screening for male hormone

Overview

This article explains screening for the main male hormone, testosterone. Screening means checking your hormone levels, usually with a blood test, especially if you have symptoms of low testosterone (sometimes called 'low T'). It helps you and your doctor understand whether your hormone levels may be affecting your health.

Yes, low testosterone is common. About 2 in 100 men have it, and the number rises with age. Screening is often recommended if you have symptoms.

It mainly affects men, especially as they get older. It can also affect younger men with certain health conditions (like diabetes, obesity, or testicular problems).

Symptoms

Common symptoms

• Low sex drive (low libido)
• Erectile dysfunction
• Feeling very tired or low energy
• Loss of muscle strength
• Depressed mood or irritability
• Difficulty concentrating
• Increased body fat, especially around the belly

Symptoms in children

• In boys, low testosterone may cause delayed puberty or reduced muscle development. This is different from adult screening and needs a specialist.

Symptoms in older adults

• In older men, symptoms can be more subtle, like reduced energy, falls, frailty, and lower bone density, which can increase fracture risk.

Causes

Main causes

• Normal aging — testosterone tends to drop slightly each year after age 40.
• Injury or infection of the testicles
• Treatments like chemotherapy or radiation for cancer
• Long-term health conditions, including diabetes, obesity, or kidney disease
• Medicines such as opioids — talk to your doctor if this applies to you

Risk factors

• Age over 40
• Obesity or excess body fat
• Type 2 diabetes
• Metabolic syndrome (high blood pressure, high blood sugar, unhealthy cholesterol)
• Sleep apnoea (pauses in breathing during sleep)
• Chronic alcohol or opioid use
• Untreated hypogonadism (underactive testes)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe testicular pain, or signs of a blood clot (leg swelling, chest pain), get care immediately.

Book a routine appointment if:

• See your doctor if you have ongoing symptoms like low sex drive, erectile dysfunction, tiredness, low mood, or reduced muscle strength, especially if these are affecting your daily life.

Diagnosis

Your doctor will ask about your symptoms, medical history, and lifestyle. They will usually recommend a blood test to check your testosterone level. The test is best done in the morning, when your level is highest. If the first test is low, they may repeat it to confirm.

Tests that may be done

• Blood test for total testosterone
• Blood test for free testosterone (sometimes)
• Repeat blood test if the first is low
• Blood tests for other hormones, such as luteinising hormone (LH) and prolactin, if the doctor thinks there may be another cause
• Your doctor may also check for diabetes or anaemia, since these can cause similar symptoms

What to expect at your appointment

The blood test is quick, and you can usually go home straight away. Results often come back in a few days. You may be asked to fast for 8–12 hours, but not always. Follow your doctor's instructions. Your doctor will explain the results and what they mean for you.

Treatment

Treatment for low testosterone depends on the cause, your symptoms, and your overall health. The goal is to relieve symptoms, improve quality of life, and prevent long-term problems like weak bones or loss of muscle. Not every man needs treatment, and it is not right for everyone. Your doctor will help you weigh the possible benefits against the risks, including effects on the heart and prostate.

Self-care at home

• Get regular physical activity, including light weights or resistance exercise.
• Prioritise sleep and try to keep a regular sleep schedule.
• Reduce stress with deep breathing, meditation, or talking to a friend.
• Maintain a healthy weight — losing extra weight can raise testosterone levels.
• Limiting alcohol can help improve symptoms.

Medical treatments

If low testosterone is confirmed and treatment is agreed, options include testosterone replacement therapy (TRT). This can be given as gels, patches, injections, or pellets placed under the skin. Your doctor will talk with you about which type might suit you. Regular blood tests will be needed to monitor your levels and check for any effects on your prostate or blood count. Always discuss the benefits and risks with your doctor. There are also separate medicines for erectile dysfunction — these require a prescription and are not the same as testosterone therapy.

When is surgery considered?

Surgery is not used for low testosterone itself. However, if the cause is a testicular problem, such as a tumour, surgery may be needed to treat that underlying issue.

Living with this condition

Living with low testosterone can be frustrating, but there are many ways to manage it. Work with your healthcare team to find a routine that supports your energy, mood, and relationships. It takes time, but most men can feel better.

Lifestyle tips

• Keep up your social connections — tell trusted friends or family how you're feeling.
• Set small, realistic goals for exercise and daily activities.
• If you have sleep apnoea, using a CPAP machine at night can improve symptoms.
• Consider speaking with a counsellor if low mood or stress is affecting you.

Diet and exercise

Eat a balanced diet with plenty of vegetables, fruits, wholegrains, and lean protein. Aim for at least 30 minutes of moderate exercise on most days. Weight training a few times a week can help maintain muscle mass. Staying active also improves your heart health and helps manage weight.

Mental health and emotional wellbeing

Low testosterone can affect your mood and sense of well-being. It can contribute to depression, irritability, and reduced confidence. If you are feeling anxious or hopeless, please talk to your doctor. If you have thoughts of self-harm, please contact a local crisis helpline or emergency service immediately.

Prevention

Not all cases of low testosterone can be prevented, especially those due to aging or injury. However, a healthy lifestyle can lower your risk. Keeping a healthy weight, exercising, getting enough sleep, and limiting alcohol can all help maintain normal hormone levels.

Screening programmes

Screening is not a routine test for every man. It is usually done only if you have symptoms or have a medical condition that increases your risk. Talk to your doctor about your personal risk and whether testing would be helpful for you.

Complications

If left untreated

• Reduced bone density, which can increase the risk of fractures
• Loss of muscle mass and strength
• Low mood or depression
• Reduced sex drive and erectile dysfunction
• Increased body fat, which raises the risk of heart disease and type 2 diabetes

Long-term outlook

With the right support and treatment, most men can manage low testosterone effectively. Although it can feel challenging, there are many options to improve energy, mood, strength, and sexual health. Untreated low testosterone can affect your long-term health, so it is worth discussing with your doctor. Facing the issue is the first step to feeling better.

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