Hypogonadism%20in%20males%20-%20late-onset Management

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

At 1 Month & 3 monthly therafter

• Follow up w/ patients to assess that the desired testosterone level is achieved
  
  • Optimal serum testosterone level 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/adverse effects & determine if symptoms are improving

During 1st Year of Therapy

• Perform prostate exam, PSA, hematocrit every 3 months
  
  • Hematocrit >54% requires dose reduction or temporary medication discontinuation
  • If the PSA increases >0.75 ng/mL over 2 consecutive controls or a PSA level abnormal for age (>4 ng/mL), further exam & eventual biopsy may be needed
• Plasma lipid determinations at the 3rd & 6th month of therapy
• Liver function test, urinalysis & measurement of bone markers may be done at the 6th month

At 1 Year

• Repeat all previous tests done on the 6th month
• Blood glucose control should be evaluated by fasting blood glucose (FBG), post-prandial glucose (PPG) or HbA_1c
• After the 1st year, follow-up may be done every 6 months for 2 years & annually thereafter