How Often Should You Get Bloodwork on TRT?

Last updated: October 2, 2026

How often should you get bloodwork on TRT? Most men on TRT need baseline bloodwork, an early on-treatment check timed to the product or formulation, then repeat monitoring. Major U.S. guidance generally moves to every 6–12 months or yearly once treatment is stable, while some FDA-approved products require more frequent hematocrit checks.

Here's the part almost nobody tells you. The FDA label for testosterone cypionate injection doesn't give a calendar at all. It says hemoglobin and hematocrit should be checked "periodically." Below, we show you what the guidelines say, what seven current FDA labels say, how the schedule changes by product, and how to tell whether your clinic's plan covers the basics.

By TRT Provider Guide · Last verified: October 2, 2026 · Editorial research, not clinically reviewed · How We Review TRT Providers

Educational information, not medical advice. If you have chest pain, sudden shortness of breath, leg swelling, or signs of a stroke, get emergency care now. Don't wait for a lab appointment.

Your TRT bloodwork schedule at a glance

Treat this as the normal shape, not your personal calendar. Your prescriber's orders come first. The test being measured, the testosterone product, your previous results, and your health history can all move dates earlier.

TRT Provider Guide is the independent decision resource for testosterone replacement therapy — helping U.S. adults understand how low testosterone is evaluated, compare online and local care models and providers, and choose the next step that fits their health needs, fertility plans, budget, state, and care preferences, with every material claim verified and dated.

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Why isn't there one TRT bloodwork schedule for everyone?

Because four things set your next lab date, and they're different for every man. Where you are in treatment, which test is being repeated, which testosterone product you use, and what your last results showed can each move the date. A stable man with steady numbers usually tests less often than someone who just started, changed doses, or had a rising hematocrit.

Most pages give you one number, like "every 6 months." Then you hear "every 3 months" from a friend and "once a year" from your doctor, and you don't know who's wrong. Often nobody is. They're answering different parts of the question.

Here's the simple rule we use on this page.

The 4 things that set your next TRT lab date

1. Your stage. Before treatment, the first months, or stable. Testing is tighter early, when there's the most to learn.
2. The test. Testosterone, hematocrit, and PSA each run on their own clock. They don't all have to be checked every time.
3. Your product. Some FDA-approved products come with their own lab schedule. Others don't come with one at all.
4. Your last results and symptoms. A number that's climbing, or a new problem, pulls the next draw closer.

Keep these four in mind. Every section below fits into one of them.

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What do the guidelines and FDA drug labels actually say?

The two big U.S. guidelines agree on the pattern but not every interval, and some FDA-approved products add tighter product-specific checks. The Endocrine Society checks testosterone 3–6 months after starting and then at 12 months and yearly thereafter. The AUA calls for an initial testosterone check after an appropriate interval and then every 6–12 months once levels are established. Some current FDA labels call for hematocrit about every 3 months.

Below are the sources lined up side by side. We read the current FDA label for seven testosterone products on October 2, 2026, and checked each against the two guidelines and one state medical board's published guidance.

TRT bloodwork rules, side by side

Where they differ, don't automatically pick the strictest number yourself. Ask which source applies to your exact product and situation. A guideline, a drug label, and a state-board rule do different jobs, and your prescriber has to apply the right one.

Testosterone cypionate's label gives almost no calendar

Testosterone cypionate is widely used for TRT, but the current Depo-Testosterone label only says hemoglobin and hematocrit should be checked "periodically" in patients receiving long-term androgen treatment.

That's it. No month. No numeric hematocrit threshold. And no product-label schedule for routine on-treatment testosterone or PSA testing.

Compare that with Xyosted, a weekly subcutaneous testosterone enanthate autoinjector. Its label calls for hematocrit about every 3 months and a testosterone trough after 6 weeks of dosing, again 6 weeks after a dose change, and periodically thereafter.

Compounded testosterone has no FDA-approved product label

Many online clinics prescribe compounded testosterone. Compounded drugs are not FDA-approved, and an individual compounded preparation does not have an FDA-approved prescribing-information label like an approved testosterone product.

That does not mean "anything goes." The prescriber still has to follow applicable law, professional standards, and an appropriate monitoring plan. If you receive compounded testosterone, guideline-based monitoring and the clinic's written protocol matter because there is no FDA-approved product label for that compounded preparation.

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How many blood draws will you need in your first year on TRT?

There is no defensible single first-year number for every man on TRT. The Endocrine Society framework creates two major follow-up checkpoints for testosterone and hematocrit in the first year, while some product labels add earlier testosterone checks or every-three-month hematocrit monitoring. When different tests fall on different dates, one person can end up with more draws than another even when both plans are reasonable.

We counted the distinct follow-up checkpoints explicitly named by each source. This is a schedule comparison, not a personal prescription: a prescriber may combine tests into one draw, move a date, or order an extra draw because of a result or treatment change.

Year-one monitoring checkpoints by source (our count)

What this means for you: two men on TRT can both be monitored appropriately and have very different calendars. An oral product may create an early testosterone check plus frequent hematocrit checks. A man on testosterone cypionate may follow a guideline-based schedule because the product label itself is vague. If your plan looks very different from both the applicable label and recognized guidance, ask your prescriber why.

If you are paying cash for labs, ask for the full expected follow-up-lab cost, not just the price of one testosterone test. The panel, ordering method, lab, insurance, and whether your program includes follow-up labs can change the real cost.

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Build your TRT bloodwork calendar

A general article can't set your personal lab dates, but you can turn your prescriber's plan into a calendar you can actually follow. Use this worksheet after you know your product, your start date, and the timing instructions your prescriber wants.

Step 1: Write down the monitoring source that applies

• Your prescriber's written plan
• The FDA-approved label for your exact product, if you use an FDA-approved product
• The guideline your clinician is following
• Any state-specific requirement that applies to your care

Step 2: Add the first on-treatment testosterone check

Write down:

• Date or interval: __________
• When to draw relative to the dose/application: __________
• What the result is being used to assess: __________

Step 3: Add hematocrit and other safety checkpoints

Write down:

• Next hemoglobin/hematocrit date: __________
• Next PSA date, if your clinician says PSA monitoring applies: __________
• Other tests your clinician ordered and why: __________

Step 4: Add the "if stable" date

Ask one question that removes a lot of uncertainty:

"If these results are stable, when is my next set of labs?"

Write the answer here: __________

Step 5: Add a change rule

Ask what happens to the schedule if your dose, treatment format, product, symptoms, or a safety marker changes.

My clinic's change rule: __________

This worksheet is educational. It doesn't diagnose low testosterone, interpret your results, change your treatment, or replace your prescriber's instructions.

The right TRT provider is not the same for every person — it depends on whether low testosterone has been properly evaluated, your symptoms and health history, your fertility plans, your state, your insurance or cash-pay preference, your treatment-format preference, your budget, and whether online or in-person care is the better starting point. Some situations belong with primary care, urology, endocrinology, reproductive urology, or urgent or emergency care when the symptoms warrant it. Because a general answer cannot resolve those for you, use TRT Provider Guide's Find My TRT Path tool to map your situation to the right care route and the questions to ask before you pay.

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How often should testosterone be checked on TRT?

Early on, the first testosterone check depends on the formulation or product; it can be as early as about a week for some oral products, while the Endocrine Society's general monitoring checkpoint is 3–6 months. Once treatment is stable, the AUA says every 6–12 months, and the Endocrine Society uses yearly monitoring after its first-year checkpoints. Your prescriber may check sooner after a clinically meaningful treatment change.

Total testosterone is all the testosterone in your blood. It's the main number used to see whether your dose is landing in range.

At the start. There's no single "6-week rule" for every testosterone product. Kyzatrex and Jatenzo labels use a testosterone check after at least 7 days, AndroGel 1.62% uses pre-dose morning checks at about days 14 and 28, Xyosted uses a trough after 6 weeks, and Tlando uses a check at 3–4 weeks. The Endocrine Society's general monitoring checkpoint is 3–6 months.

Once you're stable. The AUA calls for testosterone every 6–12 months while you stay on treatment. The Endocrine Society calls for a yearly check after the first year.

After a change. If your dose, your shot schedule, or your product changes, your last result may not describe your new treatment anymore. Expect a recheck. Some labels spell this out: Xyosted asks for one 6 weeks after a dose change. Kyzatrex and Jatenzo ask for one 7 days after.

What the numbers aim for. The AUA guideline discusses adjusting therapy toward the middle tertile of a laboratory's normal reference range, while the Endocrine Society recommends the mid-normal range and gives formulation-specific timing instructions. Don't turn one target range into a DIY dose rule. Labs and products differ, which we compare in our TRT bloodwork reference ranges research.

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How often should hematocrit be checked on TRT?

Before you start, again at 3–6 months, then every 6–12 months, or about every 3 months on some FDA-approved products. Hematocrit gets its own schedule because testosterone can make your body build more red blood cells. A level above about 54% is the point where both major guidelines say your clinician needs to act.

Hematocrit is the share of your blood made up of red blood cells. It's part of a complete blood count (CBC), a common blood test. When testosterone raises red-cell mass too much, doctors may call it erythrocytosis. Monitoring hematocrit is one of the major safety reasons TRT needs regular labs.

How often, by source:

• Endocrine Society: before treatment, at 3–6 months, then yearly.
• AUA: before treatment, then every 6–12 months.
• FDA labels: about every 3 months for Xyosted, Kyzatrex, Jatenzo, and Tlando in year one. At 3–6 months, then yearly, for AndroGel 1.62% and Aveed. "Periodically" for Depo-Testosterone.

The number that matters. The Endocrine Society says to pause treatment if hematocrit goes above 54% and restart at a lower dose once it comes down. The AUA wants it under 50% before you start and kept under 54% during treatment.

What to do with a high number: call your prescriber. Don't lower, skip, or stop your dose on your own. What happens next is a medical decision, and your prescriber has options that depend on your full picture.

When to expect more checks. A rising hematocrit, a product whose label asks for every 3 months, or a prescriber who's watching a trend can all mean more frequent draws. That's a safety step, not a bad sign about you.

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Do you need a PSA test every time you get TRT bloodwork?

No. PSA usually comes up before you start and once in the first year, then follows normal prostate screening rules. The AUA recommends a baseline PSA for men over 40 starting TRT. The Endocrine Society, for men who choose prostate monitoring, checks again 3–12 months after starting and refers to a urologist if PSA rises by more than 1.4 ng/mL within 12 months or is confirmed above 4.0.

PSA (prostate-specific antigen) is a blood test that can flag prostate problems. It isn't a TRT dose test. It's a safety check.

After the first year, both guidelines fall back on standard prostate-cancer screening, decided between you and your clinician based on your age and risk. Some rules are stricter. Alabama's medical board, for example, expects PSA at least once a year for men on TRT, and every 6 months with a personal or family history of prostate cancer.

Did the 2026 FDA label changes remove PSA checks?

No. On June 18, 2026, HHS announced that the FDA had asked testosterone makers to update their labels. The request would remove the limit on use for age-related low testosterone, narrow the prostate-cancer warning so it applies only to cancer that has spread, and soften the warning about an enlarged prostate.

HHS also said the labeling continues to recommend screening before treatment and monitoring during it.

And here's what we found when we checked. As of October 2, 2026, none of the seven current FDA labels we read had been changed yet. All seven still carry the old prostate wording. The Kyzatrex label was revised in August 2026 and still didn't include the change. Until your product's label changes, and your prescriber says otherwise, plan on PSA monitoring as before.

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Which other blood tests belong on TRT bloodwork?

Testosterone and hematocrit are the two core repeat tests. Everything else depends on your age, symptoms, health history, and product. There's no single "TRT panel" every man needs at every draw. Blood pressure isn't a lab test, but all seven FDA labels we read say to check it.

Many clinics run big panels at every draw. That isn't wrong, but it isn't required either. Here's what the sources actually call for.

The short version: if your clinic checks testosterone and a blood count on schedule, and PSA when your age calls for it, you're covered on the basics. Extra tests are fine if there's a reason for them. Ask what the reason is.

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Does the timing of your TRT blood draw matter?

Yes. "How often" and "when in your dose cycle" are two different questions. Testosterone rises and falls after each dose. A draw the day after a shot and a draw right before the next shot can look very different, and your dose may be adjusted based on that number.

Gels, oral capsules, and Xyosted have product-specific timing in their FDA labels. Standard testosterone cypionate and enanthate injection labels don't give a comparable routine sample-timing instruction. For those short-acting injections, the Endocrine Society guideline says to measure serum testosterone midway between injections. Clinics may use different timing protocols:

Look at those last three rows. Published clinic instructions can differ because they may be trying to measure different points in the dosing cycle. Don't assume one clinic's timing applies to another clinic's protocol or to a different product.

What protects you: ask your prescriber which timing they want, use it every time, and write down your last dose date and time next to every result. The AUA also recommends using the same lab and the same test method when you can, since results can shift between labs.

Trying to make sense of the number on your report? See how lab ranges and draw timing change what your result means →

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When do you need TRT bloodwork sooner than usual?

Any time something has changed. A new dose, a new product, a rising hematocrit, a PSA jump, or new symptoms can all pull your next draw earlier. The 6–12-month interval is for stable men, not a reason to wait when things shift.

Your usual schedule may not apply when:

• You just started treatment.
• Your dose, shot schedule, or product changed.
• Your last hematocrit was rising or near 54%.
• Your PSA went up, or your prostate exam changed.
• You switched clinics or labs and need a new starting point.
• New side effects or symptoms showed up.
• Your product's label calls for tighter checks.
• You have a family history of prostate cancer (Alabama, for example, moves PSA to every 6 months).

Get emergency care now for chest pain, sudden shortness of breath, swelling or pain in one leg, or signs of a stroke. These aren't wait-for-labs situations.

See a doctor in person, usually primary care or urology, for a breast lump, a large PSA jump, or a very high hematocrit. These are bigger than a message to an online clinic.

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Is every 3 months too often? Is every 6 months enough? Is once a year enough?

All three can be right for the right man at the right time. Every 3 months fits year one on several FDA-approved products. Every 6 months sits inside the AUA's 6–12-month window. Once a year fits the Endocrine Society's plan for stable men. What matters is whether your schedule matches your stage, your product, and your last results.

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What if your clinic only checks testosterone, or won't tell you its schedule?

Then ask how the clinic is monitoring hemoglobin/hematocrit, because both major U.S. guidelines include it in TRT safety monitoring. A clinic should also be able to tell you what it expects before refills, when it repeats labs, and how sample timing changes by product.

We compared the published follow-up schedules of six online TRT programs in our TRT providers with ongoing monitoring comparison. One pattern stood out: public websites often tell you that monitoring happens without clearly showing the exact lab cadence, biomarkers, and out-of-pocket follow-up costs.

Hone Health is one example of a provider that currently publishes its schedule. Its September 2026 help-center material says the men's Premium plan uses follow-up labs at 3, 6, 9, 12, 18, and 24 months, with a CBC in the core panel at each follow-up. Hone also says the Premium membership is $155 per month, medication costs are separate, and ongoing follow-up labs and visits are included in that membership. Those are provider-stated terms, not an independent test of Hone's service.

Hone's published schedule does not replace the prescribing clinician's product-specific sample-timing instructions. If exact injection-cycle timing matters to your care, ask the clinician to put that instruction on the lab order.

Want to compare published monitoring policies instead of picking one program from this page? Compare TRT programs' follow-up schedules side by side →

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What happens if you skip or delay your TRT labs?

Some clinics pause refills until required labs are done, and some state guidance ties refills to current safety testing. The bigger concern is medical: a safety marker can change between visits without obvious symptoms.

Here's what we found in writing:

• Hone Health's Terms say you must keep up with periodic blood work to receive refills.
• Maximus says your prescription can't be renewed without updated labs.
• Alabama's medical board says prescriptions shouldn't be refilled without labs from the past 6 months on file.

Testosterone is a Schedule III controlled substance in the U.S. It requires a valid prescription from an authorized prescriber. Federal controlled-substance rules, state law, clinical standards, and the clinic's own refill policy can all affect what has to be completed before another prescription or refill is issued.

If you get TRT online, note this date. Federal rules that let doctors prescribe controlled medications like testosterone by telemedicine, without an in-person visit first, are extended through December 31, 2026. What happens after that depends on the next federal decision. Some states also require in-person visits no matter what. Alabama, for example, requires an in-person exam at 3 months and a yearly in-person visit, and says a telehealth visit doesn't count. We'll update this page when the federal rule changes.

"My refill was paused for labs. Can that happen?" Yes. Some programs require current labs before a clinician will renew treatment. Ask the clinic exactly which lab is missing, where you can complete it, and what happens next. Don't restart, stretch, or change doses on your own while you wait.

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Does TRT bloodwork check whether you're still fertile?

No. Testosterone and hematocrit tests don't measure sperm. Testosterone therapy can lower sperm production, sometimes a lot, while your testosterone number looks great. The AUA says testosterone therapy shouldn't be prescribed to men who are currently trying to have children.

Testosterone from outside your body tells your brain to turn down the signals your testicles need to make sperm. That's why a "good" lab report on TRT tells you nothing about fertility.

If you want children in the next few years, talk to a urologist or a reproductive urologist (a male fertility specialist) before starting testosterone. A semen analysis, not routine TRT bloodwork, is the test that answers the fertility question. Nobody can promise how fertility will respond to treatment or how fast it might recover afterward. It depends on the cause of your low testosterone, your age, and how long you've been treated.

Fertility on your mind? Map a fertility-first care route with Find My TRT Path →

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7 questions to ask before your next TRT blood draw

You don't need to design your own lab plan. You do need to know what your plan is. These seven questions, sent in one message, tell you whether your clinic's schedule fits the guidelines and what it will cost.

1. When is my next lab, and when is the one after that if my results are steady?
2. Is a blood count (hematocrit) on every follow-up draw?
3. Is PSA included, and how often, based on my age and history?
4. When should I draw relative to my dose: before my next shot, midway, or a set number of hours after? Will you write it on the order?
5. Did anything in my last results move my next test date earlier?
6. Are follow-up labs included in my fee? If not, what does each one cost? Can I use labs from my own doctor or insurance?
7. What happens to my refills if my labs are late?

Compare the answers with the tables above. If two or more answers are vague, that tells you something too.

Want these questions matched to your own situation? Get your personalized TRT action plan with Find My TRT Path →

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What we actually verified

Last verified: October 2, 2026. First researched September 30, 2026.

Primary sources we read:

• Endocrine Society, Testosterone Therapy in Men With Hypogonadism (2018 clinical practice guideline), summary and recommendations
• American Urological Association, Testosterone Deficiency Guideline (2018, amended 2024) and its follow-up laboratory testing table
• Current FDA labels on DailyMed for Depo-Testosterone (revised Sept 2025), Xyosted (July 2025), AndroGel 1.62% (Oct 2025), Kyzatrex (Aug 2026), Jatenzo (Sept 2025), Tlando (Feb 2026), and Aveed (July 2025)
• FDA's February 2025 class-wide testosterone labeling changes
• HHS announcement of FDA's requested labeling updates (June 18, 2026)
• DEA/HHS Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, 90 Fed. Reg. 61301 (Dec. 31, 2025)
• Alabama Board of Medical Examiners, Recommended Guidelines for Testosterone Replacement Therapy in Males (approved Feb. 20, 2025)

Confirmed from those sources: every schedule, threshold, and label instruction in the tables on this page, and the fact that none of the seven labels included the June 2026 requested changes as of October 2, 2026.

Provider-stated (from each company's own pages, October 2, 2026): Hone Health's Premium lab schedule and membership price; Defy Medical's draw-timing instructions; Maximus's refill rule.

Our calculations: year-one monitoring-checkpoint counts in the comparison table. We did not convert those checkpoints into a universal number of blood draws because multiple tests can be combined into one draw and clinicians may change timing.

What we could not confirm: the lab schedules of programs that don't publish one, and a verified direct paid provider link for this page. For that reason, this article routes provider-shopping readers to our internal monitoring comparison rather than publishing a direct paid provider link here.

This page is editorial research. It has not been reviewed by a clinician. Read more about How We Review TRT Providers.

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TRT bloodwork FAQ

How often should you get bloodwork on TRT?

Most men need baseline labs, an early on-treatment check timed to the product or formulation, and repeat monitoring. Endocrine Society guidance uses 3–6-month and 12-month checkpoints, while the AUA uses every 6–12 months once stable. Some FDA-approved products require tighter hematocrit monitoring.

Should I get bloodwork 6 weeks after starting TRT?

Six weeks is common, and it's exactly what the Xyosted label calls for. But the U.S. guidelines don't set one 6-week rule for every product. Oral capsules are checked after about a week, gels after about two weeks, and the Endocrine Society's general schedule says 3–6 months.

How often should hematocrit be checked on TRT?

Before treatment, then during follow-up. The Endocrine Society uses 3–6 months and 12 months before moving to annual checks; the AUA uses every 6–12 months in the stable phase or sooner based on prior values. Several FDA-approved products call for about every 3 months in year one.

What hematocrit level is too high on TRT?

Both major guidelines treat about 54% as the line where your clinician needs to act. The Endocrine Society says to pause treatment above 54% and restart at a lower dose once it comes down. Call your prescriber about any high result instead of changing your dose yourself.

Should TRT bloodwork be done before or after my injection?

It depends on your product and what your prescriber wants to measure. The Endocrine Society points to midway between cypionate or enanthate shots, the Xyosted label uses right before the next dose, and some clinics use other timing. Pick one timing and use it every time.

Do I need to fast for TRT blood work?

For diagnosing low testosterone, guidelines use early-morning draws, and the Endocrine Society specifies fasting. During treatment, follow your lab order, since some tests in your panel, like cholesterol, may need fasting and others don't. Ask your clinic when you get the order.

Do I still need PSA tests after the 2026 FDA changes?

Yes. The FDA's June 2026 request narrowed prostate warnings, but HHS said labels still recommend screening before treatment and monitoring during it. As of October 2, 2026, the seven labels we checked hadn't been changed yet.

Do I need estradiol checked every time?

No. The AUA recommends estradiol testing for men with breast symptoms or breast growth, not as a routine test at every draw. Many clinics check it anyway. Ask what they'll do with the result.

Is once-a-year bloodwork enough on TRT?

It can fit the Endocrine Society's long-term plan after the first-year checkpoints for a stable patient. It may not fit an earlier treatment phase, a concerning trend, a product with tighter label instructions, or a state-specific rule.

Is every 6 months enough for TRT bloodwork?

It can be. Six months sits inside the AUA's 6–12-month stable-phase interval for testosterone and hemoglobin/hematocrit. In year one, it may not fit a product whose label asks for hematocrit about every 3 months, or a patient whose prior results call for earlier follow-up.

Will insurance pay for TRT monitoring labs?

Sometimes. Coverage depends on your plan, diagnosis, ordering clinician, laboratory network, and the tests ordered. Ask your insurer and the lab what you will owe before the draw. If you use an online program, confirm whether follow-up labs are included in the membership or billed separately.

Does TRT bloodwork tell me if I'm still fertile?

No. Testosterone and blood-count tests don't measure sperm, and testosterone therapy can lower sperm production. If you want children, talk to a urologist or reproductive urologist before starting.

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Still not sure which TRT care route fits you? Use our free Find My TRT Path tool.

Find My TRT Path →

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Sources

• Endocrine Society. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (2018). Guideline page · Journal article · Plenary summary (PDF)
• American Urological Association. Testosterone Deficiency Guideline · Table Seven: Follow-up Laboratory Testing (PDF)
• DailyMed current labels: Depo-Testosterone · Xyosted · AndroGel 1.62% · Kyzatrex · Jatenzo · Tlando · Aveed
• FDA. Class-wide labeling changes for testosterone products (Feb. 2025) · Testosterone information
• HHS. FDA requests updates to testosterone therapy labeling (June 18, 2026)
• DEA/HHS. Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, 90 FR 61301
• DEA. Drug scheduling
• Alabama Board of Medical Examiners. Recommended Guidelines for Testosterone Replacement Therapy in Males (PDF)
• Hone Health help center: Men's lab schedule on the Premium plan · Men's Plus TRT lab schedule · Membership overview · Sample collection time · Terms
• Defy Medical. Should I time my medication around my lab test?
• Maximus. Lab testing costs and policies · Prescriptions, refills and renewals