testosterone treatment: monitoring your health during testosterone therapy

by Chris Steidle, MD.

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

PSA tests during testosterone treatment

In spite of there being no evidence that testosterone supplementation causes prostate cancer, it pays to keep track of PSA levels. Before starting on testosterone treatment, 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.

The PSA and DRE should be repeated two to three months after the start of testosterone 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 testosterone 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.

Complete blood counts during testosterone treatment

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

Monitoring your low testosterone symptoms during treatment

It will be helpful for you to monitor your low testosterone symptoms, as well, in order for you to know if testosterone treatment 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 testosterone treatment begins, and then log in 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 log in with the password you created. If you have any questions about privacy, please read our privacy policy.

How to Know if Testosterone Treatment is Working

If your symptoms were due to a low testosterone level, you should see positive effects within about three months of starting testosterone 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 testosterone treatment.

References

¹ The Endocrine Society.
² Mayo Foundation for Medical Education and Research.
³ Brawer, MK. Androgen Supplementation and Prostate Cancer Risk: Strategies for Pretherapy Assessment and Monitoring. Urol. 2003;5(suppl 1):S29-S33.
⁴ Brawer, MK. Androgen Supplementation and Prostate Cancer Risk: Strategies for Pretherapy Assessment and Monitoring. Urol. 2003;5(suppl 1):S29-S33.
⁵ Matsumoto AM, Sandblom RE, Schoene RB, et al. Testosterone replacement in hypogonadal men: effects on obstructive sleep apnea, respiratory drives and sleep. Clin Endocrinol (Oxf). 1988;28:461-470.
⁶ Santamaria JD, Prior JC, Fleetham JA. Reversible reproductive dysfunction in men with obstructive sleep apnea. Clin Endocrinol (Oxf). 1988;28:461-470.

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Posted: June 2003
Updated: August 2009