Sex Hormone Test

A sex hormone test is carried out to diagnose various conditions and disorders that are related to the reproductive system of the body in both men and women. The test is advised in the following conditions:

• Infertility
• Impotency
• Frequent miscarriages or abortions
• Complete absence or irregular monthly periods
• Hirsutism or abnormal hair growth on the face, neck, etc. in women
• Abnormal growth of breasts or gynecomastia in men
• Hypogonadism or lack of development of sexual organs
• Ovarian cancer
• In vitro fertilisation monitoring
• Hormonal disorders related to the pituitary gland 

No special preparations are needed for this test. 

• Fasting is not essential for a sex hormone test
• Tests involving radioactive substances performed within 1 week of the test (progesterone) can give false results; hence, the sex hormone test should be avoided in such scenarios
• However, the person undergoing a sex hormone test should inform their doctor about medicines that he/she is taking regularly. These include steroids, antiepilepsy medicines, antidepressants, hormonal drugs (oral contraceptives, oestrogen therapy and progesterone therapy), blood-thinning medicines (aspirin), anticancer drugs, antibiotics or antifungal drugs

These medicines should not be taken for two days before the test.

• For a progesterone test, the patient should provide correct information regarding the gestation period of pregnancy or the duration of pregnancy and date of the last monthly cycle
•  An individual undergoing a sex hormone test should also provide appropriate information to their doctor about his or her alcohol intake

Special instructions to the person who is undergoing a sex hormone test include the following:

• A 24-hour urine sample is used for measuring the levels of oestrogen in the form of estradiol. For this test, the patient would be given a container in which they’ll have to collect a urine sample every time they pass urine, for 24 hours
• The patient should be instructed to keep the collected urine from impurities, such as tissue paper
• A blood sample for the sex hormone test is drawn from a vein in the arm of the patient
• For a testosterone test (free and total), blood should be collected at 7 am when the level of testosterone hormone is high

Normal results

• Total oestrogen in the blood
  • Female, premenopausal: 23-261 picograms per millilitre (pg/mL)
  • Female, postmenopausal: <30 pg/mL
  • Male: <50 pg/mL
• Total oestrogen in the urine​
  • Female, premenopausal: 15-80 micrograms/24 hours
  • Female, postmenopausal: <20 micrograms/24 hours
  • Male: 15-40 micrograms/24 hours 
• Progesterone
  • Female, follicular phase of the menstrual cycle: < 1.0 nanograms per millilitre (ng/mL)
  • Female, luteal phase of the menstrual cycle: 2.0-20.0 ng/mL
  • Female, postmenopausal: ≤1.1 ng/mL
  • Male: 1.2 ng/mL
• Testosterone (free)
  • Male: 9.0-30.0 ng/dL
  • Female: 0.3-1.9 ng/dL
• Testosterone (total)
  • Male: 300-1200 ng/dL
  • Female: 8-60 ng/dL

Abnormal results

High levels of oestrogen are seen in conditions such as tumour in the ovary, premature puberty and Klinefelter’s syndrome. Oestrogen levels are also high during pregnancy and ovulation.

Decreased oestrogen levels are present in conditions such as absence of monthly cycles, heavy exercising, under-developed or complete lack of development of sex organs, abnormality in the functioning of the pituitary gland, ovarian failure, Stein-Leventhal syndrome, Turner’s syndrome and menopause.

Increased levels of progesterone indicate conditions such as tumour of the adrenal gland, tumour in ovaries, abnormal pregnancy (molar pregnancy) and premature puberty.

Decreased progesterone levels signify the risk of miscarriage, lack of development or abnormality in the functioning of sex organs, irregular menstrual periods, Turner’s syndrome and high-risk of miscarriage.

High testosterone levels are observed in conditions, such as adrenal gland tumour, premature puberty, Cushing’s syndrome and testosterone-secreting tumour and different forms of testosterone (androgens) in men.

Decreased testosterone in men indicates delayed puberty, Klinefelter’s syndrome and abnormality in pituitary gland functions.

In women, increased levels of testosterone in blood indicate underdeveloped sex organs, abnormality in the functioning of reproductive organs, Klinefelter’s syndrome, tumour of the adrenal glands, tumour of the ovary and hirsutism.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.