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monitoring testosterone treatment

by Chris Steidle, MD.

Now that you are using some form of testosterone replacement therapy, there are some tests that you and your doctor will want to perform on schedule as a matter of common sense:

In spite of there being no evidence that testosterone supplementation causes prostate cancer, it pays to keep track of PSA levels. Before starting on TRT, prostate cancer will have been ruled out through a digital rectal examination (DRE) and a baseline PSA measurement. If the DRE is abnormal or the PSA is over 4.0 ng/mL, then a prostate biopsy should be done. On the other hand, if both tests are normal, you can feel comfortable about starting therapy.

A baseline CBC (complete blood count), including hemoglobin and hematocrit readings, should be done to obtain a baseline status of red blood cells.

The PSA and DRE should be repeated two to three months after the start of treatment. If the PSA is over 4.0 ng/mL and/or the DRE shows abnormalities, a biopsy should be done.

The PSA and DRE should be repeated six months after the start of treatment. If the PSA is over 4.0 ng/mL and/or the DRE shows abnormalities, a biopsy should be done.

The PSA and DRE should be repeated annually after the six-month check.

It will be helpful for you to monitor your symptoms, as well, in order for you to know if testosterone is improving the way you feel. We have developed a handy online tool, the AMS (Aging Male Symptom) questionnaire, which can help you assess your initial condition and monthly progress on three dimensions: physical, emotional and sexual. You can create a profile (using a made up identity if you prefer), take the questionnaire before treatment, and then login once a month for 3-6 months. You will be able to see what is changing and by how much as a result of testosterone therapy. You can rest assured that this information will remain private in our database and your identity will be removed from the data. Only you will be able to login with the password you created. If you have any questions about privacy, please read our privacy policy.

How to Know if A Treatment is Working

If your symptoms were due to a low testosterone level, you should see positive effects within about three months of starting therapy. Some of the changes you may experience include:

• Increased interest in sex and increased frequency of spontaneous erections
• Restored erectile function in some men
• Improved mood with less depression, anger, fatigue, or mental confusion
• Enhanced masculine characteristics such as faster beard growth and an increase in pubic hair
• Increased muscle mass and strength as well as increased bone density

If you do not see some of these improvements within the three-month time frame, you should talk with your doctor about discontinuing treatment.

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Last updated: June 2003

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