A testosterone test checks the level of testosterone in your blood. Doctors use it to diagnose conditions caused by too much or too little of the hormone.
In people with penises, the testicles make testosterone. Testosterone plays an important role during puberty. It helps build muscle, deepen the voice, grow body hair, and develop the penis. Throughout life, the hormone also helps with sperm production and sex drive.
People with vaginas make testosterone too, but in smaller amounts. They produce it in their ovaries. It helps keep hormones balanced and supports several other body functions.
Many transgender and nonbinary people take hormones as part of gender-affirming care, which can affect testosterone levels. Testosterone tests are usually used to check for possible hormone imbalances in people who are not on hormone therapy.
What Does the Testosterone Test Measure?
Testosterone travels through your blood in two ways:
Your doctor will usually order a total testosterone test first. This measures both free and attached testosterone. Sometimes, doctors can diagnose certain conditions by looking at free testosterone levels alone.
In males, a testosterone test can help find the reason for sexual problems, such as low sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can also show whether low testosterone might be causing the issue. Low levels can also mean a problem with the hypothalamus or pituitary gland, which controls how much testosterone your body makes.
In females, doctors might use this test to help find out why you’re missing periods, not having periods, having a hard time getting pregnant or noticing extra hair growth on areas such as your chest or face. The test can also help diagnose polycystic ovary syndrome (PCOS), a hormone condition that causes elevated testosterone and can lead to irregular periods or make it hard to get pregnant. Testosterone testing can also be part of diagnosing certain adrenal tumors, which may affect hormone levels.
Why Would I Get This Test?
Your doctor might order it if you have symptoms of low or high testosterone. These symptoms can affect your energy, mood, sex drive and fertility. The test helps figure out whether a hormone imbalance is causing the problem.
Kevin Campbell, an assistant professor of medicine in the Department of Urology at the University of Florida College of Medicine, who specializes in men’s health, says that not everyone who has high or low testosterone will have symptoms – especially females, whose symptoms can be more subtle.
Symptoms of low testosterone in men
If you’re a male with low testosterone, you may have some of the following symptoms:
- Fatigue, depression, or trouble concentrating
- Hair loss
- Loss of muscle mass
- Low sex drive
- Swollen breasts
- Trouble getting or keeping an erection
- Weak bones, called osteoporosis
- Hot flashes
- Shrinking testicles
Some things that cause low testosterone can also cause a low sperm count. If your sperm count is low, your doctor might order this test.
Symptoms of high testosterone in men
Higher-than-normal testosterone levels are uncommon in adult males, but they can happen in children and may trigger early puberty. In most adult cases, high testosterone happens when someone uses synthetic testosterone – such as steroids – to boost their athletic performance. Taking too much can lead to:
- Low sperm count
- Smaller testicles
- Acne
- Trouble sleeping
- Headaches
- Mood swings
- Trouble urinating
- Weight gain
- High blood pressure
Symptoms of low testosterone in women
The most common symptoms of low testosterone in females include:
- Fertility problems
- Low sex drive
- Skipped or no menstrual periods
- Vaginal dryness
- Weakened bones, called osteoporosis
Symptoms of high testosterone in women
If you’re a female with high testosterone, you may have some of the following symptoms:
Testosterone Test Cost
The cost of a testosterone test can vary based on where you live, the type of test, and whether you have insurance. On average, it’s estimated to cost between $70 and $200.
How to Test Testosterone Levels
The best way to check your testosterone levels is with a blood test. These tests can measure total testosterone, which includes all the types of testosterone in your body, or free testosterone, which isn’t attached to other proteins and is often used to diagnose low testosterone.
At-home testosterone tests are widely available, but they aren’t always accurate so it’s important to have your doctor confirm any hormone issues.
Testosterone blood test
This simple blood test is usually done early in the morning, when your testosterone levels are highest. “Testosterone peaks in the morning and goes down throughout the day,” says Campbell, adding that the best time to get tested is before 10 a.m. “We try to recreate as much of a normal day-to-day process as we can. If someone was up all night or sick, that can alter the test results,” he says.
Depending on the type of test, your doctor may ask you not to eat or drink for a few hours beforehand.
During the test, you’ll sit in a chair while a healthcare provider checks your arm for a vein. They’ll clean the area, then insert a small needle to collect the blood sample. The test usually takes about five minutes and is relatively painless, but you will feel a quick pinch when the needle goes in and might have a small bruise or some soreness afterward.
Be sure to tell your doctor if you take any drugs or herbal remedies, since some medicines can affect your test results. Because testosterone levels naturally change throughout the day, your doctor may order a second test to confirm if your levels are too high or too low.
Online testosterone test
Some websites offer online questionnaires that can check for symptoms of high or low testosterone. These tools can’t diagnose you, but they can help you decide whether to talk to your doctor about getting a testosterone blood test. Campbell says there are currently four validated questionnaires for males: the ADAM questionnaire, the Aging Males’ Symptoms (AMS) scale, the Hypogonadism Impact of Symptoms Questionnaire (HIS-Q) or the Sexual Arousal, Interest and Drive Scale (SAID). There are currently no validated questionnaires to check the symptoms of high or low testosterone in females.
Testosterone Test Results
Your test results will let you know whether you have normal, high, or low testosterone. The “normal” range for you will depend on your sex and age. “There are different numbers that are used by different societies and different groups that can define low testosterone, but all of them do require signs and symptoms,” says Campbell. “It’s important not to just go off a number.”
Testosterone is measured in nanograms per decilitre (ng/dL).
Normal testosterone levels for men
The normal testosterone range for males is:
- Up to 5 years old: Less than 12 ng/dL
- Ages 5-10: Less than 25 ng/dL
- Ages 11-15: Less than 830 ng/dL
- Ages 16-17: 102-1,010 ng/dL
- Ages 18-99: 193-824 ng/dL
Normal testosterone levels for women
The normal testosterone range for females is:
- Under 1 year old: Less than 21 ng/dL
- Ages 1-5: Less than 12 ng/dL
- Ages 6-10: Less than 25 ng/dL
- Ages 11-17: Less than 79 ng/dL
- Ages 18-99: Less than 40 ng/dL
Next steps
If your test results don’t come back normal, don’t panic. While high or low testosterone can be a sign of a medical condition, it can also be caused by medications, an existing health condition, or even a testing error.
Depending on your results, your doctor might order other tests to confirm if there’s a problem. These might include:
17-hydroxyprogesterone (17-OH). This blood test checks for congenital adrenal hyperplasia, a condition that affects how your body makes hormones.
Androstenedione (AD). This blood test measures how well your adrenal glands, ovaries, or testicles are working.
Biopsy. A simple procedure where your doctor removes a small sample of tissue from your testicles to check for cancer.
DHEAS. A blood test that looks for problems or tumors in your adrenal glands.
Estrogens. This blood test measures estrogen levels and can help diagnose infertility or menopause.
Follicle-stimulating hormone (FSH) or luteinizing hormone (LH). A blood test that examines fertility in females and delayed or early puberty in girls.
Prolactin. This blood test is used to check for symptoms such as breast discharge, missed periods, infertility, or low sex drive in females.
Takeaways
A testosterone test measures how much testosterone is in your blood. It can help diagnose hormone imbalances or other conditions that can affect your energy levels, sex drive, mood, and fertility. Both males and females produce testosterone. The most accurate way to test testosterone is with a blood test. If your results are outside the normal range for your age and sex, your doctor may order more tests to find the cause.
Testosterone Test FAQs
How accurate is a testosterone test?
Testosterone test results can vary depending on the type of test, the time of day, and other factors, such as any medications you’re taking. If your levels are unusually high or low, your doctor will likely order a second test to confirm the results.
Can certain medications affect testosterone levels?
Yes, some medications, such as opioids, steroids, and drugs used to treat cancer or certain mental health conditions, can affect testosterone levels. Always tell your doctor about any medications or supplements you’re taking.
Are there any risks with the testosterone test?
A testosterone test is a simple blood test with very few risks, but you might have a small bruise or feel a bit sore where the needle went in.
How often should testosterone be checked?
How often you need testosterone testing depends on your symptoms and whether you’re receiving treatment. Some people need tests every few months, others only once a year. Your doctor can recommend the right schedule for you based on your health history.