Safety Monitoring and Long-Term Considerations
Long-term testosterone therapy requires a structured monitoring plan to ensure safety and efficacy. During the first year of treatment, patients typically undergo blood tests every three to six months to check testosterone levels and hematocrit.
A common side effect of therapy is erythrocytosis—an overproduction of red blood cells—which can increase blood viscosity and must be managed by dose adjustment or therapeutic phlebotomy.
Prostate health is another key area of surveillance. While current evidence does not suggest that TRT causes prostate cancer, it can stimulate the growth of an existing tumor. Therefore, regular digital rectal exams and PSA (prostate-specific antigen) testing are standard for men over a certain age. Recent large-scale trials have provided reassurance regarding cardiovascular safety, showing that TRT does not significantly increase the risk of major cardiac events when prescribed correctly. Finally, patients should be monitored for improvements in bone density and mood, with therapy being discontinued if clear symptomatic relief is not achieved within a reasonable timeframe.