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Monitoring testosterone therapy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Monitoring

After starting testosterone (T) therapy, patients should be evaluated at 3, 6 and 12 months, then annually thereafter, to monitor:

  • serum testosterone - aim for a therapeutic target in the mid to upper range (15-30nmol/L), for an optimal response
  • haematocrit - levels should remain <54%. Dose reductions or preparation changes may be required to keep haematocrit levels within range. If they remain high, consider stopping T therapy and reintroducing it at a lower dose
  • PSA - prostate health should have been assessed via DRE and PSA prior to starting treatment. After initiating T therapy, a PSA increase >1.4ng/mL over a 1-year period, or a PSA velocity >0.4ng/mL/year during sequential measurements over >2 years warrants urological evaluation and more intensive surveillance for prostate cancer thereafter1
  • cardiovascular risk factors - these should also have been assessed prior to staring treatment
  • symptomatic improvement - failure to benefit within a reasonable time frame (defined as 6 months for libido, sexual function, muscle function & improved body fat) should prompt treatment discontinuation and investigation for other causes of the symptoms1

Reference


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