Amos Grunebaum, MD
Evidence Matters
Men's Health Screener

Does He Have
Low Testosterone?

Testosterone naturally declines about 1–2% per year after age 30. But real hypogonadism — low T that needs treatment — is far less common than the supplement industry wants you to believe. This screener separates the signal from the noise.
2–4%Of men have true hypogonadism
1–2%Annual T decline after age 30
~10 minTo complete this screener
Question 1 0%
This screener is written for partners, family members, and anyone asking about a man in their life. You are answering based on what you have observed. Results will help guide a conversation with his doctor — not replace one.

What You Are About To Learn

Answer questions about his symptoms, age, and health history. You will get a clear assessment of whether his symptoms are consistent with low testosterone — and crucially, what else could be causing them.

40%
Of men over 45 have low T by lab values alone
But most have no symptoms requiring treatment
$2B+
Low T supplement and therapy market annually
Most men treated do not meet clinical criteria
3+
Blood tests needed to confirm true low T
One low result is never enough — T varies daily
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Symptom Burden Score

⚠️ Symptoms Identified

    🔬 What the Numbers Actually Mean

    These are the reference values a doctor should use. A single low result is never enough — testosterone must be measured on at least two separate mornings (ideally before 10 AM) to confirm true hypogonadism.

    TestWhat It MeasuresNormal RangeClinical Significance
    Total TestosteroneAll testosterone in blood — both bound and free300–1000 ng/dLBelow 300 on two morning tests = possible hypogonadism. One low value is not diagnostic.
    Free TestosteroneTestosterone not bound to proteins — the biologically active fraction>65 pg/mL (age-dependent)More clinically meaningful in men with symptoms but borderline total T. SHBG affects this value.
    SHBGSex hormone binding globulin — binds T and makes it inactive10–57 nmol/LHigh SHBG lowers free T even when total T is normal. Important in older men and in obesity.
    LHLuteinizing hormone — the pituitary signal that tells testicles to make T1.7–8.6 IU/LHigh LH + low T = primary hypogonadism (testicular failure). Low LH + low T = secondary (pituitary/brain problem).
    FSHFollicle stimulating hormone — regulates sperm production1.5–12.4 IU/LElevated FSH with low T indicates testicular failure. Critical if fertility is a concern.
    ProlactinHormone produced by pituitary — suppresses LH/FSH when elevated<15 ng/mLElevated prolactin is a treatable cause of secondary hypogonadism. Often caused by a benign pituitary tumor.
    Morning drawTime of blood draw matters — T peaks in early morningBefore 10 AMAfternoon draws can show values 20–35% lower than morning — leading to false low results.

    📚 What Else Could Explain His Symptoms?

    Know His Numbers

    • <300 ng/dLTotal testosterone threshold for possible hypogonadism — must be confirmed on two separate morning draws
    • 2 testsMinimum number of morning testosterone tests needed before any treatment decision
    • Before 10 AMBlood must be drawn in the morning — afternoon draws can be 20–35% lower and lead to false diagnoses
    • 1–2% / yrNormal testosterone decline with age — not a disease, not always requiring treatment
    • 2–4%Prevalence of true hypogonadism in adult men — far rarer than the marketing suggests
    🔬
    If You Are Also Trying to Conceive
    Low testosterone can affect sperm production — and testosterone therapy makes it significantly worse. If fertility is a goal, his evaluation must include a semen analysis. Male factor contributes to 50% of all infertility. Use our Male Fertility Screener to assess his fertility risk alongside this evaluation.

    ✅ What To Do Next

      Clinical Summary — Amos Grunebaum, MD

      Differential Diagnosis — Consider

      Suggested Workup

        Important: This screener is an educational tool, not a medical diagnosis. Results are based on observations reported by a partner or family member. Only a clinician can evaluate testosterone deficiency — this requires a history, physical examination, and confirmed laboratory testing on at least two separate morning draws. If testosterone therapy has been recommended based on a single test, a second opinion is reasonable.

        Tool developed by Amos Grunebaum, MD — Professor of Obstetrics & Gynecology. Evidence-based content from ObGyn Intelligence (obmd.com). No data is stored or transmitted.