Free testosterone is the biologically active fraction of testosterone that is not bound to blood proteins.
- Testosterone has anabolic effects on muscle tissue, supports bone development, regulates sebaceous gland activity, and participates in the synthesis of liver lipoproteins.
- It modulates the synthesis of β-endorphins and insulin.
- In men, testosterone plays a key role in the psychophysiological aspects of the reproductive system, secondary sexual characteristics, libido, spermatogenesis, potency, and sexual behavior.
- In women, testosterone is involved in follicular regression in the ovaries and regulates gonadotropic hormone levels from the pituitary gland.
Why Measure Free Testosterone?
- Free testosterone levels are independent of sex hormone-binding globulin (SHBG).
- Therefore, measuring free testosterone is more informative than total testosterone, especially when SHBG levels are altered.
- The analysis is performed on a blood sample drawn from a vein.
- Stop eating8–14 hours before the test.
- Before the test, avoid:
- Emotional and physical stress
- Alcohol consumption
- Discontinue estrogen and androgen medications48 hours before testing.
- Unless otherwise directed by a doctor, the test should be performed before 11:00 AM.
For Both Men and Women:
- Infertility
- Hair loss
- Acne
- Oily seborrhea
- Aplastic anemia
- Adrenal tumors
- Monitoring during glucocorticoid and androgen therapy
For Women:
- Hirsutism
- Anovulation
- Amenorrhea
- Oligomenorrhea
- Dysfunctional uterine bleeding
- Miscarriages
- Polycystic ovary syndrome (PCOS)
- Androgenital syndrome
- Uterine fibroids
- Endometriosis
- Breast tumors
- Uterine and breast hypoplasia
For Men:
- Erectile dysfunction
- Decreased libido
- Male menopause (andropause)
- Primary and secondary hypogonadism
- Chronic prostatitis
- Osteoporosis
Causes of Increased Free Testosterone Levels
- Cushing's disease and syndrome
- Androgenital syndrome (in women)
- Testosterone-producing testicular tumors
- XYY karyotype (47, XYY syndrome)
- Ovarian tumors
Causes of Decreased Free Testosterone Levels
- Adrenal insufficiency
- Hypogonadism
- Chronic prostatitis
- Obesity
- Genetic disorders of sexual development