Counseling Male Patients on Testosterone Replacement Therapy With Efficacy and Safety in Mind

Andrea G. Douglas, PharmD Candidate 2016; Joylaina Speaks, PharmD Candidate 2016; Jennifer Elliott, PharmD; Deirdre B. Fanning, PharmD


US Pharmacist. 2015;40(8):25-30. 

In This Article

Treatment Guidelines

Along with signs and symptoms (Table 1),[4] male hypogonadism is confirmed by two morning testosterone levels on separate occasions. Repeating the testosterone level is necessary because testosterone levels fluctuate throughout the day. Therefore, one low reading may not be indicative of chronically low levels. As shown in Table 2,[4] LH and FSH levels are drawn once to determine primary or secondary origin. To assess the patient's risk of prostate cancer, a prostate-specific antigen (PSA) is recommended at baseline, in 3 to 6 months, and then annually. Hematocrit levels are recommended on the same schedule as PSA to evaluate the risk for developing hypoxia and sleep apnea. Additional laboratory tests may be recommended for other medical conditions in the individual patient. Pharmacists can discuss these monitoring parameters with their patients during counseling sessions to help improve awareness and compliance with proper monitoring.