Staying safe on Treatment
YOUR MONITORING PLAN
BEFORE
Review symptoms and fertility plans. Confirm low testosterone with two morning tests; obtain baseline CBC and prostate assessment.
EARLY FOLLOW-UP
Recheck symptoms, testosterone and CBC after starting or changing treatment, often within 3 to 6 months; assess PSA as appropriate.
ONGOING
Two routine lab panels per year are included. We follow CBC and testosterone, PSA at least yearly in
our practice, plus symptoms and blood pressure.
BLOOD COUNTS & DONATION
Testosterone can raise red blood cells (secondary erythrocytosis). We check a CBC at least twice yearly after stabilization. Blood donation is not automatically required. If hematocrit rises, we assess causes such as sleep apnea and may adjust treatment or discuss phlebotomy. Above 54%, testosterone is generally paused until safe to restart.
PSA & PROSTATE HEALTH
We obtain a baseline PSA when appropriate and check it at least annually in our practice. Small changes may occur, including with inflammation or infection, but a persistent rise needs repeat testing and assessment. PSA alone cannot diagnose cancer. Tell us about new urinary symptoms; we may recommend a urology evaluation.
KNOW WHAT TO REPORT
MONTHLY TESTICULAR CHECK
During or after a warm shower, when the scrotal skin is relaxed, gently roll each testicle between your fingers and thumb. Notice any new firm lump, swelling, or change in size or feel. Let us know promptly if anything changes. This check does not replace a medical examination.
MONTHLY TESTICULAR CHECK
During or after a warm shower, when the scrotal skin is relaxed, gently roll each testicle between your fingers and thumb. Notice any new firm lump, swelling, or change in size or feel. Let us know promptly if anything changes. This check does not replace a medical examination.
ESTRADIOL, SIDE EFFECTS & URGENT SYMPTOMS
Some testosterone converts to estradiol, a normal male hormone. Report new nipple tenderness or breast enlargement; mood changes alone do not prove high estradiol. We review symptoms and labs before considering an estrogen blocker. Also tell us about acne, swelling, or worsening sleep apnea. For chest pain, sudden shortness of breath, or one-sided leg swelling, seek urgent medical care rather than sending a routine message.
CLINICAL SOURCES
• Endocrine Society, testosterone guideline
• Endocrine Society, 2026 statement
• FDA, testosterone information
- • NCI, PSA test
• NIDDK, prostatitis
• American Cancer Society, testicular checks
