Reexamining Testosterone’s Function: What Are We Overlooking?

Posted by Brianna Clark, Updated on October 17th, 2023
Reading Time: 4 minutes

Testosterone, the sex hormone primarily associated with male development and sexual characteristics, has long been the subject of scientific research. Although its role in muscle development, libido, and bone health has been widely studied, recent research suggests that testosterone may have a wider range of functions than previously understood. The purpose of this article is to review testosterone function, particularly in the context of testosterone replacement therapy, free testosterone levels, serum testosterone levels, and its occurrence in women. By studying these aspects, we can gain a more comprehensive understanding of the effects of testosterone on human physiology and health.


Male testicles create the majority of the steroid hormone testosterone, with female ovaries and adrenal glands producing a smaller amount. It impacts secondary sex traits, including facial hair, voice deepening, and muscular mass growth, in addition to playing a key part in the development of male sexuality. In addition, red blood cell formation, modulation of sexual desire, and bone density maintenance all require testosterone.

We may not completely comprehend the breadth of testosterone's actions, according to recent studies. To cover the functions of testosterone in the human body, this article will concentrate on TRT, free testosterone levels, serum testosterone levels, and its incidence in females.

Testosterone Replacement Therapy:

Testosterone replacement therapy (TRT) has been widely utilized to treat low testosterone symptoms such as tiredness, decreased libido, and muscular weakness. TRT has traditionally been linked with treating hypogonadism in males, although it has gained appeal for a variety of additional purposes, including addressing age-related testosterone reduction.

Only 2% of the hormone testosterone circulates freely in the blood, with the majority of the hormone being linked to serum proteins. 60% of testosterone is attached to the sex hormone-binding globulin (SHBG), while the remaining 40% is bound to albumin or other proteins. It is believed that bioavailable testosterone, which includes both free and albumin-bound testosterone, represents physiologically active, circulating testosterone in people. Total testosterone (TT), free testosterone (FT), computed free testosterone (CFT), bioavailable testosterone (bT), and the free androgen index are standard biochemical measures used to evaluate androgen deficit. [1]

The application of TRT has been expanded beyond its conventional usage in recent research. TRT is now being researched for its ability to enhance cardiovascular health, cognitive function, and mood. This shows that testosterone has other roles in addition to its known ones.

Free Testosterone Levels:

In the body, testosterone occurs in two forms: bound and free. Free testosterone level is unbound and physiologically active, whereas bound testosterone is associated with proteins such as sex hormone-binding globulin (SHBG). The free testosterone levels are important since they reflect the hormone's bioavailability and capacity to interact with androgen receptors.

According to research, free testosterone levels are more important than total testosterone levels in determining the clinical consequences of testosterone insufficiency. Low free testosterone levels have been linked to a variety of health problems, such as depression, lethargy, and sexual dysfunction. As a result, measuring free testosterone levels can give a more precise view of testosterone's functional role.

Serum Testosterone Levels:

Serum testosterone levels vary greatly from one individual to another. While reference ranges have been established, what defines a "normal" amount might vary greatly from person to person. This variation shows that testosterone's physiological influence is extremely individualized.

Several research studies have been conducted to determine if the dropping T level found in aging men is a normal age-related phenomenon or the result of the aggregation of various chronic medical diseases that almost all aging men face. One tiny research looked at groups of males of various ages who were in "very good or excellent health" to answer this issue.

The researchers discovered no statistically significant variation in serum total testosterone levels across cohorts divided by decade of age. Their results are consistent with the idea that the reduction in serum T associated with male aging is a non-specific consequence of the many co-morbidities that develop with aging. [2]

The majority of elderly males treated in primary care offices are extremely likely to have at least two chronic medical conditions, which makes them different from the research group despite the innovative study's findings. The ability of medical providers to recognize males with low blood testosterone levels who are likely suffering from symptoms of androgen insufficiency alone and would benefit from therapy would be beneficial.

It is critical to comprehend the significance of changes in serum testosterone levels. Individuals with testosterone levels within the standard range may nonetheless have symptoms of testosterone insufficiency or excess, according to emerging data. This calls into doubt the sufficiency of current diagnostic criteria and treatment guidelines.

Testosterone Serum Levels in Females:

However, compared to males, testosterone serum levels in female are much lower. It plays a part in regulating women's sexual function, mood, and bone density and is largely generated in the ovaries and adrenal glands.

Usually, a doctor will advise on both medication and lifestyle modifications. Unwanted hair management may also include the use of certain therapies.

The following drugs can be used to treat high testosterone and related conditions: [3]

  • Eflornithine is a cream that is used topically on the skin to prevent the development of new facial hair.
  • Glucocorticosteroids are a kind of steroid hormone that reduces inflammatory response in the body.
  • Metformin is a type 2 diabetes medication occasionally used to reduce blood sugar and insulin levels in PCOS sufferers.
  • Progesterone is a hormone that may control cycles and enhance fertility.
  • Spironolactone is a diuretic that lessens excessive female hair growth while balancing water and salt levels.


Beyond its well-known responsibilities in male development and sexual traits, testosterone serves a variety of purposes in the human body. In light of recent studies on TRT, free testosterone levels, serum testosterone levels, and the existence of testosterone in females, it is crucial to reevaluate testosterone's role.

Understanding testosterone's broader functions can have a big impact on clinical practice, especially when it comes to detecting and treating disorders linked to testosterone excess or shortage. Future studies should continue to investigate the complex roles that testosterone plays in human physiology and health, taking individual differences into account.

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