How does chronic migraine affect testosterone levels in men. What are the potential implications of lower testosterone in migraine sufferers. Can testosterone supplementation help reduce migraine frequency and symptoms.

Understanding Chronic Migraine and Its Prevalence

Chronic migraine is a debilitating neurological condition that affects a significant portion of the population. According to the National Health Interview Survey in 2012, approximately 14.2% of individuals in the United States experience migraine or severe headaches, with a higher prevalence among females (19.1%) compared to males (9.0%).

The International Classification of Headache Disorders, 3rd edition (beta version), defines chronic migraine as headaches occurring on 15 or more days per month for over three months, with migraine features present on at least 8 days per month. This condition has a substantial impact on quality of life and ranks as the third most common cause of disability worldwide in individuals under 50, as reported by the Global Burden of Disease Survey 2015.

The Role of the Hypothalamus in Migraine

Migraines are believed to involve complex interactions between the hypothalamus, brainstem, and cortex. These brain regions play crucial roles in regulating autonomic, affective, cognitive, and sensory functions. Recent research has highlighted the potential involvement of the hypothalamus in migraine pathophysiology:

• Positron emission tomography (PET) studies have shown hypothalamic activation during spontaneous migraine attacks, persisting even after headache relief with sumatriptan.
• The hypothalamus is involved in circadian rhythms, pain control, and maintaining homeostasis.
• It coordinates the activity of the sympathetic and parasympathetic nervous systems.
• The hypothalamus plays a crucial role in the body’s responses to stress.

The Hypothalamo-Pituitary-Gonadal Axis and Testosterone Regulation

The hypothalamus is a key component of the hypothalamo-pituitary-gonadal (HPG) axis, which regulates testosterone production in men. Here’s how this system works:

1. The hypothalamus secretes gonadotropin-releasing hormone (GnRH).
2. GnRH stimulates the anterior pituitary gland to release luteinizing hormone (LH).
3. LH acts on Leydig cells in the testes, which synthesize testosterone.

Given the hypothalamus’s involvement in both migraine pathophysiology and testosterone regulation, researchers have begun to explore potential connections between chronic migraine and testosterone levels in men.

Investigating Testosterone Levels in Men with Chronic Migraine

A prospective observational pilot study was conducted to investigate whether men with chronic migraine have lower than expected total serum testosterone levels. The study included 14 men aged 26-51 who met the ICHD-3b criteria for chronic migraine without opioid or barbiturate overuse.

Key findings of the study include:

• The mean total testosterone level in the 14 patients was 322 ng/dL (range: 120-542 ng/dL).
• This value falls within the lower 5% of the reference range for the laboratory (300-1080 ng/dL).
• Men with chronic migraine had lower total testosterone levels compared to published age-matched normative median values by a median difference of 62 ng/dL (P=0.0494).

Implications of Lower Testosterone Levels in Chronic Migraine Sufferers

The findings of this study suggest that hypothalamic regulation may be altered in patients with chronic migraine. This potential dysregulation of the HPG axis could have several implications:

Symptoms of Hypogonadism

Many men with chronic migraine exhibit symptoms that are frequently associated with hypogonadism, including:

• Depressed mood
• Reduced energy
• Difficulty concentrating

These symptoms may be exacerbated by lower testosterone levels, potentially creating a cycle of worsening migraine symptoms and declining testosterone production.

Impact on Overall Health

Testosterone plays a crucial role in various physiological processes in men. Lower levels of testosterone may contribute to:

• Decreased muscle mass and strength
• Reduced bone density
• Increased body fat
• Changes in sexual function and libido
• Alterations in mood and cognitive function

Potential for Testosterone Supplementation in Chronic Migraine Management

The observed association between chronic migraine and lower testosterone levels raises an intriguing question: Could testosterone supplementation help alleviate migraine symptoms in affected men? While further research is needed to definitively answer this question, there are several potential benefits worth considering:

Reduction in Headache Frequency

Testosterone supplementation may potentially reduce the number of headaches experienced by men with chronic migraine. This could be due to the hormone’s effects on various physiological processes, including:

• Modulation of neurotransmitter systems involved in pain perception
• Regulation of inflammation
• Improvement in overall stress response

Alleviation of Associated Symptoms

By addressing the symptoms of hypogonadism often experienced by men with chronic migraine, testosterone supplementation may indirectly improve quality of life and overall well-being. This could include:

• Enhanced mood and reduced depressive symptoms
• Increased energy levels
• Improved cognitive function and concentration

Future Research Directions

While the findings of this pilot study are promising, they also highlight the need for further research to fully understand the relationship between chronic migraine and testosterone levels in men. Some important areas for future investigation include:

Larger-Scale Studies

Conducting studies with larger sample sizes and diverse patient populations would help confirm the observed association and provide more robust statistical evidence.

Longitudinal Research

Long-term studies tracking testosterone levels and migraine symptoms over time could reveal important insights into the temporal relationship between these factors.

Intervention Studies

Randomized controlled trials evaluating the effects of testosterone supplementation on migraine frequency and associated symptoms would be crucial in determining the potential therapeutic value of this approach.

Mechanistic Investigations

Further research into the underlying mechanisms linking chronic migraine, hypothalamic function, and testosterone regulation could uncover new targets for therapeutic intervention.

Implications for Clinical Practice

The potential connection between chronic migraine and lower testosterone levels in men has several implications for clinical practice:

Hormonal Evaluation

Should healthcare providers consider routine testosterone screening for men with chronic migraine? While it may be premature to recommend universal screening, clinicians should be aware of this potential association and consider hormonal evaluation in men with chronic migraine who exhibit symptoms of hypogonadism.

Holistic Treatment Approaches

The findings highlight the importance of considering the broader physiological impacts of chronic migraine. Treatment strategies that address not only pain management but also hormonal balance and overall well-being may lead to better outcomes for patients.

Personalized Medicine

As our understanding of the relationship between chronic migraine and testosterone levels grows, it may become possible to develop more personalized treatment approaches based on individual hormonal profiles and symptom presentations.

Challenges and Considerations in Testosterone Supplementation

While the potential benefits of testosterone supplementation in men with chronic migraine are intriguing, there are several challenges and considerations to keep in mind:

Safety Concerns

Testosterone replacement therapy can have side effects and potential risks, including:

• Increased risk of cardiovascular events in some populations
• Potential stimulation of prostate growth
• Changes in red blood cell production
• Skin reactions and acne

Any potential use of testosterone supplementation in chronic migraine management would need to carefully weigh these risks against the potential benefits.

Regulatory Hurdles

The use of testosterone supplementation for chronic migraine would likely require extensive clinical trials and regulatory approval before becoming a standard treatment option.

Individual Variability

Not all men with chronic migraine may have low testosterone levels, and not all may respond equally to supplementation. Identifying which patients are most likely to benefit from this approach would be crucial.

The Broader Context: Hormones and Headache Disorders

The potential link between testosterone levels and chronic migraine in men is part of a larger body of research exploring the role of hormones in headache disorders. Other areas of investigation include:

Estrogen and Migraine in Women

Fluctuations in estrogen levels have long been associated with migraine in women, particularly around menstruation and during perimenopause. This highlights the complex interplay between sex hormones and headache disorders.

Thyroid Function and Headaches

Some studies have suggested a higher prevalence of thyroid dysfunction in individuals with migraine and other headache disorders, further emphasizing the potential role of hormonal factors in these conditions.

Stress Hormones and Migraine

The relationship between stress, cortisol levels, and migraine frequency is another area of active research, underscoring the multifaceted nature of hormonal influences on headache disorders.

As research in this field progresses, a more comprehensive understanding of the hormonal factors influencing chronic migraine may emerge, potentially leading to novel therapeutic approaches and improved patient outcomes.

Testosterone levels in men with chronic migraine

Neurol Int. 2019 Jun 18; 11(2): 8079.

Published online 2019 Jun 19. doi: 10.4081/ni.2019.8079

,¹,¹,² and ¹

Author information Article notes Copyright and License information Disclaimer

Chronic migraine is a frequent and debilitating condition affecting 14% of the general population. This prospective observational pilot study investigated whether men with chronic migraine have lower than expected total serum testosterone levels. We identified 14 men ages 26-51 at our Institution who fulfilled the ICHD-3b criteria for chronic migraine and obtained serum total testosterone levels. The mean total testosterone level in our 14 patients was 322 ng/dL (range: 120-542 ng/dL) which is in the lower 5% of the reference range for our laboratory (300-1080 ng/dL). Men with chronic migraine had lower total testosterone levels compared to published agematched normative median values by a median difference of 62 ng/dL (P=0. 0494). This finding suggests that hypothalamic regulation is altered in patients with chronic migraine. Further studies are warranted to determine whether testosterone supplementation in men with chronic migraine reduces the number of headaches or the associated symptoms of hypogonadism.

Key words: Neurology, Migraine, Testosterone, Hypothalamus, Hypogonadism

Migraine is a common, multifactorial, disabling primary headache disorder.^1,2 According to the International Classification of Headache Disorders, 3^rd edition (beta version), chronic migraine refers to a headache occurring on 15 or more days per month for more than 3 months which has the features of migraine on at least 8 days per month.² According to the National Health Interview Survey in 2012, the overall prevalence of migraine or severe headache is 14.2% in the United States, with 19.1% of females and 9.0% of males affected with substantial variations depending on age. ³ Migraine ranked as the third most common cause of disability worldwide in individuals under 50 as reported by the Global Burden of Disease Survey 2015.⁴ Migraines are considered to involve the hypothalamus, brainstem, and cortex which regulates autonomic, affective, cognitive, and sensory functions.¹ Chronic migraine may affect hypothalamic hormonal secretion. Many men with chronic migraine exhibit symptoms that are frequently seen with hypogonadism (depressed mood, reduced energy, difficulty concentrating).

Positron emission tomography (PET) has shown hypothalamic activation in spontaneous migraine attacks which persists after headache relief by sumatriptan.^5,6 Attention has focused on the function of the hypothalamus in circadian rhythms, pain control coordinating the activity of the sympathetic and parasympathetic nervous systems, and in maintaining homeostasis.^1,5,7 In addition, the hypothalamus is integrally involved with the body’s responses to stress. ⁷ The hypothalamus secretes gonadotropin-releasing hormone (GnRH) which stimulates the anterior pituitary gland to release luteinizing hormone (LH) from the gonadotrophs.⁸ The receptors for LH are located on Leydig cells in the testis which synthesize testosterone following LH stimulation. ⁸ depicts the hypothalamic regulation of testosterone.

Open in a separate window

Hypothalamic regulation of testosterone.

There are no reports known to the authors on the effect that chronic migraine may have on testosterone levels in men. We investigated whether men with chronic migraine have lower than expected total serum testosterone levels. In this prospective pilot study, we present our findings pertaining to the interaction between chronic migraine and testosterone levels. We also discuss the impact of chronic migraine on the regulation of the hypothalamo-pituitarygonadal axis.

Patient population

Under an institutional review board (IRB) approved protocol, we prospectively identified 14 men who fulfilled the ICHD- 3b criteria for chronic migraine without opioid or barbiturate overuse at our Institution. These patients were evaluated by a neurologist at our Institution’s outpatient clinic in a metropolitan community. All men obtained serum total testosterone levels. These values were compared to the local laboratory normal values and to published agematched controls.⁹

Statistical analysis

Data are presented in listings and summarized as either mean (SD) or median (interquartile range: 25^th %-tile & 75^th %- tile). To test whether the testosterone distribution amongst those men with migraines differed from a control population distribution, the median testosterone from a published age-specific control population was matched to the age-specific testosterone level for the 14 migraine subjects.⁹ To assess whether these age-matched groups differed, Wilcoxon Signed Rank test was used to test for the testosterone distribution difference. An a-priori two-sided significance level of 5% was used to interrogate any observed difference.

A total of 14 men fulfilled the criteria for inclusion. The mean age was 36.1 years (range: 26-51 years). The local laboratory normal range for total testosterone was 300-1080 ng/dL. illustrates the total testosterone levels of migraine patients compared to published age-matched controls. The mean total testosterone level in the 14 patients with chronic migraine was 322 ng/dL (range: 120-542 ng/dL).

Table 1.

Total testosterone levels of migraine patients compared to published age-matched controls.

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Normal Testosterone Range (Local Reference Lab): 300-1080 ng/dL. ^*See Kelsey et al. 2014.⁹

For published age-matched controls, the mean total testosterone level was 384 ng/dL (SD=10.3). Six males (43%) had testosterone levels below the minimum of the normal local laboratory range. Men with chronic migraine had lower total testosterone levels compared to published agematched controls by a median difference of 62.0 ng/dL (interquartile range of 0.34 to 130). The Wilcoxon Signed rank statistic revealed a statistically significant difference between the two distributions (P=0.0494).

In our pilot study, men with chronic migraine had statistically significant lower total testosterone levels compared to an age-matched normative population, suggesting that hypothalamic regulation is altered in patients with chronic migraine. We propose that the suppression of the hypothalamic pituitary axis as a result of chronic migraine inhibits the release of GnRH resulting in secondary hypogonadism. A host of studies have investigated the pathophysiology of the hypothalamus in both cluster headache¹⁰ and chronic migraine,^1,5-7,11 however, a paucity of studies have explored the interaction between testosterone levels and chronic migraine, tension type headache (TTH), and cluster headache. ^12,13 It has been suggested that both male and female sex hormones could influence the course of primary headaches, specifically, tension-type headache, migraine, and cluster headache.¹⁴ Romiti and colleagues studied plasma testosterone levels in cluster headache and non-cluster headache controls.¹³ Plasma testosterone levels were significantly lower during the cluster attack and were within the reference limits in the remission period of episodic cluster headache.¹³ These authors suggest that a decrease of plasma testosterone levels in episodic cluster headache should be considered in relation to disordered rapid eye movement (REM) sleep in cluster headache.

The present study and that of Romiti et al. highlighted testosterone levels in migraine and cluster headache, respectively.¹³ Both studies reported that testosterone levels were significantly lower in the headache disorder group compared to controls. We demonstrated that men with chronic migraine had lower total testosterone levels compared to their agematched control by a median difference of 62 ng/dL (interquartile range of 0. 34 to 130). In addition, there was a statistically significant difference between the two distributions (P=0.0494). Six males (43%) had testosterone levels below the minimum of the normal local laboratory range. Of note, the mean total testosterone level in our 14 patients with chronic migraine was 322 ng/dL which is in the lower 5% of the reference range for our laboratory (300-1080 ng/dL). This finding supports that testosterone levels are very low in migraine patients. Abnormality of the hypothalamuspituitary- gonadal axis is believed to be involved in the pathogenesis of migraine.¹⁵ In Li and colleagues’ study of the levels of HPG axis hormones serum FSH, LH, estradiol, progesterone, testosterone, prolactin, and GnRH, they reported that these hormones were abnormal in migraineurs and were associated with migraine-related clinical characteristics.¹⁵

Hypogonadism refers to “a clinical syndrome that results from failure of the testis to produce physiological levels of testosterone (androgen deficiency) and a normal number of spermatozoa due to disruption of one or more levels of the hypothalamicpituitary- testicular axis”. ¹⁶ Hypogonadal symptoms include diminished libido, fatigue, poor concentration, erectile dysfunction, and depressed mood in the setting of low serum testosterone levels.¹⁷ Many men with chronic migraine exhibit symptoms that are frequently seen with hypogonadism, specifically, depressed mood, reduced energy, and difficulty concentrating. Testosterone supplementation has been shown to be beneficial in improving both hypogonadal symptoms and serum total testosterone levels.^16,17 Testosterone therapy in hypogonadal men has been shown to be highly effective and safe for improving lower urinary tract symtpoms, cardiometabolic risk, and major adverse cardiovascular events¹⁸ as well as urinary and sexual function and quality of life.¹⁹ Testosterone serves as a neuroprotective agent,²⁰ suggesting a valuable role in the treatment of chronic migraine. Continuous testosterone has also been reported as beneficial in reducing the severity of migraines in both pre- and post-menopausal women. ²¹ These studies demonstrate that testosterone effectively treats migraine headaches in both men and women and that low testosterone is likely causal and not the result of migraines.

The strength of the present study is the prospective evaluation of the possible role of testosterone in migraine headaches as it is far less studied than estrogen/progesterone. Our study is limited by its small sample size. Prospective, randomized studies with a larger sample size are warranted to permit generalizability of our results.

In this pilot study, men with chronic migraine had statistically significant lower total testosterone levels compared to an age-matched normative population. Further investigation is necessary to determine whether testosterone supplementation in men with chronic migraine reduces either the number of headache days per month or the accompanying symptoms of hypogonadism.

The authors acknowledge Norton Healthcare for their continued support. They also acknowledge Douglas John Lorenz, Ph. D., Andrew J. Shearer, B.S., and Lauren A. Shelton, for their contributions to this work (data management and data checks for quality).

Funding: none.

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Low T Can Cause Chronic Headaches

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Posted: March 9, 2023

Headaches can be a major hassle, affecting your ability to live a normal life. While an occasional headache is pretty normal, many people suffer from chronic and severe types of headaches like migraines and cluster headaches. Men with low T may be more susceptible to headaches and chronic headache conditions because of their hormone levels. Recent research into the link between testosterone and headaches has found connections that show men with low testosterone may have a higher risk for headaches. We’ll discuss the evidence in this article. If you’re suffering from chronic headaches and low T symptoms, know that treatment is available to help relieve your symptoms.

Make an appointment at one of our convenient locations today to learn if you have low testosterone and to get treatment customized to your lifestyle.

Low T Might Trigger Headaches

Low T may increase your risk for some types of chronic headaches like cluster headaches and migraines.

Medical experts have long recognized there may be a connection between hormones and headaches. Since they’re both linked pretty closely to the brain, it makes sense that hormones might trigger headaches. Many women, for example, experience more frequent headaches based on hormone changes during their menstrual cycle. Additionally, chronic headaches are more common in women, leading many to believe they may be closely linked with sex hormones, since women have less testosterone than men.

However, the research into men’s hormones and headaches has been pretty scarce until recently. Recent studies do show a link between testosterone and headaches. Men who experience chronic headaches like migraines and cluster headaches are more likely to suffer from low testosterone. This may mean that low T can lead to headaches or make you more susceptible to chronic headache issues. Two studies from recent years explore the connection between testosterone and headaches and show an interesting relationship between the two.

Low Testosterone Linked to Chronic Migraines in a 2019 Study

One small study looked at men with chronic migraines to determine if they were more likely to suffer from low testosterone. In the study, the researchers looked at testosterone levels in migraine sufferers. They also compared these to a control group that did not suffer from chronic migraine.

The migraine group had significantly lower testosterone levels. The range was anywhere between 120 ng/dL to 542 ng/dL, with the average being 322 ng/dL of testosterone in the blood. Low testosterone is generally defined as blood testosterone levels below 300 ng/dL. So, the men with chronic migraine were on the lower end of the spectrum for testosterone levels. On average, the non-migraine group had an average of 62 ng/dL more testosterone in their blood compared to the migraine group. The researchers concluded that men with low testosterone were more likely to suffer from chronic migraine and called for more research into the subject as well as whether testosterone medications would reduce migraine frequency or severity.

What are Migraines?

Migraines are extreme headaches that can last several hours or even days at a time. They often come with other symptoms, like:

• Light sensitivity
• Sound sensitivity
• Nausea
• Vomiting

People with migraines may suffer from severe pain in the head, neck, or even shoulders. Many also experience vision changes, also known as aura, such as seeing flashes of light or shapes. Some even experience blurred vision during migraine attacks.

Chronic migraines are migraines that occur frequently over a long period of time and they affect about 14% of the American population. About 9% of men suffer from chronic migraines. Chronic migraines are defined as having 15 or more headache days per month with at least eight days showing migraine symptoms over the course of three or more months.

Migraines are a serious issue. In fact, they are the third most common cause of disability among people under 50 years old. Researchers are still studying the causes of migraines, but the evidence from the 2019 study suggests you might be more likely to get chronic migraines if you have low T.

Low T Symptoms Linked to Men with Migraines and Cluster Headaches in a 2021 Study

Another recent study shows a connection between low T symptoms and both migraines and cluster headaches. This study from 2021 assessed testosterone in men who suffered from either chronic migraines or cluster headaches. To determine if they had low testosterone levels, they asked the participants to answer questionnaires about common symptoms associated with low testosterone. They also had a control group who didn’t experience headaches or migraines.

The study found that men who suffered from a headache disorder were more likely to report symptoms consistent with a low testosterone diagnosis compared to the non-headache group. Also, the men who reported more symptoms associated with low T also tended to have worse headache issues, such as more frequent headaches or migraines. Therefore, low testosterone may make you more prone to migraines and cluster headaches and it might also make them more severe.

What Are Cluster Headaches?

Cluster headaches are a type of headache that is more common in men, with some estimating twice the number of men experience these headaches than women. These headaches tend to focus on one eye or one side of the head and last for anywhere from one to three hours. They also happen in clusters, usually once per day for several weeks before a period of days with no headaches.

Because they’re more common in men, many have theorized that they are linked to testosterone levels. Another thing to note is that they typically start around age 30, which is also when testosterone levels naturally start to decline. This plus the above study suggest that cluster headaches may be a side effect of low testosterone levels.

Why Testosterone Might Reduce Your Risk for Headaches

There are many theories on why healthy testosterone levels are associated with a lower risk for headaches. Here are a few ways that testosterone might reduce the risk for headaches and migraines:

• It may prevent cortical spreading depression (CSD), which is basically a wave of disruptions in the electrical activity in your brain, which is commonly associated with migraines and migraine aura.
• Testosterone may increase serotonin. Low serotonin and fluctuating serotonin levels in the brain is linked with migraines and headaches.
• It may help widen blood vessels in the brain to prevent pain from extra pressure on narrow vessels that can lead to headaches.
• Testosterone may reduce swelling and inflammation in the brain, which can lead to headaches and other symptoms.

Testosterone Replacement Therapy May Improve Chronic Headache Symptoms

Since low T may lead to headaches and migraines, increasing testosterone levels in your body may prevent these issues. Some studies have found that men taking testosterone replacement therapy experienced relief from headache symptoms, including less severe headaches and less frequent headaches. Treatment can also help with other low testosterone symptoms like low sex drive and fatigue. So, if you might be suffering from low testosterone, talk to our providers about treatment options.

Signs to Talk to Our Providers About Low T

There are many signs that you might be suffering from low T. Here are some common symptoms to watch out for:

• Fatigue
• Low sex drive
• Erectile dysfunction
• Weight gain
• Muscle loss
• Difficulty concentrating
• Depression
• Anxiety

If you notice these symptoms, talk to our providers about whether you have low testosterone and what treatment options are available.

Convenient Treatment Solutions from Low T Center

Our team at Low T Center is here to provide you with total solutions for your health. We offer easy, convenient care for low T, all under one roof. Visit our locations for simple diagnosis and customized treatment to boost your testosterone levels and start feeling great again. We offer both in-office and at-home treatment options to suit your lifestyle. Make your appointment today to take the first step toward better health!

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Disclaimer: This article is made available for general, entertainment and educational purposes only. The opinions expressed herein do not necessarily reflect those of Low T Center. You should always seek the advice of a licensed healthcare professional.

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Testosterone in women and men, the rules for preparing for the test, decoding the results and indicators of the norm.

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Testosterone: indications for the appointment, rules for preparing for the test, interpretation of the results and indicators of the norm.

Indications for study appointment

Testosterone is the main male sex hormone that determines the development of secondary sexual characteristics, puberty and normal sexual function in men. In the body of women is present, but in much lower concentrations. It is produced in the adrenal cortex, in the testicles in men and in the ovaries in women.

The main functions of testosterone include the activation of potency and libido – sexual desire, control of sperm synthesis and maintenance of their viability, activation of metabolic processes, maintenance of optimal bone density, stimulation of muscle growth.

Indications for the appointment of an analysis in men and women may be infertility, adrenal tumors, hormone therapy control (glucocorticosteroids and androgen-containing drugs), as well as baldness and some skin diseases (acne, oily seborrhea).

Testosterone is most often examined in men with impaired potency, decreased libido, male menopause, suspected hypogonadism – a decrease in testosterone production.

Determination of testosterone in women is performed for various menstrual disorders (in combination with studies of other sex hormones), miscarriage, various gynecological diseases (uterine fibroids, endometriosis, hypoplasia (underdevelopment) of the uterus, polycystic ovaries, as well as neoplasms and hypoplasia mammary glands), with hirsutism (increased male pattern hair growth).

Preparation for procedure

Like any planned study, testosterone blood testing should be carried out outside of acute viral and bacterial diseases, no earlier than two weeks after recovery.

Some medications may interfere with test results; it is necessary to discuss with the attending physician the list of drugs used, it is possible to cancel some of them in agreement with the doctor.

Blood sampling should be carried out in the morning on an empty stomach, after 8-14 hours of overnight fasting. Drinking water is allowed. On the eve of the study, it is recommended to exclude significant physical and emotional stress and alcohol intake. It is not recommended to smoke at least one hour before the study.

For women, testing is usually performed 2-4 days after the onset of menstruation, unless other conditions are recommended by the attending physician.

Testosterone

Testosterone is the main androgenic hormone. The test is used in the diagnosis of disorders of sexual development and hypogonadism in men; cycle disorders, infertility, virili…

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Deadline

The analysis is performed within one working day, excluding the day of biomaterial sampling.

What can affect the results

Taking certain medications – glucocorticosteroids and other hormonal drugs, in particular, contraceptives – oral contraceptives in women, as well as the use of anticancer drugs – some cytostatics and hormonal drugs, etc.

You can take a blood test for testosterone at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the “Addresses” section.

Interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.

Normal

Floor	Age	Testosterone level, nmol/l
Female	4 days – 9 years	< 2.15
	9 – 13 years old	< 0.98
	13 – 15 years old	0.36 – 1.54
	15 – 18 years old	0.49 – 1.70
	18 – 50 years old	0. 52-1.72 Pregnancy: up to 3-4 times higher than non-pregnant values.
	Over 50 years old	0.46 – 1.18
Male	4 days – 6 months	0.30 – 10.36
	6 months – 9 years	< 1.24
	9 – 11 years old	< 0.81
	11 – 14 years old	< 15.41
	14 – 16 years old	1.25 – 21.92
	16 – 18 years old	5.13 – 27.53
	18 – 50 years old	8.9 – 42.0 Lower diagnostic threshold recommended by ISSAM: 12 nmol/l
	Over 50 years old	8. 6 – 23.4

There are various methods for testing testosterone. Currently, they are not standardized enough, so the results of the analysis taken from the same person may differ when determined in different laboratories. When using most methods in men aged 18 to 50 years, total testosterone values ​​\u200b\u200bmore than 12 nmol / l are normal, values ​​\u200b\u200bbelow 8 nmol / l indicate deficiency, and intermediate values ​​\u200b\u200bin the range of 8-12 nmol / l may require additional research, e.g. free testosterone, sex hormone-binding globulin (SHBG), etc.

Free Testosterone

Synonyms: Blood test for free testosterone; Testosterone free; Testosterone direct. Testosterone Free, Testosterone Direct, Unbound Testosterone.
Brief description define…

Up to 4 business days

Available with home visit

RUB 1,460

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Sex hormone-binding globulin (SHBG)

Synonyms: Blood test for SHBG; Sex steroid-binding globulin; SSSG; Testosterone-estradiol-binding globulin.
Sex Hormone Binding Globulin; SHBG; Testosterone-estradiol-binding globulin.
Red…

Up to 1 business day

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715 RUB

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Explanation of indicators

In women, the concentration of testosterone depends on the phase of the menstrual cycle, reaching a maximum in the second phase (from 14 days after the onset of menstruation with a 28-day menstrual cycle). Testosterone rises significantly in the third trimester of pregnancy.

The level of testosterone also depends on the time of day: in the morning its concentration is maximum, and in the evening – minimum.

What do low readings mean

A decrease in testosterone is detected when there is a violation of the production of gonadotropic hormones of the pituitary gland, which regulate the work of the sex glands (secondary hypogonadism), with a decrease in testosterone production in the adrenal glands, in the sex glands – testicles, ovaries (primary hypogonadism).

Often detected in obese men.

Dietary habits such as eating too many sweets, vegetarianism, fasting, low-fat diets in women, and alcohol abuse can lead to lower testosterone levels.

Occurs with certain drugs ( see above ).

What do high rates mean

An increase in testosterone occurs in Itsenko-Cushing’s disease and syndrome – a severe endocrine disease that develops as a result of increased production of adrenocorticotropic hormone by the pituitary gland (disease) or cortisol by the adrenal glands (syndrome). The condition is manifested by a certain type of obesity, thinning of the skin with the formation of stretch marks (stretch marks), muscle weakness due to atrophy of muscle tissue, increased blood pressure, decreased calcium levels in the bones (osteoporosis), and the formation of kidney stones. An increase in testosterone levels in this case is only one of the abnormalities detected in the analyzes.

Adrenogenital syndrome in women is a hereditary disease associated with insufficient production of glucocorticosteroid hormones and increased production of testosterone by the adrenal glands. It is manifested by cessation of growth after 12 years, abnormal development of the genital organs, development of the “male type” – virilization: male physique, rough voice, hirsutism, as well as menstrual irregularities, infertility.

Testicular tumors in men and ovarian tumors in women are a possible cause of testosterone elevation.

Occurs with excessive physical exertion, taking certain medications ( see above ).

Additional examination in case of deviation of the indicator from the norm

Usually, other hormones are determined along with testosterone to make an accurate diagnosis:
Synonyms: Blood test for FSH; Follitropin. Follicle-Stimulating Hormone; follitropin; FSH.

Brief description of the analyte Follicle-stimulating hormone

…

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715 RUB

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Luteinizing hormone (LH, Luteinizing Hormone, LH)

Synonyms: Glycoprotein gonadotropic hormone; luteotropin; Lutropin. luteinizing hormone; LH; Lutropin; Interstitial cell stimulating hormone; ICSH.

Brief characteristic determined …

Up to 1 business day

Available with home visit

715 RUB

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Prolactin (+ additional macroprolactin test if prolactin result is above 700 mU/l)

Synonyms: Prolactin blood test; Lactotropic hormone; lactogenic hormone; Mammotropin; mammotropic hormone. lactotropin; PRL; luteotropic hormone; LTH.
Brief description …

Up to 1 business day

Available with home visit

715 RUB

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ACTH (Adrenocorticotropic hormone, corticotropin, Adrenocorticotropic Hormone, ACTH)

Adrenocorticotropic hormone is a pituitary hormone that regulates the production of glucocorticoids in the adrenal cortex.

Synonyms: Blood test for ACTH; Address…

Up to 1 business day

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RUB 1,125

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Cortisol (Hydrocortisone, Cortisol)

Synonyms: Blood test for cortisol. hydrocortisone; Compound F.
Brief characteristics of the analyte Cortisol
Cortisol is a steroid hormone, the main rep…

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In addition, instrumental examination methods can be prescribed, in particular, transrectal ultrasound (TRUS) of the prostate gland, scrotal organs for visualizing the testicles in men, ultrasound (ultrasound) of the pelvic organs for visualizing the uterus and ovaries in women, as well as magnetic resonance tomography (MRI) of the brain with intravenous contrast to visualize the pituitary gland. Ultrasound, MRI or multislice computed tomography (MSCT) with intravenous contrast, scintigraphy allow to assess the structure of the adrenal glands.

US examination of pelvic organs (uterus, adnexa)

Ultrasound scanning of the organs of the female reproductive system to assess the shape and size, as well as exclude pathology.

RUB 2,590

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MRI of the brain

Safe and informative scanning of brain structures for the diagnosis of its pathologies.

RUB 5,640

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Sources:

1. Protocol rules. Progesterone preparations in clinical guidelines / L.I. Maltseva, Yu.A. Bril; ed. V.E. Radzinsky. M.: Editorial staff of Status Praesens, 2018. 20 p.
2. Radzinsky V.E., Khamoshina M.B., Tulupova M.S. , Damirova K.F., Ramazanova F.U., Kaushanskaya L.V. Progesterone: controversial issues of therapy and prevention of miscarriage and prematurity. Journal for the continuing medical education of physicians. Vol.7, No. 3, 2019. Application. pp. 74-78.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Testosterone

Testosterone is a steroid hormone from the androgen group, responsible for the formation of secondary sexual characteristics and sexual function.

Synonyms Russian

Total testosterone, steroid androgenic hormone.

Synonyms English

Testosterone, total testosterone.

Test method

Electrochemiluminescent immunoassay (ECLIA).

Detection range: 0.087 – 520 nmol/L.

Units

Nmol/l (nanomoles per liter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

• Do not eat for 2-3 hours before the test, you can drink pure non-carbonated water.
• Exclude the intake of steroid and thyroid hormones 2 days before the study (as agreed with the doctor).
• Unless otherwise instructed by a doctor, it is recommended to donate blood for analysis before 11 am.
• Exclude physical and emotional overstrain during the day before the study.
• Do not smoke 3 hours before the study.

General information about the study

Testosterone is a steroid hormone (androgen) that is produced by the Leydig cells of the endocrine tissue of the male testes. Its synthesis is stimulated and controlled by luteinizing hormone (LH) produced by the pituitary gland. Testosterone functions on the principle of negative feedback: as testosterone increases, the concentration of luteinizing hormone decreases, while an increase in luteinizing hormone levels decreases testosterone.

Testosterone levels fluctuate throughout the day, peaking in the morning (between 4 and 8 am) and reaching their lowest levels in the evening (between 4 and 8 pm). In addition, its concentration increases after exercise and decreases with age.

Almost two-thirds of the testosterone circulating in the bloodstream is associated with a protein that binds to sex hormones, while slightly less than a third – with albumin. There is very little free testosterone, about 1-4%.

Testosterone promotes the development of secondary sexual characteristics such as penis enlargement, body hair growth, muscle development and a deep voice. It is produced in large quantities in adolescents during puberty, and in adult men it regulates sexual instincts and the maintenance of muscle mass.

In men, testosterone is produced by the adrenal glands, in women by the adrenal glands and, to a lesser extent, by the ovaries .

What is research used for?

For the diagnosis of the following anomalies:

• delayed or premature puberty in boys,
• decreased sex drive in men and women,
• male erectile dysfunction,
• male and female infertility,
• testicular tumor,
• diseases of the hypothalamus or pituitary gland.

When is the test scheduled?

• With delayed sexual development of boys. Typically, puberty occurs at age 10, with hormonal and physical changes taking place. Slow development of muscle mass, lack of a deep voice and body hair, slow growth of the testicles and penis indicate a delay in sexual development. Its cause is that the testicles do not produce enough testosterone, or that the pituitary gland does not synthesize the required amount of luteinizing hormone. The analysis can also be performed if the boy has precocious puberty with pronounced secondary sexual characteristics – the cause may be an increased level of testosterone due to various tumors and congenital adrenal hyperplasia.
• Suspected infertility, decreased sex drive, or erectile dysfunction in adult men may all be due to low testosterone production.
• In violation of the regularity of menstruation, with problems with the onset of pregnancy or with masculine signs in women. Their testosterone levels may increase due to tumors of the ovaries or adrenal glands, or due to other diseases, such as polycystic ovary syndrome.

What do the results mean?

Reference values ​​

Tanner stages for adolescents (10-18 years) ^*

^* Puberty is determined on a scale developed by John Tanner by examining a teenager and assessing his physical condition (development of the genitals and mammary glands, degree of hairiness).

Normal testosterone levels in men vary by stage of puberty and age, with the older a man gets, the lower his testosterone levels.

Low testosterone levels in men can be caused by:

• disease of the hypothalamus or pituitary gland,
• genetic disease at a young age (Klinefelter syndrome, Kallman syndrome, Prader-Willi syndrome) or testicular underdevelopment with infertility (eg, myotonic dystrophy),
• damage to the testicles.

Causes of increased testosterone production in men:

• testicular tumor,
• adrenal tumor,
• use of androgens (anabolic steroids),
• early puberty,
• hyperthyroidism (increased activity of the thyroid gland and its increase),
• congenital hyperplasia.

In women, testosterone levels are usually low, but may be elevated in:

• polycystic ovary syndrome,
• ovarian or adrenal tumors,
• congenital hyperplasia of the adrenal cortex.

Important Notes

• Alcoholism and liver disease lower testosterone levels, while androgens and steroids increase them.
• Prostate cancer responds to androgens, so patients in the later stages are prescribed drugs that reduce testosterone levels.
• Anticonvulsants, barbiturates and clomiphene may increase testosterone levels.
• Estrogen intake increases testosterone levels in women.