A hormone test for men measures far more than testosterone alone. A broader view of your male sex hormones usually covers seven to nine values: total testosterone, free testosterone, SHBG, LH, FSH, oestradiol and sometimes DHEA-S, androstenedione and prolactin. Together they tell a story that a single number never can.
I see it often: men fixate on that one testosterone number. Yet the other hormones decide how much testosterone is active, and where a possible problem comes from.
Which hormones are male sex hormones?
The male sex hormones are the androgens (testosterone, free testosterone, DHEA-S and androstenedione), the transport protein SHBG, and the driving hormones LH and FSH from your pituitary. Oestradiol and prolactin belong on the edge of this group, because they help set the balance.
A short guide per group:
- Androgens: testosterone is the best known, but DHEA-S and androstenedione are precursors your body partly converts into testosterone.
- Transport: SHBG binds testosterone in your blood and sets how much stays free and active.
- Drive: LH and FSH come from your brain and put your testicles to work.
- Counterparts: oestradiol (an oestrogen men also need) and prolactin can suppress testosterone when they run high.
What does each hormone on your test do?
Each hormone has its own role, and an abnormal value can mean something different when it is high than when it is low. The table below sums up what each value does and what a high or low result may sometimes suggest. Treat it as a reading guide, not a diagnosis.
| Hormone | What it does | A high value may sometimes suggest | A low value may sometimes suggest |
|---|---|---|---|
| Total testosterone | Main androgen for libido, muscle, energy | Supplementation, rarely a tumour | Hypogonadism, stress, excess weight, poor sleep |
| Free testosterone | The biologically active fraction (about 1 to 3 percent) | Low SHBG, supplementation | High SHBG, true androgen deficiency |
| SHBG | Binds testosterone in the blood | Overactive thyroid, liver disease, ageing | Insulin resistance, excess weight, fatty liver |
| LH | Signal from the pituitary to the testicles | Testicles respond poorly (primary) | Brain signal falls back (secondary) |
| FSH | Helps drive sperm production | Reduced testicular function | Lower drive from the brain |
| Oestradiol | Oestrogen, also needed for bone and libido | High belly fat, high aromatase activity | Very low testosterone, certain medication |
| DHEA-S | Adrenal androgen and precursor | An adrenal issue | Normal ageing, adrenal depletion |
| Androstenedione | Precursor of testosterone and oestrone | Adrenal or testicular androgen source | Rarely clinically relevant |
| Prolactin | Pituitary hormone that can suppress testosterone | Medication, pituitary adenoma, stress | Rarely a problem in men |
To go deeper per hormone, read the separate articles: DHEA, prolactin, androstenedione, SHBG and LH and FSH.
Why does one hormone value say too little?
Measuring one hormone on its own can mislead you. A normal total testosterone with a high SHBG can still leave too little free testosterone. And a low testosterone means something different with a high LH than with a low LH. Context makes the difference.
Your testosterone production works like a thermostat. Your hypothalamus and pituitary read your testosterone and adjust through LH. That is why LH tells you whether a low testosterone comes from your brain or your testicles, and that difference shapes what is worth discussing.
The backdrop matters too. In men, testosterone falls from about age 30 by 1 to 2 percent a year (Harman et al., 2001), and average population values sit lower than a few decades ago (Travison et al., 2007). A number without context says little.
What is on a hormone test for men?
A hormone test for men usually holds the core five: total testosterone, free testosterone, SHBG, LH and FSH. Broader panels add oestradiol, DHEA-S, androstenedione or prolactin. Which values are useful depends on your symptoms and your question.
The reason labs often calculate free testosterone from total testosterone and SHBG is that this free fraction is the part that reaches your tissues (Narinx et al., 2022). Reliable measurement and interpretation of androgens also depend on a good lab method (Heijboer, 2023).
To measure these values in one go, the Hormones Man test covers the core including free testosterone. For a broader view with thyroid and metabolism, look at the Men 40+ Panel, and to track testosterone alone a focused testosterone panel often suffices. For the wider context, read our pillar on male hormonal health.
How do you get your sex hormones measured?
Have testosterone and its related hormones drawn in the morning, before 10 am, because testosterone follows a daily rhythm and peaks then. A single result can swing due to sleep, illness or stress on the test day, so an abnormal value is usually confirmed with a second measurement.
Reliable Dutch-language patient information on hormone complaints is maintained by GPs at Thuisarts.nl.
My take is simple: read your hormones as a set, not as loose numbers. For the exact meaning of oestradiol, read our piece on high oestrogen in men, and for testosterone itself the guide on understanding your testosterone levels. If you see an abnormal value, discuss it with your GP before drawing conclusions.
Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
Sources
- Harman SM, et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001. PMID 11158037.
- Travison TG, et al. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007. PMID 17062768.
- Narinx N, et al. Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone. Cell Mol Life Sci. 2022. PMID 36205798.
- Heijboer AC. Androgen excess and deficiency: analytical and diagnostic approaches. Clin Chem. 2023. PMID 37794651.
Autor
Caliberhealth
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