Two colleagues, the same result, a different conclusion. He is told his ferritin is fine; at exactly the same number she is told her iron stores are on the low side. Not a lab error, but biology: for a number of blood values, different reference ranges apply to men and women.
What I find important: you always read a value in context, and sex is one of those contexts. Anyone comparing their result with the wrong reference range easily draws the wrong conclusion.
Which blood values differ between men and women?
The best-known differences lie in the blood count, iron stores and hormones. Men have higher haemoglobin on average, women more often a lower iron store through menstruation. The table lists the main ones, with indicative figures. Always use the range printed on your own result.
| Blood value | Men | Women | Why it differs |
|---|---|---|---|
| Haemoglobin | 8.5 to 11.0 mmol/L | 7.5 to 10.0 mmol/L | Testosterone stimulates production |
| Ferritin | 30 to 300 µg/L | 15 to 150 µg/L | Monthly blood loss through menstruation |
| Uric acid | Slightly higher on average | Slightly lower on average | Oestrogen helps excrete uric acid |
| Sex hormones | Testosterone high | Oestrogen and progesterone leading | Different hormonal drive |
For most other values, such as kidney and liver function, the differences are small. Read our guide to the annual blood test for the wider picture.
Why does sex factor into your result?
Reference values are based on large groups of healthy people. Because men and women differ biologically, separate ranges apply to some values. A good lab therefore states which range applies to you. The Dutch College of General Practitioners (NHG) uses sex-specific reference values in its guidelines, precisely because one range for everyone leads to wrong conclusions.
Iron is the clearest example in fatigue. Women of reproductive age lose blood, and so iron, every month, which keeps their ferritin structurally lower. That explains why fatigue from iron deficiency is more common in women. To map this specifically, an iron studies panel helps.
How do you read your own result in context?
The practical lesson from all this: do not look at the bare number, but at the number next to the range that belongs to it. Three rules of thumb help.
- Check which reference range is printed on your result. A good lab states the range for your sex, and sometimes your age.
- Never compare with your partner's result or a friend of the other sex. The same value can mean something different.
- In women, watch the life stage. Menstruation, pregnancy and menopause shift some values considerably.
That life stage is more than a detail. In a woman of reproductive age a low ferritin is often a direct result of menstrual blood loss, while the same low value in a man after midlife is a reason to look further.
Does sex matter for which test you choose?
Sometimes yes. For hormone-related symptoms, men and women often choose different values. A broad package such as the complete metabolic panel gives a general picture, while for specific symptoms you test more selectively. The Dutch Heart Foundation (Hartstichting) also points out that heart risk in women changes after menopause, as the protective effect of oestrogen falls away. So the importance of cholesterol monitoring shifts with age too. For men, symptoms such as fatigue, loss of libido and mood swings sometimes relate to low testosterone, which declines gradually over the years.
Values that are the same for everyone
It is good not to overstate the differences. For by far the most blood values, the same reference range applies to men and women. Think of sodium, potassium, most liver values and your fasting glucose. A deviation there means the same for both sexes, so you do not have to wonder at every value whether your sex plays a role.
Where it really matters is the blood count, iron stores, uric acid and the sex hormones. Those are exactly the values where the difference is biologically explainable. For the rest the rule of thumb is simple: the lab chooses the right range, and you only have to place your own result next to that range. If you are unsure what a value means, your GP is the right person to consult, precisely because they know your whole context. That is especially true when a value falls just outside the range: one number is rarely the whole story, and the combination with your symptoms and history weighs far more than a single outlier.
Frequently asked questions
Does the lab automatically use the right reference values?
Yes, a good lab adjusts reference values for sex and sometimes age. Your result shows which range was used.
Can I test male and female hormones together?
You can, but what is worthwhile depends on your symptoms. Discuss with your GP which hormones suit your situation.
Does this also apply after menopause?
After menopause some values in women shift towards the male range, for example in cardiovascular risk. Your doctor takes this into account.
Every blood test result at Vitalcheck includes a professional assessment by a BIG-registered doctor. A blood value is not a diagnosis: always discuss treatment decisions with your GP.
Sources
- NHG / Thuisarts.nl. Blood testing and sex-specific reference values. Accessed 2026.
- Hartstichting (Dutch Heart Foundation). Cardiovascular disease in women and menopause. Accessed 2026.
Autor
