What is the difference between direct and calculated free testosterone?

Calculated free testosterone is derived mathematically from total testosterone, SHBG, and albumin using the Vermeulen equation. Direct measurement uses equilibrium dialysis or mass spectrometry. Direct measurement is preferred when SHBG is abnormal, as calculated values can be inaccurate in those circumstances.

What is the normal range for free testosterone in pg/mL?

For adult men, the standard normal range is 35–155 pg/mL. For adult women of reproductive age, approximately 0.1–6.4 pg/mL using LabCorp equilibrium dialysis; some labs report a narrower range of 0.3–4.2 pg/mL. Always refer to your specific lab's reference range.

What is a normal free testosterone level for a woman?

For most adult women of reproductive age, values between approximately 0.5 and 6.4 pg/mL are within normal range. Postmenopausal women typically have lower values around 0.1–3.8 pg/mL. Results must be interpreted alongside clinical symptoms and total testosterone.

What are normal free testosterone levels for women by age?

Levels decline with age. Approximate ranges: 20s–30s: 1.0–6.4 pg/mL; 40s (perimenopause): 0.5–4.5 pg/mL; postmenopausal (50+): 0.1–3.8 pg/mL. These are estimates — individual variation is significant and your specific lab range is the reference point for interpretation.

What is a normal free testosterone level for my age?

Levels vary significantly by age and sex. Adult men 18–49: 35–155 pg/mL, declining to 30–120 pg/mL by age 70+. Women of reproductive age: 0.1–6.4 pg/mL, declining after menopause to 0.1–3.8 pg/mL. See the full age-specific tables above.

What does "Free Testosterone, Direct Female" mean on a lab report?

This is a LabCorp test ordered specifically for female patients using female-specific reference ranges. A high result in this context most commonly points toward PCOS or excess androgen production.

What does "WarningLow Free Testosterone (Direct)" mean?

This is a portal display flag indicating the result fell below the reference range. In women this can reflect menopause or oral contraceptive use. In men it may indicate aging, hypogonadism, or elevated SHBG.

What is pmol/L for free testosterone?

pmol/L is used by laboratories in the UK, Canada, and Australia. To convert from pg/mL to pmol/L, multiply by 2.887. Adult male normal: ~101–447 pmol/L. Adult female normal: ~0.3–18.5 pmol/L.

What does high free testosterone mean in females?

Elevated free testosterone in females most commonly indicates PCOS. Other causes include congenital adrenal hyperplasia, ovarian or adrenal tumors, and exogenous androgen use. Symptoms may include irregular periods, acne, hirsutism, and scalp hair thinning.

Free Testosterone (Direct): Normal Range, High & Low Results

Serum Plasma

Other names: TESTOSTERONE, FREE, Testost., Free, Calc, Testosterone,Free, Free Testosterone, Serum, CALC FREE TESTOSTERONE, FREE TESTOSTERONE,CALC, Free Testosterone (Serum)

Optimal Result: 35 - 155 pg/mL, 3.5 - 15.5 ng/dL, or 10.09 - 44.67 pmol/L.

Metabolic Health

From Healthmatters.io Team and reviewed by HM Editorial Team

Written on April 27, 2026 | Last updated Updated on April 27, 2026

Lab Results Explained and Tracked

Free testosterone (direct) measures the unbound, biologically active testosterone in your blood. Only about 1–3% of total testosterone circulates as free testosterone, but this is the active form that enters cells and exerts hormonal effects.

Most searches for free testosterone relate to female levels. Free testosterone in women is much lower than in men (0.1–6.4 pg/mL), and even small increases can be clinically significant. In women, elevated free testosterone is most commonly associated with polycystic ovary syndrome (PCOS).

Free testosterone — quick answer

Free testosterone (direct) measures the unbound, biologically active testosterone in blood.

Normal range:

Men (adult): 35–155 pg/mL
Women (adult): 0.1–6.4 pg/mL (LabCorp equilibrium dialysis reference)

High: PCOS (women), steroid use or tumors (men) Low: aging, high SHBG, hypogonadism

Also called: Free Testosterone Direct, Testosterone Free (Direct), Free Testosterone LC

What is "Free Testosterone Direct"?

"Free testosterone direct" refers to a specific laboratory method — direct measurement of free testosterone using equilibrium dialysis or mass spectrometry — as opposed to calculated free testosterone, which is derived mathematically from total testosterone, SHBG, and albumin values. The direct method is more accurate when SHBG levels are abnormal.

You may see this test reported as:

Free Testosterone, Direct
Free Testosterone (Direct)
Testosterone, Free (Direct)
Free Testosterone Direct LC (LabCorp)
Free Testosterone LC-MS/MS (mass spectrometry method)
Free Testosterone, Direct Female (female-specific ordering)
WarningLow Free Testosterone (Direct) — portal flag meaning the result fell below the reference range

What is the difference between free and total testosterone?

Total testosterone measures all testosterone in the blood — bound and free combined. It is the standard first-line test.

Free testosterone measures only the unbound, active fraction. It is particularly valuable when:

Total testosterone is normal but symptoms of deficiency or excess persist
SHBG is elevated (which reduces free testosterone disproportionately)
SHBG is low (which elevates free testosterone relative to total)
Evaluating testosterone status in women, where absolute levels are low and small changes matter more

Calculated free testosterone uses the Vermeulen equation incorporating total testosterone, SHBG, and albumin. Direct free testosterone measures the free fraction directly and is generally preferred for clinical decision-making when SHBG is abnormal.

Normal range — women

Free testosterone levels in women are significantly lower than in men. Reference ranges vary by laboratory method, age, and menopausal status. Always refer to your specific lab's reference range printed alongside your result.

Life stage	Normal range (pg/mL)	Notes
Premenopausal adult (20–49)	0.1–6.4	LabCorp equilibrium dialysis
Premenopausal adult (alternate method)	0.3–4.2	Varies by assay; some labs use this range
Postmenopausal	0.1–3.8	Lower due to reduced ovarian production
Pregnancy	Not interpretable	Standard ranges do not apply

Note on lab variability: Women's normal ranges vary more than men's depending on the assay used. LabCorp equilibrium dialysis uses 0.1–6.4 pg/mL for premenopausal adults; other methods may report a narrower range such as 0.3–4.2 pg/mL. The range printed on your report is the one to use for interpretation.

Normal free testosterone levels for women by age

Levels decline with age, most sharply around menopause:

20s–30s: typically 1.0–6.4 pg/mL
40s (perimenopause): typically 0.5–4.5 pg/mL
Postmenopausal (50+): typically 0.1–3.8 pg/mL

These are approximate ranges. Individual variation is significant and clinical interpretation always requires symptom context.

Normal range — men

Reference ranges for pediatric males are based on Endocrine Society and laboratory-validated data. Adult ranges reflect the most commonly used laboratory thresholds.

Age	Normal range (pg/mL)	Normal range (ng/dL)	Normal range (pmol/L)
0–9 years	<1	<0.1	<2.9
10–11 years	<4	<0.4	<11.6
12–13 years	<68	<6.8	<197
14–15 years	2–95	0.2–9.5	5.8–275
16–17 years	26–119	2.6–11.9	75–345
18–49 years (adult)	35–155	3.5–15.5	101–447
50–69 years	40–140	4.0–14.0	115–404
70+ years	30–120	3.0–12.0	87–346

Note: Free testosterone declines gradually in men with age — approximately 1–2% per year after age 30–40. The adult male HealthMatters optimal range of 35–155 pg/mL reflects the broad adult reference; levels at the lower end of this range are more typical of older men.

Unit conversion

Free testosterone is commonly reported in pg/mL, ng/dL, or pmol/L. Many users search how to convert between these units.

To convert	Multiply by
pg/mL → ng/dL	÷ 10
ng/dL → pg/mL	× 10
pg/mL → pmol/L	× 2.887
pmol/L → pg/mL	÷ 2.887
ng/dL → nmol/L	× 0.03467

Example: 5 pg/mL = 0.5 ng/dL = 14.4 pmol/L.

What does high free testosterone mean?

A high result means more unbound, active testosterone is present than expected for your sex and age.

In women — most common causes:

Polycystic ovary syndrome (PCOS) — the most frequent cause; associated with irregular periods, acne, and excess hair growth (hirsutism)
Congenital adrenal hyperplasia (CAH) — inherited enzyme deficiency causing excess androgen production
Ovarian or adrenal tumors — rare but important to exclude when testosterone is markedly elevated
Exogenous androgen use — testosterone therapy or DHEA supplements
Cushing's syndrome — excess cortisol associated with androgen overproduction

In men — most common causes:

Anabolic steroid use — the most common cause of a markedly elevated result
Testicular or adrenal tumors
Congenital adrenal hyperplasia
Low SHBG — reduces binding, increasing the free fraction even when total testosterone is normal

What does low free testosterone mean?

A low result means the active testosterone fraction is below the reference range for your sex and age.

Common causes in men:

Age-related decline — testosterone falls approximately 1–2% per year after age 30–40
Hypogonadism — primary (testicular failure) or secondary (pituitary or hypothalamic dysfunction)
Elevated SHBG — caused by aging, liver disease, hyperthyroidism, or medications
Obesity, type 2 diabetes, chronic kidney disease
Medications — glucocorticoids, opioids, certain antifungals

Common causes in women:

Menopause and age — ovarian testosterone production declines significantly after menopause
Oral contraceptives — increase SHBG, reducing free testosterone
Oophorectomy (surgical removal of the ovaries)
Adrenal insufficiency, hypopituitarism

FAQ about Free testosterone

What is the difference between direct and calculated free testosterone?

Calculated free testosterone is derived mathematically from total testosterone, SHBG, and albumin using the Vermeulen equation. Direct measurement uses equilibrium dialysis or mass spectrometry. Direct measurement is preferred when SHBG is abnormal, as calculated values can be inaccurate in those circumstances.
What is free testosterone direct?

Free testosterone direct refers to a laboratory method that directly measures the unbound fraction of testosterone in blood, as opposed to calculating it from total testosterone and SHBG. The direct method is more accurate when SHBG levels are abnormal. It appears on lab reports as "Free Testosterone, Direct," "Testosterone, Free (Direct)," or "Free Testosterone Direct LC."
What is the normal range for free testosterone in pg/mL?

For adult men, the standard normal range is 35–155 pg/mL. For adult women of reproductive age, approximately 0.1–6.4 pg/mL using LabCorp equilibrium dialysis; some labs report a narrower range of 0.3–4.2 pg/mL. Always refer to your specific lab's reference range.
What is a normal free testosterone level for a woman?

For most adult women of reproductive age, values between approximately 0.5 and 6.4 pg/mL are within normal range. Postmenopausal women typically have lower values around 0.1–3.8 pg/mL. Results must be interpreted alongside clinical symptoms and total testosterone.
What are normal free testosterone levels for women by age?

Levels decline with age. Approximate ranges: 20s–30s: 1.0–6.4 pg/mL; 40s (perimenopause): 0.5–4.5 pg/mL; postmenopausal (50+): 0.1–3.8 pg/mL. These are estimates — individual variation is significant and your specific lab range is the reference point for interpretation.
What is a normal free testosterone level for my age?

Levels vary significantly by age and sex. Adult men 18–49: 35–155 pg/mL, declining to 30–120 pg/mL by age 70+. Women of reproductive age: 0.1–6.4 pg/mL, declining after menopause to 0.1–3.8 pg/mL. See the full age-specific tables above.
What does "Free Testosterone, Direct Female" mean on a lab report?

This is a LabCorp test ordered specifically for female patients using female-specific reference ranges. A high result in this context most commonly points toward PCOS or excess androgen production.
What does "WarningLow Free Testosterone (Direct)" mean?

This is a portal display flag indicating the result fell below the reference range. In women this can reflect menopause or oral contraceptive use. In men it may indicate aging, hypogonadism, or elevated SHBG.
What is the difference between free and total testosterone?

Total testosterone measures all testosterone — both bound and free. Free testosterone measures only the unbound, active fraction (~1–3% of total). Free testosterone testing is most useful when total testosterone is normal but symptoms persist, or when SHBG is abnormal.
What is pmol/L for free testosterone?

pmol/L is used by laboratories in the UK, Canada, and Australia. To convert from pg/mL to pmol/L, multiply by 2.887. Adult male normal: ~101–447 pmol/L. Adult female normal: ~0.3–18.5 pmol/L.
What does high free testosterone mean in females?

Elevated free testosterone in females most commonly indicates PCOS. Other causes include congenital adrenal hyperplasia, ovarian or adrenal tumors, and exogenous androgen use. Symptoms may include irregular periods, acne, hirsutism, and scalp hair thinning.
What does low free testosterone mean?

A low result means the active testosterone fraction is below the reference range. In men, common causes include aging, elevated SHBG, and hypogonadism. In women, common causes include menopause, oral contraceptive use, and oophorectomy.

Lab Results Explained and Tracked

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What does it mean if your Free testosterone result is too high?

A high free testosterone result means the unbound, active testosterone is above the reference range for your sex and age. In women this is most commonly associated with polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia, or — in markedly elevated cases — an ovarian or adrenal tumor. In men, anabolic steroid use, testicular tumors, and low SHBG are the main causes.

If your result is high, your doctor may evaluate for PCOS, adrenal disorders, or medication effects. Discuss the result alongside total testosterone, SHBG, and clinical symptoms to determine the cause and whether further investigation is needed.

Related Health Conditions

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What does it mean if your Free testosterone result is too low?

A low free testosterone result means the unbound, active testosterone is below the reference range for your sex and age. In men, the most common causes are aging, elevated SHBG, and hypogonadism. In women, low free testosterone is often related to menopause, oral contraceptive use, or oophorectomy.

If your result is low, additional testing — total testosterone, SHBG, LH, and FSH — is often needed to determine the cause. A low free testosterone with normal total testosterone and high SHBG has different implications than a low free testosterone with low total testosterone.

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Free Testosterone (Direct): Normal Range, High & Low Results

Free testosterone — quick answer

What is "Free Testosterone Direct"?

What is the difference between free and total testosterone?

Normal range — women

Normal range — men

Unit conversion

What does high free testosterone mean?

What does low free testosterone mean?

FAQ about Free testosterone

What is the difference between direct and calculated free testosterone?

What is free testosterone direct?

What is the normal range for free testosterone in pg/mL?

What is a normal free testosterone level for a woman?

What are normal free testosterone levels for women by age?

What is a normal free testosterone level for my age?

What does "Free Testosterone, Direct Female" mean on a lab report?

What does "WarningLow Free Testosterone (Direct)" mean?

What is the difference between free and total testosterone?

What is pmol/L for free testosterone?

What does high free testosterone mean in females?

What does low free testosterone mean?

All Your Lab Results. One Simple Dashboard.

What does it mean if your Free testosterone result is too high?

Related Health Conditions

All Your Lab Results. One Simple Dashboard.

Import, Track, and Share Your Lab Results Easily

Import, Track, and Share Your Lab Results

What does it mean if your Free testosterone result is too low?

Related Biomarkers

Article Review & Sources

Bring All Your Lab Results Together — In One Place

Gather Your Lab History — and Finally Make Sense of It

Finally, Your Lab Results Organized and Clear

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What's included in a Healthmatters membership

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Securely Share With Anyone You Trust

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Bring all your results together to compare, track progress, export your history, and share securely.

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