attached testosterone.
• Free testosterone, which shows free testosterone only. This test may be more helpful for diagnosing certain medical conditions.

When would I need a testosterone test?

Healthcare providers mainly recommend testosterone tests for people AMAB who’ve gone through puberty and have symptoms of low testosterone, like:

• Erectile dysfunction.
• Infertility.
• Low libido (low sex drive).
• Loss of armpit and pubic hair.
• Low muscle mass.
• Gynecomastia.

Healthcare providers mainly order testosterone tests for people AFAB who have symptoms of high testosterone, like:

• Acne.
• Excess facial or body hair (hirsutism).
• Irregular periods.
• Voice deepening.
• Infertility.

If you’re taking masculinizing hormone therapy (gender-affirming hormone therapy), your provider will likely recommend regular testosterone blood tests to make sure your testosterone dose is working well for you.

Testosterone blood test for children

Your child’s healthcare provider may recommend a testosterone blood test if your child has signs of starting puberty earlier or later than expected. High levels may point to precocious (early) puberty. Low levels may indicate a delay in sexual development.

How do I prepare for a testosterone test?

If you’re getting a total testosterone blood test, you may need to get it in the morning since testosterone levels are highest then. In some cases, your healthcare provider may ask you to fast (not eat or drink anything except water) several hours before the test.

Your provider will let you know if you need to follow any specific instructions.

What should I expect during a testosterone blood test?

You can expect the following during a blood test:

1. You’ll sit in a chair, and a healthcare provider (usually a phlebotomist) will check your arms for an easily accessible vein. This is usually on the inside bend of your elbow.
2. Once they’ve located a vein, they’ll clean and disinfect the area.
3. They’ll then insert a small needle into your vein to take a blood sample. This may feel like a small pinch.
4. After they insert the needle, they’ll collect a small amount of blood in a test tube.
5. Once they have enough blood to test, they’ll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding.
6. They’ll place a bandage over the site, and you’ll be finished.

How long does a testosterone test take?

The entire procedure (blood draw) for a testosterone test usually takes less than five minutes. In most cases, you should get the results of your testosterone test within two to three business days, though it could take longer.

What are the risks of a testosterone blood test?

Blood tests are a very common and essential part of medical testing. There’s very little risk to getting a testosterone blood test. You may have slight tenderness or a bruise at the site of the blood draw. This usually resolves quickly.

What do the results of a testosterone test mean?

Blood test reports, including testosterone test reports, usually include:

• The name of the blood test or what was measured in your blood.
• The number or measurement of your blood test result.
• The reference range (“normal” range) for that test.
• Information that indicates if your result is normal or abnormal or high or low.

Laboratories may have different reference ranges for normal testosterone levels. “Normal” ranges for testosterone also vary significantly based on your age and sex assigned at birth. When you get your blood test results back, there will be information that indicates what that lab’s normal ranges are.

Testosterone test results for men and people assigned male at birth

In people AMAB, low testosterone levels could point to:

• Primary hypogonadism, which means there’s an issue with your testicles and their ability to produce testosterone. Conditions that cause primary hypogonadism could be congenital (you were born with them) or acquired (you developed them later in life).
• Secondary hypogonadism, which means there’s an issue with your pituitary gland and/or hypothalamus. Secondary hypogonadism also has congenital and acquired causes.

High testosterone levels could indicate a tumor in your adrenal glands or testicles.

Testosterone test results for women and people assigned female at birth

In people AFAB, high testosterone levels could point to:

• Polycystic ovarian syndrome (PCOS).
• Congenital adrenal hyperplasia.
• Ovarian cancer.
• Adrenal tumors.
• Cushing disease (a type of Cushing syndrome).

Certain medications can cause high testosterone levels, as well, like:

• Anabolic steroids.
• Progestins.
• Antiseizure medications.

Low testosterone in people AFAB can have several causes, like:

• Menopause.
• Turner syndrome.
• Ovarian insufficiency.
• Adrenal insufficiency (Addison’s disease).
• Malnutrition.

Should I be worried if I have an abnormal testosterone test result?

An abnormal testosterone test result doesn’t guarantee that you have a medical condition. Other factors, like certain medications and existing health conditions, can affect your test results. There could’ve also been an error in the processing of the test.

Your healthcare provider will consider your medical history and current medications when they review your results. They’ll let you know if you need further testing.

Are there at-home testosterone tests?

Pharmacies and various companies may sell at-home testosterone tests. But the accuracy of these tests can vary. You shouldn’t try to self-diagnose a testosterone issue.

If you’re concerned about your health or testosterone levels, it’s best to talk to a healthcare provider. They can do a physical exam and address your concerns. They may also recommend a laboratory testosterone test.

How do you know if you have low testosterone?

The only way to know your testosterone level is with a blood test. You may talk to your healthcare provider about a testosterone level test if you have symptoms of low testosterone. Not everyone with low testosterone has symptoms (like low sex drive, fertility problems or erectile dysfunction).