The Total Testosterone blood test measures the total amount of testosterone circulating in your bloodstream. Testosterone is a key androgen (often called a “male hormone,” though it is important in all sexes) that supports sexual development, libido, erectile function, sperm production, muscle mass, bone strength, mood, and energy levels.

“Total” testosterone includes testosterone that is bound to proteins (mainly sex hormone–binding globulin, SHBG, and albumin) plus a smaller portion that is unbound (free). Because most testosterone travels attached to proteins, the total testosterone value is often a good first-line screening test. However, if protein binding is abnormal (for example, high or low SHBG), your clinician may also order free testosterone, bioavailable testosterone, and/or SHBG to better interpret results.

Results are typically reported in ng/dL (or nmol/L). A “normal” range varies by laboratory, age, sex at birth, time of day, and medical context. In general:

Low total testosterone may suggest reduced testosterone production by the testes/ovaries or dysregulation of hormone signaling from the brain (pituitary/hypothalamus). It can be associated with low sex drive, infertility, decreased morning erections, erectile dysfunction, fatigue, depressed mood, loss of muscle, and reduced bone density.

High total testosterone may suggest excess androgen production (from ovaries, testes, or adrenal glands) or external exposure (testosterone therapy or anabolic steroids). In some people it is linked with acne, increased body/facial hair (hirsutism), scalp hair thinning, irregular periods, or changes in mood.

Because testosterone naturally fluctuates, many clinicians prefer measuring it in the morning (often between ~7–10 a.m., especially in younger men) and may repeat the test to confirm abnormal results. Your provider will interpret your number alongside symptoms, exam findings, and other labs (such as LH, FSH, prolactin, estradiol, SHBG, and thyroid tests when appropriate).

A Total Testosterone test is commonly ordered when symptoms or clinical findings suggest an imbalance in androgens. It can help evaluate both low and high testosterone states and guide further testing or treatment decisions.

Your clinician may order this test to evaluate:

In men (or people with testes):

Symptoms of possible low testosterone (hypogonadism), such as reduced libido, fewer morning erections, erectile dysfunction, infertility, low sperm count, fatigue, decreased muscle mass/strength, increased body fat, depressed mood, or low bone density/osteoporosis.

Delayed puberty or poor development of secondary sex characteristics.

Monitoring safety and effectiveness of testosterone replacement therapy (TRT) or evaluation of possible anabolic steroid use.

In women (or people with ovaries):

Symptoms of excess androgens such as hirsutism (excess facial/body hair), persistent acne, scalp hair thinning, irregular or absent menstrual cycles, or signs of virilization (deepening voice, clitoromegaly—rare but important to assess).

Evaluation for common causes of androgen excess such as polycystic ovary syndrome (PCOS) and, less commonly, adrenal or ovarian tumors.

In children/adolescents:

Evaluation of early puberty (precocious puberty) or delayed puberty, depending on age and clinical context.

Risk factors and related reasons it may be checked:

History of pituitary disease, head trauma, radiation, chemotherapy, testicular injury/infection, genetic conditions affecting gonadal function, chronic opioid or glucocorticoid use, significant obesity, uncontrolled diabetes, or chronic illness that may affect hormone production.

• Male hypogonadism (primary or secondary low testosterone)
• Erectile dysfunction related to hormonal imbalance
• Infertility (male factor infertility and ovulatory dysfunction when androgen excess is present)
• Polycystic ovary syndrome (PCOS)
• Hirsutism and androgen-related acne
• Testicular disorders (e.g., orchitis, trauma, testicular failure)
• Pituitary or hypothalamic disorders (e.g., pituitary adenoma, hyperprolactinemia)
• Adrenal disorders causing androgen excess (e.g., congenital adrenal hyperplasia)
• Androgen-secreting ovarian or adrenal tumors (less common but important)
• Osteoporosis/low bone density associated with low testosterone

• Supporting sexual health goals (improving libido and evaluating causes of erectile dysfunction)
• Assessing energy, mood, and overall vitality when symptoms suggest hormone imbalance
• Optimizing fertility planning and reproductive hormone health
• Monitoring testosterone therapy (TRT) effectiveness and safety under medical supervision
• Managing unwanted hair growth or acne by identifying possible androgen excess
• Protecting bone health by evaluating hormonal contributors to low bone density
• Guiding broader endocrine evaluation when symptoms suggest pituitary, ovarian, testicular, or adrenal hormone issues