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Testosterone – information about testosterone, measurement and reference values
Testosterone is one of the body's most important hormones. Testosterone levels naturally change throughout life. They can also be affected by, for example, illnesses, medication and lifestyle. In this information package, we tell you what you should know about testosterone and when you should pay attention to abnormal testosterone levels.
Most important about testosterone
✓ Prolonged fatigue, decreased sexual desire or reduced muscle mass may indicate testosterone deficiency.
✓ Testosterone is measured with a blood test, and the results are always assessed together with symptoms and other health conditions.
✓ Lifestyle can support normal testosterone levels, but an abnormal result can also be due to a treatable illness.
Table of contents
What does testosterone do in the body?
Testosterone is a sex hormone belonging to androgens, which is formed in both men and women. In men, it is mainly formed in the testicles, while in women, testosterone is produced in smaller amounts in the ovaries and adrenal glands. Although testosterone is often known as the “male sex hormone”, it plays an important role in the bodies of both sexes.
During puberty, testosterone initiates the development of male sexual characteristics, such as beard growth, deepening of the voice and increased muscle mass. In adulthood, it helps maintain muscle mass and strength, bone health, sexual desire, sperm formation, red blood cell production, as well as mood, alertness and recovery. In addition, it affects how fat and muscle tissue are distributed in the body.
How do you know if testosterone is low?
Low testosterone can cause a variety of symptoms, which often develop gradually. They may initially go unnoticed or resemble symptoms caused by, for example, prolonged stress, sleep deprivation or other illnesses. Therefore, based on symptoms alone, it cannot be concluded whether the deterioration of well-being is due to testosterone deficiency.
Possible symptoms of testosterone deficiency include:
- constant fatigue or lack of energy
- decreased sexual desire
- erectile dysfunction
- decreased muscle mass or muscle strength
- increased fat mass, especially in the waist area
- low mood, irritability or difficulty concentrating
- impaired recovery from exercise
- decreased sperm production and reduced fertility
- decreased bone density
- sleep disorders
- more rarely, breast growth, i.e. gynecomastia.
Similar symptoms can also occur, for example, in thyroid disorders, sleep apnoea, depression or in connection with prolonged stress. The underlying cause of the symptoms should therefore always be clarified before drawing conclusions.
When should a testosterone examination be performed?
A testosterone examination should be considered when several symptoms indicating testosterone deficiency occur simultaneously, they have continued for a long time or no other explanation has been found for them. A single symptom, such as occasional fatigue, is usually not alone a reason for a testosterone measurement.
The examination may also be appropriate when:
- lifestyle changes have not alleviated the symptoms
- there are underlying illnesses or medications that may affect testosterone levels
- hormone function is to be assessed in connection with infertility examinations
- a physician suspects a hormone disorder based on symptoms or other examination results.
How to measure your testosterone levels with Puhti
How is testosterone measured?
Testosterone levels are measured with a blood test. The sample is usually taken in the morning between 7 and 10 a.m., as testosterone levels vary during the day and are highest in the morning.
A testosterone examination usually begins by measuring total testosterone (S-Testo). If the result is at the lower limit of the reference range or it does not correspond to the person’s symptoms, the examinations can be supplemented by determining free testosterone or SHBG. SHBG is a transport protein in the blood that binds testosterone. Its abnormal concentration can affect how well total testosterone describes the amount of testosterone available to the body.
If necessary, other hormone determinations, such as LH and FSH examinations, can also be included in the examinations. These can be used to assess whether testosterone deficiency is due to a testicular dysfunction or the function of brain structures regulating testosterone production, such as the pituitary gland or hypothalamus. In some situations, prolactin can also be examined if a pituitary dysfunction is suspected.
How are testosterone results interpreted?
A single laboratory result alone does not indicate whether a person has testosterone deficiency. For example, a low testosterone level without symptoms does not necessarily require treatment, while symptoms can also occur in people whose testosterone level is within the reference range. If the first examination result is abnormal, it can be confirmed with a repeat measurement or supplemented with other hormone examinations if necessary.
Testosterone results are always interpreted together with symptoms, other laboratory examinations and possible primary diseases. The goal is not to evaluate only a single numerical value, but to form an overall picture of hormone function and whether testosterone levels can explain the symptoms.
Testosterone reference values
Testosterone reference values vary according to the method used by the laboratory, age and gender. Therefore, your own result should always be compared to the reference values provided with the examination.
What are the testosterone reference values for men?
| Age | Reference value S -Testo |
| 19 – 39 years | 9,2 – 31,8 nmol/l |
| 40 – 49 years | 8,1 – 32,2 nmol/l |
| 50 – 79 years | 7,6 – 32,2 nmol/l |
| over 80 years | 5,4 – 31,7 nmol/l |
What are the testosterone reference values for women?
The reference values for testosterone (S-Testo) for women are 0.4 – 2.1 nmol/l.
What causes testosterone deficiency?
There can be many reasons behind testosterone deficiency. Sometimes too little testosterone is formed, sometimes there is a disorder in the hormone function regulating its production. Lifestyle, chronic diseases and certain medications can also affect testosterone levels.
Treatment of testosterone deficiency
The treatment of testosterone deficiency always depends on the cause of the low testosterone level. Before starting treatment, it is clarified what causes the abnormal testosterone level, as not all low testosterone values require treatment.
If the decrease in testosterone levels is affected by, for example, overweight, low physical activity, sleep deprivation or heavy alcohol consumption, treatment usually begins with lifestyle changes. In some situations, testosterone levels can improve already with improved lifestyle.
If a person has symptoms consistent with testosterone deficiency and laboratory examinations repeatedly show a low testosterone level, a physician can assess the need for testosterone replacement therapy. Replacement therapy can be implemented, for example, as a gel or injections, and its effects and safety are monitored regularly.
Can testosterone be too high?
Although testosterone deficiency is a significantly more common reason for examinations, abnormally high testosterone levels may also require further clarification. Elevated testosterone can be associated with, for example, testosterone medication, the use of anabolic steroids, rare hormone-producing tumors or adrenal diseases. In women, the background can be polycystic ovary syndrome (PCOS) or another hormone disorder.
In men, high testosterone levels are most often associated with the use of testosterone preparations or anabolic steroids. It can cause acne, an increase in the number of red blood cells and impair fertility.
In women, elevated testosterone can cause, for example, hirsutism, acne, menstrual disorders, deepening of the voice and thinning hair.
Myth or fact about testosterone?
Summary
Testosterone affects many bodily functions, such as energy levels, muscle mass, sexual health and bone health. Both low and abnormally high testosterone levels can be associated with various illnesses or lifestyles, but a laboratory result alone is not enough for a diagnosis.
If you have symptoms consistent with testosterone deficiency, a laboratory examination can help clarify their background. However, the results should always be assessed together with symptoms, other examinations and health conditions.
Frequently asked questions about testosterone
Testosterone can be obtained as a prescription medication, which can be a gel, injection, or tablet. Your doctor will assess your need for testosterone treatment based on a thorough examination and blood tests.
The effects of testosterone can begin to appear within a few weeks of starting treatment, but full effects are typically achieved after several months.
Testosterone levels are usually highest in the morning, especially in young men. Levels decline throughout the day and are lowest in the evening.
To achieve hormonal balance, it is important to follow a healthy lifestyle, such as regular exercise, a balanced diet, and adequate sleep. In some cases, hormone replacement therapy or other medical interventions prescribed by a doctor may also be necessary.
There are several supplements on the market that claim to increase testosterone levels. However, there is currently little research evidence to support their effects. If you suspect you have low testosterone, the most reliable way to determine the situation is to have a laboratory test and review the results with a healthcare professional.
In adult men, the lower limit of the reference range for total testosterone is usually around 7.6–9.2 nmol/L, depending on age. If your testosterone level is below the reference range and you have symptoms consistent with testosterone deficiency, your doctor may recommend further testing or assess the need for treatment.
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