How is primary testosterone deficiency diagnosed?

Like most problems, a detailed history and physical examination with the doctor in the office is an essential start. A discussion will be had of sexual desire and performance, along with a review of secondary sexual features such as strength, energy level, and hair growth. Lab tests of total serum testosterone will be taken in the morning. Other hormonal tests may be taken as well depending on the history. If prolactin is high there may be a pituitary problem, and if low then LH helps determine if the body is asking the testicles to make more testosterone. If LH is high and testosterone is low, this means that the testicles cannot produce enough testosterone to satisfy demand. In this case replacement therapy is indicated.