Part 5 · What to check and when Pharmacology 45 min

Monitoring: Hematocrit, PSA, Estradiol, and the Follow-Up Rhythm

A concrete monitoring calendar, the hematocrit thresholds that trigger action, how to approach PSA changes on therapy, when estradiol is worth measuring, and what does not need routine monitoring.

Learning objectives for this Part
  1. Construct a formulation-specific monitoring schedule for a man initiating testosterone therapy.
  2. Apply hematocrit thresholds to decide between dose reduction, formulation change, therapeutic phlebotomy, and discontinuation.
  3. Interpret PSA changes on testosterone therapy and determine when urology referral is indicated.
  4. Determine when estradiol measurement changes management and when it does not.

Monitoring is where testosterone therapy is either safe or not. The good news is that the required monitoring is short, cheap, and well defined. The failure mode in practice is not that the monitoring is difficult — it is that it silently stops happening after the first year.

The Monitoring Calendar

TimepointTestosterone levelHematocrit / HgbPSAOther
BaselineTwo confirmatory morning valuesYesYes if age ≥40 or risk factorsLH, FSH, SHBG, prolactin as indicated; DRE; blood pressure
3 monthsYes, timed to formulationYesYes if age ≥40 or risk factorsSymptom reassessment; adherence; injection technique; blood pressure
6 monthsYes if dose changedYesYes if age ≥40 or risk factorsSymptom reassessment
12 monthsYesYesYes if age ≥40 or risk factorsFull reassessment; reconfirm ongoing benefit
Annually thereafterYesYesPer shared decision and ageBlood pressure, symptoms, adverse effects, continued indication
Baseline bone density is appropriate in men with severe or long-standing hypogonadism, low-trauma fracture, or other osteoporosis risk factors.

Erythrocytosis

Testosterone stimulates erythropoiesis, partly through suppression of hepcidin and increased iron availability. Erythrocytosis is the most common adverse effect requiring intervention, is more frequent with injectable formulations and with higher peak concentrations, and is more likely in men who smoke, who have obstructive sleep apnea, or who have chronic lung disease.

HematocritAction
Below 50%Continue current therapy; routine monitoring
50–53%Recheck; address contributors — smoking, untreated OSA, dehydration at draw. Consider reducing dose or shortening the interval to lower peaks.
54% or aboveHold or reduce therapy. Evaluate for OSA and other causes. Consider switching from injectable to transdermal. Therapeutic phlebotomy may be used, with hematology input for recurrent cases. Do not simply continue at the same dose.
Before you blame the testosterone

A rising hematocrit on therapy should prompt a look at smoking status, sleep apnea, altitude, chronic hypoxemia, and the timing of the draw relative to the injection. Peak-timed draws in a man on every-2-week injections overstate his average exposure. Fix the schedule and the contributors before abandoning an otherwise effective therapy.

Prostate Considerations

Testosterone therapy produces a modest PSA rise in the first several months as the prostate responds to restored androgen exposure, typically stabilizing thereafter. The contemporary evidence, including the prostate safety data collected within TRAVERSE, does not support the historical claim that testosterone therapy causes prostate cancer. It remains contraindicated in active untreated prostate cancer, and men on therapy should receive age-appropriate prostate cancer screening discussions like any other man.

  • Obtain a baseline PSA and prostate examination in men aged 40 and older, or younger with risk factors, before initiating.
  • Refer to urology for a confirmed PSA increase greater than roughly 1.4 ng/mL within any 12-month period on therapy.
  • Refer for a new palpable nodule or induration on examination.
  • Refer for a PSA above the age-appropriate threshold, or for symptoms of significant lower urinary tract obstruction.
Moderate evidence

Prostate safety data from TRAVERSE and multiple meta-analyses are reassuring for men without known prostate cancer; long-term data in men with treated prostate cancer remain limited and specialist-directed.

Estradiol: When It Matters

Testosterone aromatizes to estradiol, and estradiol has genuine physiologic roles in men — bone density, libido, and lipid handling among them. Routine estradiol measurement in an asymptomatic man on stable therapy is not recommended and frequently leads to inappropriate treatment. Measure estradiol when there is a clinical reason: new or worsening gynecomastia, breast tenderness, notable fluid retention, or persistent mood symptoms in a man whose testosterone is at target. When measurement is warranted, a sensitive assay such as LC-MS/MS is preferred, since standard immunoassays perform poorly at male concentrations.

Aromatase inhibitors are overused

Routine addition of anastrozole to testosterone therapy to 'control estrogen' is not evidence-based, is off-label, and risks driving estradiol too low — with consequences for bone density, libido, and lipids. Reserve aromatase inhibition for symptomatic, confirmed elevation that has not responded to dose reduction or interval adjustment, and consider specialist input.

Limited evidence

Routine aromatase inhibitor use in men on testosterone therapy lacks supportive outcome trials; harms from over-suppression of estradiol are mechanistically well established.

What Does Not Need Routine Monitoring

  • Liver function tests — modern formulations are not hepatotoxic; this was a concern with 17-alpha-alkylated oral androgens such as methyltestosterone, which are not used for replacement.
  • Routine lipid panels beyond standard cardiovascular risk screening.
  • Routine estradiol in the asymptomatic patient.
  • Routine LH and FSH after therapy has started — they will be suppressed, and that is expected.
Case 5

The PSA that needed a phone call

A 62-year-old man has been on testosterone gel for 14 months with good symptom response. His baseline PSA was 1.1 ng/mL. At 12 months it was 1.5 ng/mL. He returns at 14 months for an unrelated visit and a repeat PSA is 3.1 ng/mL. Digital rectal examination is normal. He has no urinary symptoms.

What is your interpretation and next step?

Self-assessment

Check yourself before moving on

1. A man on testosterone cypionate has a hematocrit of 55 percent at his 6-month visit. What is the most appropriate management?

2. Which laboratory test does NOT require routine monitoring in a man on modern testosterone replacement therapy?

References for this Part
  1. 1.Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744. Source
  2. 2.Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200(2):423–432. Source
  3. 3.Wei JT, Barocas D, Carlsson S, et al. Early detection of prostate cancer: AUA/SUO guideline. J Urol. 2023;210(1):46–53 and 210(1):54–63. Source
  4. 4.Ohlander SJ, Varghese B, Pastuszak AW. Erythrocytosis following testosterone therapy. Sex Med Rev. 2018;6(1):77–85. Source
Full course reference list