Is it low testosterone, ED, or something else? 5 signs testing can help explain

Low energy. Lower sex drive. Trouble with erections. Workouts that don’t feel as effective as they used to.

For many men, symptoms like these bring up one big question: Is it low testosterone?

Maybe. But testosterone is only one piece of men’s health. Erectile dysfunction, stress, sleep problems, medications, heart health, diabetes, and other conditions can cause similar changes. That’s why guessing can only take you so far.

“Get your number,” says Shandra Wilson, MD, a board-certified urologist and medical director of urologic oncology at Intermountain Health. “Then you know if it’s low testosterone or something else.”

5 signs that may be worth a testosterone test

Low testosterone can influence how you feel, how you move, and how your body responds to exercise. These signs do not prove your testosterone is low, but they can help you decide when to get checked.

1. Low energy that doesn’t feel normal

Low energy is one of the most common reasons men ask about testosterone. “Some guys say they feel saggy,” Dr. Wilson says. “They get home from work and don’t feel like doing as much.” Fatigue can also come from sleep problems, stress, thyroid issues, anemia, depression, or other conditions. 

2. A lower sex drive

Testosterone plays an important role in libido. If your interest in sex has clearly changed, especially over time, a testosterone test can help show whether hormones may be part of the reason.

3. Trouble with erections

Erectile dysfunction and low testosterone can overlap, but they are not the same. “Erections need good blood flow,” Dr. Wilson says. “But if testosterone is really low, that can also be one of the signs.” ED may also involve circulation, heart health, diabetes, blood pressure, medications, or stress. 

4. Less strength or muscle

Some men notice they are working out but not seeing the same results. “People tell me they don’t get as much out of their workouts,” Dr. Wilson says. “They’re going to the gym, but they’re not seeing muscle building as quickly.” Diet, sleep, activity level, and aging can also affect strength.

5. Weaker bones

Low testosterone can contribute to bone loss, especially in older men. “In older men, sometimes the sign is not what they feel day to day,” Dr. Wilson says. “It may show up as osteoporosis because testosterone helps build bones too.”

Testing helps you stop guessing 

A testosterone test is a simple blood test. It may also be called total testosterone, serum testosterone, or free testosterone.

Most providers start with total testosterone. The test is usually done in the morning because testosterone levels tend to be highest then. If results are low or unclear, your provider may recommend repeat testing or additional labs to look at related hormones or other possible causes.

Testosterone levels naturally decline with age, but age alone does not always explain symptoms. Dr. Wilson says low testosterone can also show up after major surgery, illness, or significant stress.

“Sometimes it’s gradual, and sometimes it’s reactionary,” she says.

What your testosterone test results can and can’t tell you

A testosterone result is useful, but it is not the whole story. Your provider will look at your number along with your symptoms, age, health history, medications, fertility goals, and other lab results.

A low number may help explain symptoms. A normal number may point your provider toward another cause. Either way, the test helps move the conversation from guessing to planning.

At-home testosterone lab draws in Utah and Nevada

For eligible patients in select areas of Utah and Nevada, Intermountain Health offers at-home lab draws. That means you may be able to complete testosterone testing without going to a lab.

Results are typically available in the Intermountain Health patient portal within 24 to 48 hours after the sample is collected.

Here’s how it works:

• Complete the eligibility assessment and consent form
• Choose your tests
• Schedule an appointment time over the phone
• A trained phlebotomist comes to your home usually within 2 to 3 days
• View your results in the patient portal

At-home lab draws are currently available along Utah’s Wasatch Front from Logan to Nephi, in Southern Utah from Cedar City to St. George, and in Clark County, Nevada, from Mesquite to Las Vegas. The service costs $45 plus the cost of tests ordered and is FSA/HSA eligible.

What if the issue is ED or premature ejaculation?

Low testosterone can affect sex drive and, when levels are very low, may play a role in erections. But sexual health symptoms are not always caused by testosterone.

Erectile dysfunction means trouble getting or keeping an erection. Premature ejaculation means ejaculation happens sooner than you or your partner would like. They are different concerns, but both can affect confidence, relationships, and quality of life.

Testing can help answer the low testosterone question. And for eligible patients dealing with ED or PE, Intermountain Health offers on-demand treatment from home.

The process is simple: complete an online health assessment, talk with a clinical pharmacist by phone, and have medication shipped to your door. 

The service is available to adults 18 and older who were assigned male at birth in Utah, Idaho, Montana, and Nevada. It costs $49 plus medication and is FSA/HSA eligible.

Get the right support for men’s health

June is Men’s Health Month, but these conversations matter all year. At Intermountain Health, board-certified urologists, primary care providers, and clinical pharmacists can help you get answers about low testosterone, erectile dysfunction, premature ejaculation, infertility, and other reproductive health concerns.

Whether you start with an at-home lab draw, an on-demand ED or PE visit, or a conversation with your provider, you don’t have to keep wondering what’s going on.

Visit our Urology Services page to learn more or find a provider.