Testosterone

What testosterone does

• Sexual desire and erectile function.
• Muscle mass and strength, and fat distribution.
• Bone density.
• Red blood cell production.
• Sperm production, along with FSH.
• Energy and mood, though these are influenced by many other factors.

How it is controlled

The brain controls testosterone production. The pituitary releases LH, which tells the testes to make testosterone, and rising testosterone tells the brain to ease off. That loop is why testosterone therapy from outside the body lowers LH, sperm production and testicle size in many men.

How it is measured

Most testosterone in blood is attached to SHBG or albumin. A total testosterone test counts all of it and is the standard starting point. Free and bioavailable tests estimate the active portion and are useful when SHBG is abnormal. Because levels peak in the morning, MedlinePlus notes samples are usually drawn between 7 and 10 a.m.

Results must be read with symptoms and age. Acute illness, poor sleep, opioids and heavy alcohol use can all temporarily lower readings.

Low testosterone in men

Both the American Urological Association and the Endocrine Society require symptoms plus consistently low morning results on separate days before diagnosing deficiency. The Endocrine Society advises against screening men without symptoms. A gradual, age-related dip without symptoms is not, by itself, a reason to treat.

Treatment requires monitoring of hematocrit, PSA in men over 40, and testosterone levels. It suppresses sperm production, so it is not suitable for men trying to conceive.

Testosterone in women

Women make far less testosterone, and levels decline gradually with age. MedlinePlus notes testing in women is mostly done to investigate signs of excess, such as unwanted hair growth or irregular periods, which can point to PCOS or adrenal conditions. Testosterone treatment for women is an evolving area with limited approved options, and any use requires careful monitoring.

At HealifyMD

Testosterone Replacement Therapy through HealifyMD is $249 for the first month and $149/month after, confirmed at your eligibility review. The first month includes the lab panel. A licensed clinician confirms the diagnosis with morning labs, reviews risks including higher hematocrit and fertility suppression, and sets a monitoring schedule.

Common myths

Testosterone is often marketed as a fix for every midlife complaint, from fatigue to weight gain. In reality, those symptoms have many causes, including sleep apnea, depression, thyroid disease and medication side effects. Testing confirms whether testosterone is actually part of the picture, and treatment is meant to correct a deficiency rather than push levels as high as possible.