HomeAnswersEndocrinologysex driveI have had reduced sexual drive and erection than earlier. What do my reports signify?

Are my low sexual drive and reduced erection because of my high testosterone level?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At August 8, 2022
Reviewed AtDecember 27, 2023

Patient's Query

Hi doctor,

I am around 37 years old and noticed that my sexual drive and erection have reduced. So I consulted a doctor for the same and performed tests, including thyroid, kidney, STI, and testosterone, where my free testosterone came out high. Next, I was referred to a urologist who checked my total testosterone, LH, and prolactin. Total testosterone was high, and the others were within the normal range but on the high side. Kindly help.

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your reports (attachment removed to protect the patient’s identity). All are normal except total testosterone. Have you done LH-FSH (luteinizing hormone- follicular stimulating hormone)? Have you taken any testosterone medication or used any steroids? And what is your height and weight?

Kindly revert in case of further queries.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I have done LH and prolactin; the results are included in the attachment. I do not take any steroids or any Chinese medicines. I will redo the free testosterone test and see what the values are. As you can see from my results, LH and Prolactin are also high but still within the range. So is this something to be concerned about? Kindly help.

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

I checked again but could not find LH (luteinizing hormone), and prolactin results in the attachment (attachment removed to protect the patient’s identity). It depends on how high are LH and prolactin. There is nothing to worry about if they are in the normal range. You can do free testosterone levels and see if that is high. Testosterone exists in three forms in the body, bound to SHBG (sex hormone binding globulin), albumin, and free form. It is the free form that is active.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

The LH and prolactin is on page three of the laboratory report.

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

Sorry, it is not visible. So first, you sent me five attachments, which are not among them, and then you sent total testosterone and PSA (prostate-specific antigen) but not LH (luteinizing hormone) and prolactin. I am sorry, but I cannot see LH and prolactin.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

LH is 7 mIU/ml and prolactin is 12.5 ng/ml. My height is 6 feet, and my weight is 143 lbs.

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

Both LH (luteinizing hormone) and prolactin are in the normal range. Your BMI (body mass index) is also in the normal range. I suggest doing free testosterone. If it is also normal, then nothing to worry about, but if it is high, you may need further testing.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

1. What other things should I test for if free testosterone is high?

2. Will my total and free testosterone possibly be high due to a temporary change, and will they return to normal?

3. Is this something to worry about if free testosterone is high?

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

If free testosterone is high, we need to rule out any testicular or adrenal tumor, as I mentioned. It can be a temporary finding, especially when your testosterone is not very high. To be significantly increased, it should be over 50 percent of normal. So do free testosterone, and if it is significantly high, you may need to do the following:

1. LH (luteinizing hormone), FSH (follicle-stimulating hormone), TSH (thyroid stimulating hormone), DHEAS (dehydroepiandrosterone sulfate), and 17-hydroxy progesterone.

2. Serum electrolytes like sodium, potassium, and chlorine.

3. Aldosterone and renin.

Depending upon these results, you may need a CT (computed tomography) abdomen.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

What should be the ideal range of free testosterone for me?

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

Usually, in a male of your age, it is 4.65 to 18.1 ng/dL, but it also depends upon the laboratory. Every laboratory has its reference ranges. It also depends on which units they use for measurement.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

I retested my total testosterone, which is now in the normal range. Should I still test for free testosterone as well?

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

I think it is normal, and if you do not have any symptoms, there is no need to repeat the test. As a caution, you can recheck the total testosterone after six months.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

To be safe, I also did a free testosterone test. Please see the attached results. Is testosterone possible to swing up and down so much in just two weeks? Do you think my initial report resulted from a hormonal imbalance that has not been corrected?

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome back to icliniq.com.

I understand your concern.

Your testosterone levels are normal from the attached reports (attachments removed to protect the patient's identity). Appropriate preparation and an accredited laboratory are essential in the testing. I always emphasize that the blood sample should be taken in the early morning and at least after six hours of fasting, and test should be done in an accredited laboratory. Some laboratories need to be better to give relevant results.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply,

I had the opportunity to do a blood test again recently and noticed that the thyroid values are a bit low. Is this something to be concerned about? Please see the attached report.

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome back to icliniq.com.

I understand your concern.

From the attached reports (attachments removed to protect the patient's identity), your TSH (thyroid stimulating hormone) is low. If T4 (thyroxine) is low, TSH should be high in primary hypothyroidism; if T4 is high, TSH should be low in primary hyperthyroidism. Still, both are low in your case, so it is either non-significant or the problem is above in the pituitary, which is very rare. So you should repeat the blood test after one month.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply.

I will repeat it after one month and let you know. Could this be related to the previous testosterone results I initially contacted you for? I am unsure if I am overreacting or should just relax, as I am shocked by all these findings as they came by pure chance during routine blood tests.

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome back to icliniq.com.

I understand your concern.

Hormones are interconnected, and one hormone can disturb others as well. But it seems less likely in your case. If you repeat it after four weeks, it should be normal, but we need to do further tests if it persists. Then It might include some scans and other hormonal tests. The tests are quite expensive, and it is not logical to do all those right now. We can wait at least three weeks or so.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply.

As discussed, I have repeated TSH and T3 and T4 thyroid blood tests. I have attached the results.

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

Your tests are in normal range.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply.

Given all our past discussions in this thread, is there anything further I should do now?

Thanks.

Answered by Dr. Zulfiqar Ahmed

Hi,

Welcome back to icliniq.com.

I understand your concern.

There is no need to do anything until you do not have any symptoms. If you have any symptoms, we can discuss them. As a matter of caution, you can repeat total testosterone in six to eight months from the last result and repeat TSH (thyroid stimulating hormone) only then.

I hope this information will help you.

Thank u.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed

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