Hypogonadism in Males - Late-Onset Follow Up

The patient should be monitored carefully (by monthly check-up every 3 months) for the development of adverse effects.

At 1 Month and 3 Monthly Thereafter

Follow up with patients to assess that the desired testosterone level is achieved. Optimal serum testosterone levels for efficacy is unknown. It is generally recommended that mid- to lower young adult levels may be appropriate as the therapeutic goal. Evaluate the patient for complications or adverse effects and determine if symptoms are improving.

During First Year of Therapy

Perform a prostate exam, prostate-specific antigen (PSA), and hematocrit every 3 months. A hematocrit of >54% requires dose reduction or temporary medication discontinuation. If the PSA increases >0.75 ng/mL over two consecutive controls or a PSA level is abnormal for age (>4 ng/mL), further exam and eventual biopsy may be needed. Plasma lipid determinations may be done at the third and sixth months of therapy. A liver function test, urinalysis, and measurement of bone markers may be done at the sixth month.

At 1 Year

Repeat all previous tests done in the sixth month. Blood glucose control should be evaluated by fasting blood glucose (FBG), post-prandial glucose (PPG), or HbA1c. After the first year, follow-up may be done every 6 months for 2 years and annually thereafter.