Men's hormone profile – saliva testosterone test at home

Testosterone is the main male sex hormone and is produced mainly in the testes. In a large European study of more than 3,000 men aged 40 to 79, three sexual complaints in particular were linked to lower testosterone levels: fewer morning erections, less desire for sex and erection problems (PubMed 20554979).

The Endocrine Society guideline only regards testosterone deficiency (hypogonadism) as present if there are matching complaints and testosterone in blood is clearly and repeatedly low, measured fasting in the morning (PubMed 29562364). A low saliva value is therefore a reason for a conversation, not a diagnosis.

Saliva contains the free fraction of testosterone, which is not bound to proteins. In studies, salivary testosterone was compared with free testosterone calculated from blood values and remained fairly stable on repeated measurement (PubMed 16916746). Compared with mass spectrometry, ELISA tests in saliva performed better for testosterone than for oestradiol and progesterone (PubMed 39933211).

For diagnosing a deficiency, the guideline nevertheless recommends blood values: fasting, in the morning, with an accurate method and a second time for confirmation (PubMed 29562364). Saliva and blood values are not directly comparable; the report gives the laboratory's reference ranges.

Men also produce oestradiol, mostly from testosterone: an enzyme (aromatase) converts it, mainly in fat tissue. Only about 20% comes directly from the testes (PubMed 12198740). In men, oestradiol is involved in hormone regulation, bone metabolism and sexual desire.

In men, higher oestradiol levels are linked, among other things, to more body fat (PubMed 12198740). What a single saliva value means can only be assessed together with testosterone, age and the overall situation.

DHEA (dehydroepiandrosterone) is produced mainly in the adrenal gland and is a precursor of sex hormones. DHEA falls markedly with age, sometimes to 10–20% of the values of young people (PubMed 23647054). A lower value at an older age is therefore common.

According to this review, whether falling DHEA levels explain complaints of ageing and whether taking it helps has not been sufficiently studied; data on the safety of long-term use are lacking. This page makes no recommendation on it.

Cortisol is produced in the adrenal cortex and follows a daily rhythm: it rises markedly in the first 30–45 minutes after waking (PubMed 26563991). That is why the two samples are taken right after waking and 30 minutes later. The report shows a snapshot of that morning, not a daily profile.

According to a systematic review, the often-cited "adrenal fatigue" is not an established medical condition (PubMed 27557747). Real adrenal diseases such as Cushing's syndrome are investigated by doctors with their own procedures, for example late-night salivary cortisol (PubMed 35334030).

Progesterone also occurs in men, in small amounts from the adrenal gland and testes. The progesterone/oestradiol ratio is calculated from the two measured values; it is not a separate measurement. Its meaning in men has hardly been studied, and because ELISA values for oestradiol and progesterone in saliva are less reliable (PubMed 39933211), this uncertainty carries over to the ratio. An unusual ratio is a topic for the results consultation, not a diagnosis.

Testosterone deficiency or hypogonadism means that the body produces too little testosterone and this causes complaints. The cause can lie in the testes or in the control by the pituitary gland and brain. That is why the guideline recommends further investigation of the cause after a confirmed deficiency (PubMed 29562364).

What matters is the combination: a low value without complaints is not yet a deficiency, and neither are complaints without clearly low blood values (PubMed 29562364).

In men, testosterone falls slowly with age, not abruptly like women's hormones in menopause. Whether an age-related lower testosterone level is a condition of its own ("late-onset hypogonadism", colloquially "male menopause") is controversial (PubMed 20554979).

The European EMAS study proposed using the term only when at least three sexual complaints occur together with low testosterone levels in blood (PubMed 20554979). Tiredness or reduced performance alone are not enough.

Yes, but the values will then not show your body's own hormone production, because the hormones you take overlay it. Please list all hormone-containing medication on the request form, for example testosterone gel or injections, DHEA products or cortisone, so the laboratory can classify the values correctly. Never stop prescribed medication on your own.

Research describes the following associations, with varying strength of evidence:

• Less desire for sex (loss of libido), fewer morning erections and erection problems: most clearly linked to low testosterone in the EMAS study, well documented (PubMed 20554979).
• Tiredness, reduced physical performance and low mood: were also linked to testosterone levels in the same study, but more weakly and non-specifically, as they have many other causes (PubMed 20554979).
• Exhaustion and stress: often associated with cortisol; "adrenal fatigue" as a cause is not supported by evidence (PubMed 27557747).

These are associations from studies, not causes in an individual. A hormone test cannot explain complaints and does not provide a diagnosis. Persistent complaints should first be checked by a doctor.

Erection problems should be discussed with a doctor, as they are statistically associated with a higher risk of cardiovascular disease (PubMed 31104857). Likewise, newly enlarged or painful breasts, a lump or swelling in the testicle, an unfulfilled wish to have children, and headaches together with visual disturbances belong first in a GP, urology or endocrinology practice, not in a self-test. With chest pain or shortness of breath, call 112 immediately.

If you want children, note that the guideline advises against testosterone treatment if children are planned in the near future (PubMed 29562364). If low mood, exhaustion or sleep problems persist or weigh heavily on you, talk to your GP. If you are thinking about harming yourself, get help immediately. In Germany, the TelefonSeelsorge crisis line is free and available around the clock on 0800 111 0 111; in an emergency call 112.

This page does not give treatment recommendations. According to the guideline, testosterone treatment is only an option after a confirmed diagnosis and after weighing benefits and risks (PubMed 29562364). Whether a value means anything at all and which steps make sense depends on complaints, age, previous findings and medication.

That belongs in a conversation with the ORY expert team or with your doctor or naturopath, for example from the ORY expert network. The results consultation is included in the price.

On the day before, avoid hormone-containing foods: meat, pulses, dairy products, cucumbers and soy. No alcohol, nicotine, chocolate or sex for 24 hours beforehand. On the morning of collection, stay fasting, collect before brushing your teeth and rinse your mouth with clear water first; bleeding gums distort the result.

List hormone-containing medication on the request form and do not stop it on your own. Keep the filled tubes in the fridge until shipping and do not send them on a Friday or before a public holiday.

Analysis usually takes 7–21 days from the arrival of the samples at the laboratory. As soon as your report is ready, we let you know. A results consultation with the ORY expert team is included in the price.

The men's hormone profile costs €160.05 including VAT, shipping, return postage and results consultation.

Statutory health insurance in Germany generally does not cover hormone tests you order yourself. With private insurance, reimbursement may be possible; how it works is described under "Reimbursement by private insurance". With complaints, a GP, urology or endocrinology practice is the right first step; testosterone is measured in blood there.

The men's hormone profile (€160.05) measures five hormones on one morning. The cortisol daily profile (€155) measures cortisol in saliva at three times of day and shows the course over the day. The melatonin test (€55) measures melatonin in night-time saliva. For women there is the women's hormone profile (€160.05) with the same five hormones.

Which scope makes sense for you can be clarified in the free initial consultation.