Insights on Testosterone Testing

Insights on Testosterone Testing

Men are having their testosterone levels tested more frequently nowadays, but physicians could test more consistently, American researchers report.

Low testosterone (sometimes called “low T”) has gotten more coverage – both in the general media and in medical journals – over the past few years. However, scientists weren’t sure just how many men were having their levels checked.

Produced by the testes, testosterone is a hormone responsible for male characteristics like facial hair and increased muscle mass. It also drives a man’s libido.

Some men have low levels of testosterone because their testes can’t produce enough of it. This may happen because of problems in the testes themselves. It can also occur when signals from the brain that trigger hormone production don’t reach the testes. This condition is called hypogonadism.


Only 5 – 35% of men eligible for testosterone replacement therapy actually receive it. Click here to tweet.


But men’s testosterone levels also decline as they get older. This is normal, but it can have bothersome symptoms, like fatigue, weakness, and lower sex drive.

In both cases, treatment with testosterone replacement therapy may help, along with making lifestyle changes like losing weight and quitting smoking.

In this study, researchers from the University of Chicago Medical Center and NorthShore University Health Systems looked at the electronic health records of over 300,000 men between the ages of 18 and 85. Their average age was about 55 years and the records were recorded from 2009 to 2012.

Medical societies differ in their cutoff point to diagnose low testosterone. For this study, the researchers used a measurement of 300 ng/dL

Overall, 3.2% of the men had their testosterone levels checked during this time period. However, the rate of testing increased over the four years, however from 2.5% at the start of the study to 3.6% by the end.

Men were more likely to be tested if they had other conditions related to low testosterone, such as low libido, diabetes, erectile dysfunction, infertility, osteoporosis, depression, prostate cancer, high blood pressure, chronic obstructive pulmonary disease (COPD), or an enlarged prostate.

The researchers also looked at the time of day the men were tested. Men’s testosterone levels fluctuate during the day and usually peak in the morning. Typically, testing guidelines provided by professional societies recommend early morning testing for consistency. But in the group of tested men, only about 9% were tested between 7 a.m. and 12 noon.

This low rate might be explained by clinician preference and scheduling conflicts. Also, levels tend to fluctuate less in older men, so it’s possible that their doctors didn’t feel it was necessary to test in the early morning.

However, the researchers found that men who were tested later in the day were more likely to have lower levels than those tested in the morning. “It is our belief that early morning testing should still be considered” when testing men with symptoms of low testosterone, they wrote.

The researchers were also concerned about the low rate of men being tested overall. They noted that testosterone replacement therapy can benefit some men, but only 5 – 35% of men eligible for this treatment actually receive it.

“Further education of practitioners is required to appropriately test patients for hypogonadism,” they wrote.

The study was first published online in November in the Journal of Sexual Medicine.

Print this article or view it as a PDF file here: Insights on Testosterone Testing


Journal of Sexual Medicine

Malik, Rena D., MD, et al.

“Are We Testing Appropriately for Low Testosterone?: Characterization of Tested Men and Compliance with Current Guidelines”

(Full-text. First published online: November 10, 2014)

You may also be interested in...

Other Popular Articles

What Is Jelqing, and Does It Actually Work?

The term “jelqing” refers to a set of penis stretching exercises that some believe can make the penis bigger. Although the practice has gained attention and popularity in blogs and internet forums in recent years, there is no scientific evidence that it is an effective way to permanently increase the size of one’s penis. In fact, in some cases, jelqing may actually cause damage to the penis, so it is a good idea to get all the facts before setting off to try it.

What Is Sensate Focus and How Does It Work?

Sensate focus is a technique used to improve intimacy and communication between partners around sex, reduce sexual performance anxiety, and shift away from ingrained, goal-oriented sexual patterns that may not be serving a couple.

What Is the Average Penis Size?

If you have ever wondered how your penis compares to others in terms of size, you are not alone. Many men are curious to know how their penises stack up compared to the average. Unfortunately, general curiosity can sometimes give way to full-on obsession and anxiety about penis size. This can be an unhealthy and often unnecessary fixation, especially because most men who think their penises are too small have perfectly normal-sized penises.

What Is Edging and Why Do People Do It?

Edging is the practice of stopping sexual stimulation before reaching orgasm to prolong a sexual experience. The term stems from the concept of approaching the metaphorical “edge” of orgasm but stopping before going over the edge.

Can Sex Reduce Menstrual Cramps?

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

Having sex while you experience menstrual cramps is healthy and can provide significant benefits. While it might not be the first activity that comes to mind when your PMS or period cramping begins, many people enjoy sex to reduce menstrual cramps, experience increased pleasure and benefit from other advantages. Learn more about having sex while menstrual cramps are happening and how it can help your body.

Can Sex Throw off Your Vaginal pH Balance?

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

Your vagina is a pretty powerful organ. It is a pathway for menstrual blood and babies. It also is a main player in sexual intercourse. You might hear about your vagina’s pH and worry that yours is at risk. Here’s what to know about vaginal pH, including the impacts sex could have.

Find a Provider

Find a provider who specializes in sexual medicine in your area.