Gynaecomastia assessment

Hormone assessment of male gynaecomastia with testosterone, oestradiol, FSH, LH, pooled prolactin, TSH, free T4 and beta-hCG. It looks for hormonal abnormalities that may contribute to enlarged breast tissue, although a medical examination is still needed to confirm that it is gynaecomastia and not fat or another type of lump.

No prescription or appointment needed

Results in 1-2 working days

Includes: Total testosterone · Oestradiol · FSH · LH · Pooled prolactin · TSH · Free T4 · Beta-hCG. See what each one measures

What it is for

It is used to investigate whether gynaecomastia may be related to low testosterone, raised oestradiol, a pituitary disorder, hyperthyroidism or other hormonal causes. It is particularly useful when the growth is recent, progressing or accompanied by sexual or testicular symptoms.

The blood test does not cover every cause. Medicines, alcohol, liver or kidney disease and changes in weight can also play a part. That is why the medical history and examination are part of the assessment.

When it is recommended

Recent enlargement of breast tissue in a man
Painful, progressive or rapidly developing gynaecomastia
Gynaecomastia together with loss of sexual desire, erection problems or signs of low testosterone
Gynaecomastia associated with testicular changes or a recent treatment
If the lump is hard, fixed, one-sided or causes nipple discharge, a priority medical assessment is required and the blood test does not replace the examination

Clinical comment

In gynaecomastia, what matters is the balance between androgens and oestrogens, not a single hormone. That is why this profile includes oestradiol, which is not part of the routine assessment of low testosterone without breast enlargement.

Beta-hCG is included because some hCG-producing tumours can present with gynaecomastia. These are uncommon causes, but a positive result changes the priority of the investigation. The blood test does not replace testicular examination or imaging if there are suspicious findings.

Pooled prolactin reduces the effect of a temporary rise caused by the stress of venepuncture. Even so, raised prolactin needs confirmation and a review of medicines and other causes. Thyroid function completes the profile because hyperthyroidism can change SHBG and encourage hormonal imbalance.

Dr. Antonio Mas

What is tested

Total testosterone: Assesses the androgen side of the hormonal balance.
Oestradiol: Measures the main circulating oestrogen and helps identify an imbalance relative to androgens.
FSH: Provides information on testicular function and the pituitary response.
LH: The pituitary signal that stimulates testosterone production in the testis.
Pooled prolactin: Averages several samples taken through the same line to reduce the effect of the stress of the blood draw.
TSH: The first test of thyroid function.
Free T4: Completes the thyroid assessment, especially when TSH is abnormal.
Beta-hCG: Can be raised in certain tumours, including some of testicular origin, and needs prompt assessment if it is positive.

How to prepare

Have the sample taken in the morning, after 8 hours of fasting. Arrive in good time and without intense exercise beforehand. Pooled prolactin requires you to stay at rest while the samples are taken, to reduce the effect of stress.

You can add

Without another needle. It is offered when you order, so you do not have to decide now.

General blood testA general blood test with full blood count, glucose, cholesterol and kidney and liver function: the basic parameters included in any general check-up.+€59.00
General + nutritional blood testEverything in the general blood test (anaemia, kidneys, liver, cholesterol and glucose) plus iron stores, vitamin D, vitamin B12 and folic acid. It is the broadest add-on: it covers the general and the nutritional in one go.+€129.00
Male androgen profileAssesses androgen function better than total testosterone alone by including SHBG and calculating free testosterone.+€49.00

Related blood tests

We have other profiles in Men with more or fewer tests:

The most comprehensive is not always the most useful. If you are not sure, the one we recommend to start with is Low testosterone assessment.

What it is based on

We have not yet published the sources for this protocol. If you would like to know what it is based on, ask us: the answer exists, it just has not been written here yet.

Protocol designed by Dr. Antonio Mas, specialist in Endocrinology and Nutrition, Spanish medical licence no. 080846289, and reviewed in September 2026.

This blood test is a standardised protocol and does not replace a medical consultation. If you have symptoms, a known condition or a complex clinical situation, speak to your doctor.