Testosterone

What is testosterone and what role does it play in the body?

Testosterone is an important sex hormone found in both men and women, although men generally have much higher levels. In men, it is mainly produced in the testicles. In women, smaller amounts are produced in the ovaries, while the adrenal glands also contribute to androgen production in both sexes. Testosterone plays an important role in the development of male characteristics, such as muscle growth, body hair, voice changes and libido (sex drive). It is also important for red blood cell production, bone strength and overall energy levels.

What does a high or low testosterone level mean?

A low testosterone level means that there is less testosterone in the blood than expected. This can be associated with symptoms such as fatigue, reduced sex drive, muscle weakness and mood changes. High testosterone levels are less common and can have various causes. In women, high testosterone levels may be associated with increased body hair, acne and irregular periods.

What symptoms can be associated with abnormal testosterone levels?

Low testosterone can be associated with fatigue, reduced muscle strength, increased body fat, low mood, reduced sex drive, erectile problems (in men) and reduced bone density. In women, low testosterone may also be associated with reduced sex drive and changes in mood. High testosterone or androgen levels may be associated with acne and other symptoms. In women, these can include increased facial or body hair and irregular periods.

What can cause testosterone levels to increase or decrease?

A low testosterone level can have various causes, including ageing, obesity, chronic illness, certain medications, or problems affecting the testicles or pituitary gland, which helps regulate hormone production. High testosterone levels may be caused by the use of anabolic steroids, certain tumours, or less common hormonal conditions.

How is testosterone related to free testosterone?

Testosterone in the blood is partly bound to proteins, particularly SHBG and albumin, while a small proportion circulates as ‘free’ testosterone. Free testosterone is not bound to these proteins and is readily available to tissues. Total testosterone indicates the overall amount of testosterone in the blood, but in some situations it can also be useful to assess free testosterone, particularly when symptoms do not appear to correspond with the total testosterone level.

When should you consider having your testosterone measured?

It may be useful to measure your testosterone if you have symptoms that could be associated with high or low testosterone levels, such as fatigue, reduced sex drive, unexplained changes in body composition, mood changes or changes in body hair. Testosterone testing may also be useful in cases of fertility problems or erectile difficulties.

How is testosterone measured and how should you interpret the result?

Testosterone is measured using a finger-prick blood test, preferably in the morning because testosterone levels are generally highest at this time. The result is compared with the relevant reference values for your age and sex. If your testosterone level is outside the reference range, you can discuss the result with your doctor to determine whether further investigation may be appropriate.

How can abnormal testosterone levels be improved or treated?

Treatment depends on the underlying cause. Lifestyle changes, such as maintaining a healthy weight, exercising regularly, limiting alcohol consumption and reducing stress, may help in some situations. If a testosterone deficiency is confirmed, a doctor may consider testosterone replacement therapy, for example in the form of a gel or injections. If testosterone levels are too high, the underlying cause should be investigated and treated where appropriate. Any treatment should be discussed with your doctor.

This article is for informational purposes only and is not a substitute for medical advice from a doctor. If your symptoms persist or you are concerned about your health, always contact your doctor.n een huisarts. Blijven je klachten bestaan of maak je je zorgen, neem dan altijd contact op met je huisarts.