TRT in the UK

How does TRT Monitoring Work?

How does TRT Monitoring Work?

By Mike Kocsis | 7 minutes read | Last updated: July 13, 2023
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  • Medically Reviewed by Dr. George Touliatos

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    Testosterone is an essential hormone secreted by the testes in men and ovaries in women. In men, it is involved in many important processes and helps maintain bone strength, muscle mass, and sexual function. Hence, its deficiency can cause serious health problems, including low sex drive and loss of muscle mass.

    Most men with low testosterone are recommended TRT, a therapy that involves the administration of exogenous testosterone to bring blood testosterone levels back to normal. This treatment has helped many men get rid of their low T symptoms and improve the quality of their lives.

    However, when a man starts TRT that does not mean his condition is now under control. TRT monitoring is crucial to ensure his testosterone levels stay normal and he gets the most out of this treatment.

    Keep reading the article to learn what exactly is done during TRT monitoring and why it is important.

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    What is TRT monitoring, and why is it done?

    TRT monitoring involves checking your overall health, the effects of TRT, and your testosterone levels throughout the treatment. Initially, it is done every 3 to 6 months. Once your testosterone levels become stable, your doctor may suggest an annual checkup.

    TRT monitoring is mainly done to make sure:

    • You achieve your health goals via TRT
    • Your testosterone levels stay within the normal range
    • Your low T symptom go away
    • There are no serious side effects of TRT


    How does TRT monitoring work?

    Every man is unique and has different TRT-related goals. Once you decide to have TRT, your healthcare provider will run a few tests and do a physical examination to evaluate your baseline health and design a TRT plan to cater to your individual needs.

    When you receive your first testosterone dose, your healthcare provider will see you in 3 to 6 months to check how your body is responding to the treatment and what your current testosterone levels are.

    If your testosterone level is within the desired range, they will keep the testosterone dose the same. But in case your testosterone levels are not normal, they will tweak the dosage to make sure you get desired results and feel your best.


    What is checked during TRT monitoring?

    Consistent monitoring is done to ensure you reach your goals. Generally, it involves blood pressure analysis, testosterone level testing, a full blood panel, a physical examination, and a general health questionnaire.

    Most healthcare providers customise monitoring according to each patient’s individual needs. For instance, if your risk of developing a certain condition is higher, you may have more monitoring sessions per year to help the doctor detect the problem earlier.

    There are a few things that most doctors analyse during treatment monitoring.

    Blood testosterone levels

    Doctors conduct testosterone tests throughout the treatment to ensure the hormone is within normal range. Through this test, they analyse your total testosterone and free testosterone levels and compare them with the testosterone levels that you had before starting TRT. It helps them optimise your dose and ensure you get the best possible results.

    Your doctor will most probably check your testosterone levels every 3 to 6 months during the first year of the treatment. When they become stable, testosterone testing will be done once per year.

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    Low T symptoms

    TRT aims to elevate your testosterone levels to help you eliminate low T symptoms and feel good. During testosterone monitoring, your doctor will ask a few questions to see how much TRT has helped you manage your symptoms. They may increase your dose if no change is observed.

    Treatment side effects

    Like any other treatment, TRT also produces side effects, including acne, male breast enlargement, disturbed breathing when sleeping, etc. Your doctor will watch out for these effects to help you manage them in the best possible way.

    Prostate-specific antigen (PSA)

    Studies don’t show any correlation between prostate cancer development and TRT, but they do tell that the treatment can stimulate cancer growth in men who already have it, or it may increase the risk of prostate cancer in men with certain medical conditions.

    The PSA test is done to screen for prostate cancer. In this test, your PSA count is calculated. PSA is a protein produced by the prostate. Men with prostate cancer have a higher PSA level than healthy men.

    Blood count

    TRT may increase your red blood cell count, which makes the blood thicker. It can increase the risk of blood clot formation, high blood pressure, and heart attack.

    Therefore, testing blood counts regularly is important as it helps detect the problem beforehand and prevents its serious consequences. In most cases, if the blood count is higher than normal, your doctor may reduce your testosterone dosage.

    Blood pressure

    Your blood pressure will be monitored every time you visit the clinic to have the treatment. If you are on the at-home program, you will have to check it regularly on your own.

    Blood pressure is used as an indicator of overall health. As mentioned earlier, TRT may increase the risk of high blood pressure and heart stroke; therefore, evaluating your blood pressure is required to help avoid these potential side effects.


    What else do you need to know about TRT

    Keep your expectations real

    Although TRT helps with low T symptoms, it may not improve your condition as much as you expect. It is mainly because many factors are involved in improving your health. For instance, low testosterone alone may not be the culprit of poor sex drive. It may be due to lack of sleep, excessive weight, low self-esteem, or a certain health condition.

    Choose a simpler and more effective TRT method

    There are different ways to administer testosterone. Each method has its unique pros and cons. A method that works for someone else may not be as effective for you as it was for them. Discuss the pros, cons, methods of application, and effects of each method with your doctor to choose a TRT method that best suits your needs.

    TRT is a lifetime commitment

    TRT is a lifelong procedure. You cannot take it on and off and expect your testosterone levels to stay stable. When you stop taking testosterone, your levels will basically go back to what they used to be before starting TRT. Your low T symptoms will also return.

    So, before you start your TRT journey, prepare yourself fully for this lifelong commitment.

    Keep track of your results and side effects

    If you are new to TRT, you should note down your symptoms, side effects, or whatever you are feeling due to the treatment, so you can discuss it with your doctor the next time you visit him.

    In our busy routines, we tend to easily forget how we were feeling or doing the past week. So, telling your doctor how you have been feeling throughout the last few months can be difficult. We suggest you keep making notes until your next session, so you don’t have any trouble explaining your condition to the doctor.



    Can any person have TRT?

    TRT is an effective treatment, but it is not for all. It is only prescribed to men with low T symptoms that too if they don’t have prostate cancer and cardiovascular disease development risk. Your doctor may suggest natural ways of increasing testosterone if you are not the right candidate for TRT.

    How much does TRT cost?

    TRT cost depends on different factors, which is why it is hard to give an exact number. Common factors that influence TRT cost are:

    • Mode of testosterone administration
    • Frequency of administration
    • Your location
    • Insurance coverage

    If you are considering TRT cost, know that the treatment does not cure low T; it simply elevates your testosterone levels. It means you will have to take it and pay for it throughout your life to keep your testosterone levels stable.

    How to get started with TRT?

    During your first consultation, your doctor will run a few tests to measure your testosterone levels and find the cause of low T. Once low T and its cause have been diagnosed, the doctor will design a suitable treatment plan to help you improve your health and testosterone levels.

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    Summing it up

    Some men believe getting testosterone is all they need to fix their low T condition. Remember that testosterone administration and treatment monitoring go hand in hand. In addition to receiving testosterone, you need to monitor your testosterone levels as well to ensure they stay stable and TRT does not produce potential side effects.

    A monitoring session usually involves a questionnaire, blood count test, and testosterone test. Your doctor will design a monitoring schedule for your individual needs according to your lifestyle.


    References/Further reading/Bibliography/Scientific studies 

    • Baillargeon, J., Urban, R.J., Kuo, Y.F., Holmes, H.M., Raji, M.A., Morgentaler, A., Howrey, B.T., Lin, Y.L. and Ottenbacher, K.J., 2015. Screening and monitoring in men prescribed testosterone therapy in the US, 2001–2010. Public health reports130(2), pp.143-152.
    • Mulhall, J.P., Trost, L.W., Brannigan, R.E., Kurtz, E.G., Redmon, J.B., Chiles, K.A., Lightner, D.J., Miner, M.M., Murad, M.H., Nelson, C.J. and Platz, E.A., 2018. Evaluation and management of testosterone deficiency: AUA guideline. The Journal of urology200(2), pp.423-432.
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    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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    Last update: July 13th, 2023
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