- Evaluate patient every three months in the first year and then one to two times per year to monitor for appropriate signs of virilization and for development of adverse reactions.
|
- Measure serum testosterone every three months until levels are in the normal physiologic male range:
|
- For testosterone enanthate/cypionate injections, the testosterone level should be measured midway between injections. The target level is 400 to 700 ng/dL. Alternatively, measure peak and trough levels to ensure levels remain in the normal male range.
|
- For parenteral testosterone undecanoate, testosterone should be measured just before the following injection. If the level is <400 ng/dL, adjust dosing interval.
|
- For transdermal testosterone, the testosterone level can be measured no sooner than after one week of daily application (at least two hours after application).
|
- Measure hematocrit or hemoglobin at baseline and every three months for the first year and then one to two times a year. Monitor weight, blood pressure, and lipids at regular intervals.
|
- Screening for osteoporosis should be conducted in those who stop testosterone treatment, are not compliant with hormone therapy, or who develop risks for bone loss.
|
- If cervical tissue is present, monitoring as recommended by the American College of Obstetricians and Gynecologists.
|
- Ovariectomy can be considered after completion of hormone transition.
|
- Conduct sub- and periareolar annual breast examinations if mastectomy performed. If mastectomy is not performed, then consider mammograms as recommended by the American Cancer Society.
|
