Testosterone is an androgen (male sex hormone) found in both men and women but in significantly larger quantities in men due to the testes. A small amount is made by our pituitary glands, and in women, by the ovaries. In pubescent boys, testosterone causes the voice to deepen, muscles to get bigger, sperm production to begin, and facial/ body hair to grow. Most of the testosterone in the blood is bound to a protein called sex hormone binding globulin. Testosterone that is not bound (“free” testosterone) may be checked if a man or a woman is having sexual problems, such as:
- Decreased sex drive
- Erectile dysfunction in men
- Infertility in men and women
- Delayed or accelerated puberty in boys
- Male features (deep voice, excessive hairiness) in women
In addition, certain conditions are known to affect free testosterone like hyperthyroidism and some types of kidney disease.
Age-specific Reference Ranges (for men):
- 0-9 years < 1 pg/mL
- 10-11 years < 4 pg/mL
- 12-13 years < 68 pg/mL
- 14-15 years = 2-95 pg/mL
- 16-17 years = 26-119 pg/mL
- 18 years and older = 32-168 pg/mL
Tanner-stages spefific Reference Ranges (for men):
- Tanner stage I < 3 pg/mL
- Tanner stage II < 15 pg/mL
- Tanner stage III < 68 pg/mL
- Tanner stage IV = 24-117 pg/mL
- Tanner stage V = 28-165 pg/mL
(To find out more about the different Tanner stages, please refer to: Tanner Stages)
A low testosterone level in men may be due to:
- Hypothalamic or pituitary disease
- A genetic condition causing decreased testosterone production in young men
- Testicular failure / infertility, which can be genetic (myotonic dystrophy) or due to impairment (due to alcoholism, physical injury, or the mumps)
- A chronic disease like diabetes
A low testosterone level in women is normal and healthy.
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What could a slightly elevated free testosterone level mean in men?
Slightly elevated free testosterone levels in a male can have several implications, and the interpretation may vary depending on the specific value and the individual's overall health. Here are some potential meanings:
→ Normal Variation: It's important to note that testosterone levels can fluctuate naturally throughout the day and over time. Slight elevations may fall within the normal range of variation and may not necessarily indicate a medical issue.
→ Hormonal Imbalance: Elevated free testosterone can sometimes be a sign of a hormonal imbalance. This may be due to conditions like polycystic ovary syndrome (PCOS) in women or other hormonal disorders in both sexes.
→ Symptoms: The significance of elevated free testosterone often depends on the presence of symptoms. Some individuals with higher testosterone levels may experience symptoms such as increased facial or body hair growth, acne, or changes in mood and libido.
→ Underlying Health Conditions: Elevated free testosterone could be associated with certain medical conditions, such as adrenal tumors or hormonal disorders. Further tests and evaluation by a healthcare provider are usually necessary to identify and address any underlying issues.
→ Fertility: In some cases, elevated testosterone levels can impact fertility, affecting sperm production and quality.
It's crucial to consult a healthcare professional for a thorough evaluation if you have concerns about elevated free testosterone levels. They can provide personalized guidance and recommend appropriate interventions if necessary.
What could a highly elevated free testosterone level mean in men?
- Testicular tumors
- Adrenal tumors producing testosterone
- Use of anabolic steroids
- Early puberty
- Congenital adrenal hyperplasia affecting the adrenal glands
Increased testosterone in women may be caused by:
- Ovarian or adrenal gland tumor
- Polycystic ovary syndrome
- Congenital adrenal hyperplasia affecting the adrenal glands
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