Men’s health tests: testosterone, fertility hormones and PSA

Why men book these tests

MedlinePlus lists the possible signs of low testosterone in adult men as a low sex drive, erection problems, difficulty getting a partner pregnant, enlarged breasts, loss of face or body hair, loss of muscle, and thinning bones or anaemia without a known cause. Many of these have other causes too.

The NHS says a PSA test may be suggested if you are peeing more often, have a sudden urge to pee, get up often in the night to pee, see blood in your pee or have problems getting or keeping an erection.

What each test measures

• Total testosterone measures all the testosterone in your blood. Free testosterone measures the part that is not bound to proteins such as SHBG, which your body can use more easily.
• FSH and LH are pituitary hormones. In men, FSH helps control how much sperm the testicles make. A doctor may use them to look into infertility or a low sperm count.
• PSA (prostate-specific antigen) is a protein made by the prostate. MedlinePlus explains that a high level can come from prostate cancer, but also from an enlarged prostate, an inflamed prostate, a urine infection or some medicines.

The listings differ. The Hormone Profile listing covers testosterone, FSH and LH. The Cancer Screening and Executive Health Package listings include PSA among other tests. Check each listing before you book.

Preparing properly

MedlinePlus says testosterone is usually measured from a sample taken between 7 and 10 in the morning. For PSA, the NHS advises not ejaculating, having anal sex, exercising hard or cycling for 48 hours before, and waiting 4 to 6 weeks after a urine infection has cleared. You can eat and drink as usual for PSA. The male hormone and cancer screening listings say no fasting is needed, while the Executive Health Package listing recommends fasting for 8 to 10 hours.

You can have the sample taken at home if collection is available at your address. The app shows this when you enter it. See what to expect from a home lab test or lab tests at home.

Think before a PSA test

The NHS is clear that a PSA result may not be accurate, and that testing can lead to tests and treatment you do not need. MedlinePlus adds that most prostate cancers grow slowly and may never cause problems, and that a biopsy is the only way to find out if a raised PSA is caused by cancer. A doctor can talk through the benefits and risks with you first.

For any hormone result, a doctor looks at the number alongside your symptoms, age and other tests. A GP can review results with you by video and refer you if needed.

When to get help quickly

Call 998 or go to an emergency department straight away for sudden, severe pain in a testicle, testicle pain with feeling or being sick or tummy pain, or testicle pain that has lasted more than an hour. Sudden severe pain can be caused by a twisted testicle, which needs treatment in hospital as soon as possible.

See a doctor soon for a lump, swelling or change in the shape or feel of a testicle, or for blood in your pee.