This guide covers what the group is, which hormones belong to it, what they do in men and in women, what high and low results may reflect, what moves levels around, how the group is tested and which related markers are read alongside.
An androgen is any steroid hormone that produces its main effects by binding to the androgen receptor inside target cells. The group is defined by that shared mechanism, not by where the hormone is made or by which sex makes more of it.
All of them begin as cholesterol and pass through a shared chain of enzyme steps in the testes, the ovaries and the adrenal cortex, and several tissues finish the conversion locally, turning a weaker precursor into a stronger hormone right where it acts 1. That local step matters. A blood level describes what is circulating, not how much signal a particular tissue is generating for itself.
Once in the bloodstream, most of the hormone is not free. The larger share travels bound to sex hormone binding globulin, a smaller share binds loosely to albumin, and only a small unbound fraction crosses into cells 1. Two people can carry the same total number on a lab report and have different amounts of usable hormone, because their carrier protein levels differ.
Research suggests that these hormones work largely as regulators of gene transcription, with the hormone bound receptor moving into the cell nucleus and changing which genes that cell reads 2. That is why effects build over days and weeks rather than minutes, and why the same hormone can thicken a beard, build muscle and quietly adjust red blood cell production, depending on which tissue is listening.
One more point that trips people up. This is not a male only group. Men produce far more, women produce less and still depend on the same molecules for bone, muscle, sexual function and energy.
Testosterone Total is the headline member of the group and the first measurement most panels run. It counts every testosterone molecule in the sample, the protein bound share and the free share together, which makes it a good starting point and an incomplete one on its own.
Because one marker cannot carry a whole hormone picture, it is read with carrier proteins, pituitary signals and symptoms. The dedicated guide to Testosterone Total covers what that test measures, how the sample is collected, how its ranges are set and how to interpret a single value. The rest of this page stays on the wider family and what the class does.
Four hormones carry most of the androgen signal in adults, and they differ sharply in strength and in where they come from. Testosterone and dihydrotestosterone do most of the direct receptor work, while dehydroepiandrosterone and androstenedione act mostly as raw material that tissues convert into something stronger 3.
| Hormone | Mainly produced in | What it does, in short |
|---|---|---|
| Testosterone | Testes in men, ovaries and adrenal glands in women | The main circulating androgen, acting directly and as raw material for DHT and estradiol |
| Dihydrotestosterone (DHT) | Converted from testosterone inside skin, hair follicles, prostate and other tissues | The strongest androgen at the receptor, with heavy influence on skin, scalp and body hair |
| Androstenedione | Adrenal glands and gonads | An intermediate that tissues convert onward into testosterone or into estrogen |
| DHEA and DHEA sulfate (DHEA-S) | Adrenal cortex, mainly | Abundant but weak precursors, acting mostly after conversion in peripheral tissues |
The hierarchy explains a lot of confusion. A high DHEA-S and a high testosterone are not the same finding, because the first points towards the adrenal glands and the second can come from gonads, adrenals or peripheral conversion. It also explains why a weak hormone present in large amounts can still produce visible effects once skin or hair follicles convert it locally.
They work by switching genes on and off, not by acting on the cell surface. The free hormone diffuses into the cell, binds the androgen receptor, and the hormone bound receptor then travels to the nucleus and attaches to specific stretches of DNA, altering which proteins that cell builds 2.
Two enzymes decide what the signal becomes. The enzyme 5 alpha reductase converts testosterone into DHT, a stronger receptor activator, in tissues such as skin and hair follicles. The enzyme aromatase converts testosterone into estradiol, which means a share of what starts as an androgen ends up acting as an estrogen in bone, brain and fat tissue 1. The same blood level can therefore produce different tissue effects in two people with different enzyme activity.
Production is controlled by a feedback loop. The hypothalamus releases gonadotropin releasing hormone, the pituitary responds with luteinising hormone and follicle stimulating hormone, and the gonads respond by producing hormone, which then feeds back to slow the pituitary signal 1. Adrenal androgen production runs on a partly separate track, which is why adrenal and gonadal patterns on a lab report can move independently.
That loop is the reason a clinician reads pituitary markers next to a low result. A low hormone with high pituitary signalling points in one direction, a low hormone with low or normal pituitary signalling points in another, and only the pair together narrows it down.
Androgenicity is the degree to which a hormone or compound produces androgen type effects, which depends on how strongly and how long it activates the androgen receptor. DHT sits at the high end, testosterone in the middle, and DHEA and androstenedione at the low end until a tissue converts them.
The term is also used for tissue sensitivity, and that is the version most people actually experience. Receptor density, local enzyme activity and carrier protein levels all vary between individuals, so two people with identical blood values can show very different skin oiliness, scalp hair behaviour and body hair patterns. Someone can have mid range numbers and visible androgen driven skin changes, and someone else can sit higher with none.
This is why a lab number is read next to a person, not instead of one. A value that looks unremarkable in isolation can still sit alongside symptoms worth investigating, and a value near the edge of a reference range can sit alongside nothing at all.
In men they drive sexual development and function, support muscle protein balance, maintain bone, influence red blood cell production, shape fat distribution and contribute to libido, drive and mood 3. Sperm production depends less on the blood level and more on the very high concentration maintained inside the testes themselves 1.
The day to day experience of the hormone is less specific than most people expect. Low energy, reduced motivation, poorer recovery from training, lower libido, worse sleep and a slow shift in body composition are all common reports, and all of them have other explanations too. That overlap is exactly why testing exists. Symptoms generate a question, a blood panel answers part of it, and repeat testing answers more.
Age changes the picture gradually. Average levels drift down across adult life, carrier protein levels tend to drift up, and the free fraction can fall faster than the total value suggests. A total result that still sits inside a laboratory range can therefore sit alongside a free fraction that has fallen a long way from where it was a decade earlier, which is one reason a clinician may order both.
In women the same hormones circulate at a small fraction of male concentrations and remain biologically important, with the ovaries and the adrenal glands both contributing. They support libido and sexual response, contribute to muscle and bone maintenance, and act as the raw material from which the ovary builds estrogen.
Because the concentrations are so low, two technical details matter more than they do in men. The first is assay quality, since routine immunoassays lose accuracy at the low end and mass spectrometry based methods are generally preferred for female samples. The second is carrier protein level, because a change in sex hormone binding globulin can move the free fraction substantially while the total value barely shifts.
Symptoms attributed to low androgen activity in women, such as flattened libido, reduced stamina, low mood and loss of muscle tone, overlap heavily with thyroid patterns, iron status, sleep debt, perimenopausal change and energy availability. A single value cannot separate those. A panel read alongside the menstrual cycle phase, the symptom history and related markers can start to.
Androgen levels in women also decline gradually with age rather than falling off a cliff at menopause, since the adrenal contribution declines on its own schedule.
They act on bone and muscle directly through the androgen receptor and indirectly after conversion to estrogen, which is why both sexes depend on them for skeletal maintenance. Androgen receptor signalling is associated with the maintenance of bone mass in both men and women 6.
Research suggests that a meaningful part of the skeletal effect in men runs through aromatisation of testosterone to estrogen acting on bone cells, rather than through androgen receptor activation alone 5. That is a useful thing to understand before reading a hormone panel, because it explains why estradiol is often measured in men as well as women, and why a very low estradiol in a man is not automatically a good sign.
For muscle and body composition, androgen signalling supports lean mass and influences how fat is distributed 3. In practice this is a slow signal. Hormone status sets part of the ceiling for what training and protein intake can build, and it does not replace either. Someone with mid range values who sleeps badly and under eats will usually get less out of training than someone with similar values who does not.
The practical reading is that bone and muscle findings are context for a hormone result rather than proof of one. Low bone density or a steady loss of lean mass is a reason to look at hormones among other things, not a conclusion about them.
A high result most often reflects increased production, reduced carrier protein, an outside source or a timing artefact, and the right interpretation depends on which hormone is elevated and in whom. In women, studies indicate that androgen excess is a central feature of polycystic ovary syndrome and interacts with insulin signalling in that setting 7.
For a woman, a raised testosterone or androstenedione alongside irregular cycles, acne or increased facial and body hair is a pattern a clinician investigates rather than a conclusion in itself. A raised DHEA-S points attention towards the adrenal glands. A rapid change, a very high value or symptoms that appeared suddenly is worth discussing with a clinician promptly, because the workup is different from the one used for a gradual pattern.
For a man, a high total value can reflect a genuine surplus, a high carrier protein level that inflates the total while the free fraction stays ordinary, an early morning draw at the daily peak, or an outside source. Some medicines also shift sex hormone results, so bring your full list to the appointment and ask your prescriber.
The sequence that keeps this safe is simple. Observe the value, consider what it may reflect, confirm it on a repeat sample taken under the same conditions, then take the pattern to a clinician. A single out of range number is a prompt to look more carefully, never a diagnosis, and never a reason to ignore the result either.
A low result can reflect reduced production at the gland, a reduced signal from the pituitary, a temporary suppression from illness, poor sleep or low energy availability, or a laboratory snapshot taken at an unrepresentative moment. Distinguishing a gland level problem from a signalling level problem is the first fork in the road, and it is what luteinising hormone and follicle stimulating hormone are for.
In men, the common contributors are age, excess body fat, chronic sleep restriction, heavy alcohol intake, prolonged under eating relative to training load, significant illness and some medicines, which is another question for your prescriber. Any acute illness in the weeks before a draw can push a value down temporarily, so a single low result during or just after a rough stretch deserves a repeat before anything is concluded.
In women, low androgen activity is harder to define, because the measurement sits near the limit of many assays and symptoms are non specific. Age related decline, adrenal insufficiency and conditions that raise sex hormone binding globulin can all lower the usable fraction.
Whatever the sex, a low value is described as suboptimal or outside the standard range rather than anything more alarming, and the next step is confirmation plus context, not action on one number. Where a treatment is being considered, a licensed provider evaluates whether it is appropriate after reviewing the person, and treatment decisions belong to a licensed provider.
More than most people assume, which is why one reading rarely settles a question. Testosterone in men follows a daily rhythm with the highest values in the morning, so a sample taken at noon and a sample taken at eight in the morning are not comparable.
The main movers to control before testing are timing, recent illness, sleep, alcohol and acute training load. Sleep restriction and very heavy training blocks without adequate fuel both tend to push levels down temporarily. Body composition matters over longer timeframes, since fat tissue carries aromatase activity and insulin resistance tends to lower sex hormone binding globulin, which changes the balance between total and free values.
In women, cycle phase changes the reference point, so a clinician will often ask for an early cycle draw to make results comparable between tests. Carrier protein levels also drift with thyroid status, liver function, body composition and age, and because carrier protein sets the free fraction, a change there can move how a result feels without moving total production at all.
Finally, assays differ. Two laboratories using different methods can return slightly different numbers from the same blood, which is why trending results at one laboratory, under the same conditions, tells you more than comparing single values from different places.
Through a blood draw, ideally in the morning and ideally repeated before any conclusion is drawn. For men, a morning sample captures the daily peak and makes results comparable over time. For women, timing to the early part of the cycle serves the same purpose where cycles are regular.
A useful panel usually goes beyond one hormone. Total testosterone gives the headline figure, sex hormone binding globulin and albumin allow the free or bioavailable fraction to be calculated, DHEA-S reports on the adrenal contribution, androstenedione fills in an intermediate step, and luteinising hormone and follicle stimulating hormone show whether the pituitary signal is high, low or ordinary. Estradiol is measured in both sexes because so much androgen activity is converted onward.
Method matters at low concentrations. Mass spectrometry based measurement is generally preferred for women and for men with very low values, since immunoassays lose precision at the bottom of the scale. If you are comparing a new result with an older one, check whether the method changed before reading anything into the difference.
Fasting is not strictly required for sex hormones, although many panels are drawn fasted because the same blood sample is used for metabolic markers. Hold any non essential supplements only on your prescriber's advice, and tell the laboratory and your clinician about everything you take. FitScript tests 150+ biomarkers per year, and Atlas, its AI health advisor, reads each result against the rest of the panel rather than in isolation.
Typical laboratory reference ranges describe what is common in a reference population, while optimal ranges describe a narrower target zone. The two answer different questions, and only the first is used by laboratories to flag a result.
| Marker | Group | Standard lab reference range | FitScript optimal range |
|---|---|---|---|
| Testosterone Total | Men | 264 to 1200 ng/dL | 500 to 900 ng/dL |
| Testosterone Total | Women | 8 to 120 ng/dL | 15 to 70 ng/dL |
Reference ranges vary by laboratory, age and sex, and the figures above are typical lab reference ranges rather than universal cut points. FitScript's optimal ranges are optimization targets, not diagnostic cut-offs, and a value outside them is not a diagnosis.
For the other androgens, reference ranges are strongly age dependent, especially DHEA-S, which is highest in early adulthood and declines steadily afterwards. Each laboratory publishes its own age banded ranges, so read your result against the range printed on your own report rather than against a number found online.
Sex hormones are best read as a group, because a single value cannot distinguish production from transport from conversion. The markers below are the ones most often read next to an androgen result.
| Marker | Why it is read alongside |
|---|---|
| Sex hormone binding globulin | Sets how much hormone is bound and how much is free, so it explains total and free results that disagree |
| Free or bioavailable testosterone | Estimates the fraction able to enter cells, often more informative than the total at the extremes |
| Luteinising hormone and follicle stimulating hormone | Show whether the pituitary signal is driving or failing to drive production |
| Estradiol | Reports the product of aromatisation, which carries part of the skeletal and vascular signal in both sexes |
| DHEA-S | Reflects the adrenal contribution and separates adrenal from gonadal patterns |
| Prolactin | A pituitary marker that can explain an unexplained low gonadal signal |
| Fasting insulin, glucose and HbA1c | Metabolic context, since insulin signalling interacts with androgen activity in polycystic ovary syndrome |
| Thyroid panel and ferritin | Common alternative explanations for fatigue, low libido and hair change |
The point of a panel is pattern recognition. A low total with a low free fraction and a high pituitary signal reads differently from a low total with ordinary free hormone and a high carrier protein, and neither reads the same as a normal panel in someone whose symptoms are being driven by iron status or sleep.
Whenever a result sits outside the range printed on your report, whenever symptoms persist despite ordinary looking numbers, and whenever a value changes sharply between two comparable tests. A very high or very low reading, or symptoms that appeared suddenly, is worth discussing with a clinician promptly rather than at the next convenient check.
Bring the full report rather than a single number, including the units, the reference range, the collection time and the method used. Bring the list of everything you take, since some medicines shift sex hormone results and your prescriber is the person who can say whether yours do. Bring the symptom timeline too, because the pattern over months usually carries more information than any one value.
If a treatment enters the conversation, a licensed provider evaluates whether it is appropriate for you after reviewing your history, your examination and your labs, and treatment decisions belong to a licensed provider. This page is educational and is not medical advice. Discuss your results and any treatment with a clinician or licensed provider before changing anything.
For deeper reading on one of the groups this page touches, see the guide to low testosterone in women.
They are a family of steroid hormones that work by switching on the androgen receptor inside cells. Testosterone is the best known member, and DHT, DHEA, DHEA-S and androstenedione belong to the same group. Their effects show up in muscle, bone, skin, body hair, libido and energy.
Yes. Women produce them in the ovaries and the adrenal glands, at a small fraction of male concentrations, and they still contribute to libido, bone, muscle and energy. They are also the raw material the ovary uses to build estrogen.
Testosterone is the main hormone in circulation, while DHT is made from it inside tissues such as skin and hair follicles. DHT activates the receptor more strongly, which is why it has a large influence on skin oiliness and hair patterns. Most blood panels measure testosterone first and add DHT only when there is a specific reason.
It describes how strongly a hormone produces androgen type effects, which depends on how powerfully it activates the receptor. It is also used to describe how sensitive a person's tissues are. That is why two people with similar blood values can have noticeably different skin and hair.
It depends on the hormone, the sex, the age and the laboratory, so read your result against the range printed on your own report. For total testosterone, typical lab ranges are roughly 264 to 1200 ng/dL in men and 8 to 120 ng/dL in women. FitScript's optimal ranges are narrower optimization targets, 500 to 900 ng/dL for men and 15 to 70 ng/dL for women, and they are not diagnostic cut-offs.
Morning is standard for men, because testosterone peaks early in the day and a later sample can read artificially low. Women are often asked to test in the early part of the cycle so that results can be compared over time. Keep conditions the same between tests, including the laboratory.
Common considerations include increased ovarian or adrenal production, a low carrier protein level, an outside source and polycystic ovary syndrome, which a clinician assesses using the full picture rather than one value. A sudden change or a very high value is worth discussing with a clinician promptly. Confirming the result on a repeat sample is usually the first step.
Sleep, alcohol intake, body composition, training load and how much you eat relative to what you burn can all influence results over time, and illness can lower them temporarily. These factors explain why two tests taken months apart can differ. Any decision about testing again or doing anything further belongs to your clinician.