Michael A. Werner, M.D.

People start hormone replacement therapy for a number of reasons, but once you begin the treatment understand that monitoring it is a lifetime commitment. 

So far, there isn’t a general consensus about how men undergoing testosterone replacement should be monitored.  It is clear that those patients who have begun testosterone replacement for a particular symptom should have that symptom carefully observed. For example, a patient using testosterone because of problems with osteoporosis should have regular serial bone density screens. Patients with mood or libido changes must also be carefully evaluated.

In general, we recommend that dosage begin low. Hormone levels and subjective impressions should then be checked two to three months afterward. If adequate blood hormone levels have not been reached, the dosage should be increased, and, again, the patient should return in another two to three months for blood work.

Our goal is to get you in the mid-range of the testosterone values. Once this has occurred, you will be monitored at regular intervals both in terms of symptoms and blood work.

We’ll be monitoring your blood fairly frequently. Once we achieve the right dosage of hormone, we follow your progress and draw blood every three months for at least a year. The following year, we evaluate you and draw blood every four months. Thereafter, appointments and blood work are required every six months.

During the initial follow-up appointments, we evaluate you psychologically and physically. Blood work includes hormone levels, a complete chemistry profile including chemistries, lipids (fat profiles), and liver function tests. We also perform a complete blood cell count to check your hematocrit (an increased hematocrit is a common side effect of testosterone replacement therapy). It is important that you receive serial prostate exams at all of these visits as well as a PSA test. It is also important to discuss any sleep disorders and to assess your mood, libido, and emotional state.

To learn more about testosterone therapy and treatment options, please call Dr. Werner's office at (646) 380-2700 in NYC, (914) 997-4100 in Westchester, or (203) 831-9900 in Connecticut, or send us an email at info@wernermd.com.