From the Guidelines
For patients with sexual dysfunction, recommended hormone laboratory tests include total testosterone, free testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, thyroid-stimulating hormone (TSH), and estradiol, as supported by the most recent guidelines 1. Morning testing is preferred for testosterone (between 8-10 AM) when levels are highest, and fasting samples are ideal for accurate results. These tests help identify underlying hormonal imbalances that may contribute to sexual dysfunction.
Key Hormone Tests
- Total testosterone
- Free testosterone
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Prolactin
- Thyroid-stimulating hormone (TSH)
- Estradiol Low testosterone can cause decreased libido and erectile dysfunction in men, while abnormal estradiol, prolactin, or thyroid levels can affect sexual function in both sexes.
Additional Tests
Additional tests may include:
- Complete blood count
- Comprehensive metabolic panel
- Lipid profile
- Hemoglobin A1c to rule out other medical conditions like diabetes or cardiovascular disease that can impact sexual health. If initial results are abnormal, follow-up testing may be necessary to confirm findings before initiating treatment. Hormone testing should be part of a comprehensive evaluation that includes medical history, physical examination, and assessment of psychological factors that may contribute to sexual dysfunction, as recommended by recent studies 1.
From the Research
Hormone Labs for Sex Dysfunction
The following hormone labs are recommended to test in patients with sex dysfunction:
- Testosterone levels: Low testosterone levels have been linked to decreased sexual desire and erectile dysfunction in men 2, 3
- Free testosterone determinations: Measurement of free fraction of testosterone can help identify hypogonadism and reduce unnecessary endocrine evaluations 2
- Prolactin levels: Elevated prolactin levels can be associated with sexual dysfunction, particularly in men with hypogonadism 2, 3
- Estrogen levels: Decreased estrogen levels can lead to vaginal atrophy and dyspareunia in postmenopausal women, contributing to sexual dysfunction 4, 3
- Thyroid function tests: Abnormal thyroid function may be associated with sexual dysfunction, although more research is needed to understand this relationship 3
Additional Considerations
- A comprehensive medical, sexual, and psychosocial history is essential in evaluating patients with sexual dysfunction 5
- Physical examination and laboratory tests, including hormone labs, are highly recommended in most cases 5
- Screening tools, such as the Brief Sexual Symptom Checklist (BSSC) and the Sexual Complaints Screener (SCS), can be useful in identifying sexual dysfunction in men and women 5