How often is bloodwork done on TRT?

The Endocrine Society monitoring schedule

The 2018 Endocrine Society Clinical Practice Guideline (Bhasin et al., The Journal of Clinical Endocrinology & Metabolism, 103(5):1715–1744) recommends a standardized plan during the first year of therapy: evaluate symptoms, adverse effects, and adherence, and measure serum testosterone and hematocrit, at an initial follow-up of 3–6 months after starting.

Testosterone

The guideline recommends measuring serum testosterone to confirm it is in the target range (it targets the mid-normal range for the assay used), checked at the 3–6 month follow-up and then periodically.

Hematocrit

Because testosterone can raise red-cell mass, the guideline recommends checking hematocrit at baseline, at 3–6 months, and then annually. It advises against starting therapy in a man whose baseline hematocrit is already above the lab's upper limit without first addressing the erythrocytosis risk.

PSA and prostate exam

For men 40 and older with a baseline PSA above 0.6 ng/mL, the guideline recommends a digital rectal exam and PSA before starting, again at 3–6 months, and thereafter in line with standard prostate-cancer screening guidelines.

This is the guideline's monitoring protocol, reported as written. Testosterone therapy is a prescription treatment; what to test and how often for a given person is a clinical decision made with a licensed physician. This page is educational and describes what the guideline says — it is not medical advice.

• Initial follow-up: 3–6 months after starting, then annually (Endocrine Society 2018).
• Testosterone + hematocrit: baseline, 3–6 months, then annually.
• PSA + prostate exam: men 40+ with baseline PSA >0.6 ng/mL — before, at 3–6 months, then per screening guidelines.