A blood test is a useful diagnostic tool for all sorts of conditions. Erectile dysfunction (ED) can be a sign of heart disease, diabetes, and low testosterone (low T), among other things.
All of these conditions can be serious, but are treatable and should be addressed. A blood test can determine whether you have high sugar levels, high cholesterol, or low testosterone.
Although no specific laboratory tests are universally recommended for the diagnosis of FSD, routine Pap smears and stool guaiac tests should not be overlooked. Baseline hormone levels may be helpful when indicated, including thyroid-stimulating hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total and free testosterone levels, sex hormone-binding globulin (SHBG), estradiol, and prolactin.
The diagnosis of primary and secondary hypogonadism can be assessed with FSH and LH. An elevation of FSH and LH may suggest primary gonadal failure, whereas lower levels suggest impairment of the hypothalamic-pituitary axis. Decreased estrogen levels can lead to decreased libido, vaginal dryness, and dyspareunia. Testosterone deficiencies can also cause FSD, including decreased libido, arousal, and sensation. SHBG levels increase with age but decrease with the use of exogenous estrogens. Hyperprolactinemia may also be associated with decreased libido.
Testosterone is considered to be the “male hormone” that’s produced in men by the testes. Although women’s ovaries produce some testosterone, the hormone is produced in much higher concentrations in men and it is responsible for many of the secondary sex characteristics seen in men such as a deeper voice and hair on the chest, in addition to contributing to a healthy libido, building muscle mass, and maintaining energy levels.
The problems associated with high testosterone levels are infrequent and rare in middle-aged and elderly men who are not receiving testosterone or other steroid treatments. When the testosterone level becomes out of balance, it usually becomes too low rather than too elevated.
Normal or average testosterone levels
In general, the normal range in males is about 270 to 1070 ng/dL with an average level of 679 ng/dL. A normal male testosterone level peaks at about age 20, and then it slowly declines. Testosterone levels above or below the normal range are considered by many to be out of balance. Moreover, some researchers suggest that the healthiest men have testosterone levels between 400 – 600 ng/dL.
Benefits and disadvantages of higher than average testosterone levels
Men who have a testosterone level that is higher than average may experience both benefits and drawbacks.
Examples of benefits, which are modest, of men having higher than average testosterone levels (low-T) include:
- It normalizes blood pressure, and
- It lowers the likelihood of obesity and heart attacks.
Examples of drawbacks or disadvantages of men having higher than average testosterone levels include:
- Men tend to consume more alcoholic beverages.
- Men are more likely to smoke.
- Men are more likely to get injured.
- According to some researchers, the higher the testosterone level, the more likely men are to participate in risk-taking behavior (sexual, injury risk, and even criminal activity).
A semen analysis (plural: semen analyses) evaluates certain characteristics of a male’s semen and the sperm contained therein. It is done to help evaluate male fertility, whether for those seeking pregnancy or verifying the success of vasectomy. Depending on the measurement method, just a few characteristics may be evaluated (such as with a home kit) or many characteristics may be evaluated (generally by a diagnostic laboratory). Collection techniques and precise measurement method may influence results.
Reasons for testing
The most common reasons for laboratory semen analysis in humans are as part of a couple’s infertility investigation and after a vasectomy to verify that the procedure was successful. It is also commonly used for testing human donors for sperm donation, and for animals semen analysis is commonly used in stud farming and farm animal breeding.
Occasionally a man will have a semen analysis done as part of routine pre-pregnancy testing. At the laboratory level this is rare, as most healthcare providers will not test the semen and sperm unless specifically requested or there is a strong suspicion of a pathology in one of these areas discovered during the medical history or during the physical examination. Such testing is very expensive and time-consuming, and in the U.S. is unlikely to be covered by insurance. In other countries, such as Germany, the testing is covered by all insurances.
Relation to fertility
The characteristics measured by semen analysis are only some of the factors in semen quality. One source states that 30% of men with a normal semen analysis actually have abnormal sperm function. Conversely, men with poor semen analysis results may go on to father children. In NICE guidelines, mild male factor infertility is defined as when 2 or more semen analyses have 1 or more variables below the 5th percentile, and confers a chance of pregnancy occurring naturally through vaginal intercourse within 2 years similar to people with mild endometriosis.
The Papanicolaou test (abbreviated as Pap test, known earlier as Pap smear, cervical smear, or smear test) is a method ofcervical screening used to detect potentially pre-cancerous and cancerous processes in the cervix (opening of the uterus or womb). Abnormal findings are often followed up by more sensitive diagnostic procedures, and, if warranted, interventions that aim to prevent progression to cervical cancer. The test was invented by and named after the prominent Greek doctor Georgios Papanikolaou.
A Pap smear is performed by opening the vaginal canal with a speculum, then collecting cells at the outer opening of the cervix at the transformation zone (where the outer squamous cervical cells meet the inner glandular endocervical cells). The collected cells are examined under a microscope to look for abnormalities. The test aims to detect potentially pre-cancerous changes (calledcervical intraepithelial neoplasia (CIN) or cervical dysplasia; the squamous intraepithelial lesion system (SIL) is also used to describe abnormalities), which are caused by sexually transmitted human papillomaviruses. The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. While the test may also detect infections and abnormalities in the endocervix and endometrium, it is not designed to do so.
In the United States Pap smear screening is recommended starting around 21 years of age until the age of 65. Guidelines on frequency vary from every three to five years. If results are abnormal, and depending on the nature of the abnormality, the test may need to be repeated in six to twelve months. If the abnormality requires closer scrutiny, the person may be referred for detailed inspection of the cervix by colposcopy. The person may also be referred for HPV DNA testing, which can serve as an adjunct to Pap testing. Additional biomarkers which may be applied as ancillary test with Pap test are evolving.
Stool guaiac test
The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself.
It is the most common type of fecal occult blood test (FOBT).
How the Test is Performed
Usually, you collect a small sample of stool at home. Sometimes, a doctor may collect a small amount of stool from you during a rectal examination.
If the test is done at home, you use a test kit. Follow the kit instructions exactly. This ensures accurate results. In brief:
- You collect a stool sample from three different bowel movements.
- For each bowel movement, you smear a small amount of the stool on a card provided in the kit.
- You mail the card to a laboratory for testing.
Do not take stool samples from the toilet bowl water. This can cause errors.
For infants and young children wearing diapers, you can line the diaper with plastic wrap. Place the plastic wrap so that it keeps the stool away from any urine. Mixing of urine and stool can spoil the sample.
How to Prepare for the Test
Some foods can affect test results. Do not eat the following foods for 3 days before the test:
- Red meat
- Uncooked broccoli
Some medicines may interfere with the test. These include vitamin C, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Ask your doctor or nurse if you need to stop taking these before the test. Never stop or change your medicine without first talking to your health care provider.
How the Test will Feel
The at-home test involves a normal bowel movement. There is no discomfort.
You may have some discomfort if the stool is collected during a rectal exam.
Why the Test is Performed
This test detects blood in the digestive tract. It may be done if:
- You are being screened or tested for colon cancer
- You have abdominal pain, changes in bowel movements, or weight loss
- You have anemia (low blood count)
- You say you have blood in the stool or black, tarry stools
A negative test result means that there is no blood in the stool.
What Abnormal Results Mean
Abnormal results may be due to problems that cause bleeding in the stomach or intestinal tract, including:
- Colon cancer or other gastrointestinal (GI) tumors
- Colon polyps
- Bleeding veins in the esophagus or stomach (esophageal varices and portal hypertensive gastropathy)
- Inflammation of the esophagus (esophagitis)
- Inflammation of the stomach (gastritis) GI infections
- Inflammatory bowel disease
- Peptic ulcer
Other causes of positive test may include:
- Coughing up blood and then swallowing it.
Abnormal tests require follow-up with your doctor. In many cases, no explanation for the abnormal result is found.