What questions should you ask your TRT doctor?
The questions to ask your TRT doctor fall into four groups: is the diagnosis solid, what are the risks for you, how will you be monitored, and how does the practical side work. The Endocrine Society says prescribers should talk with you about the benefits and risks of treatment and of monitoring, and should involve you in the decision. Good questions are how you take part.
Preparing is also one of the first steps of starting TRT.
Preparing may help, though the evidence is mixed. A review of 42 studies found some evidence that a question list handed out just before a visit makes patients ask more questions and get more information. Writing your questions down costs almost nothing.
If you only remember three questions, make them these. In a small trial, actors posing as patients asked them, and family doctors then gave clearer information about treatment options:
- What are my options?
- What are the possible benefits and harms of each?
- How likely are those benefits and harms for someone like me?
The full, visit-by-visit list is at the end of this page, ready to print.
What should you bring to a TRT appointment?
Your prescriber can only work with what they can see. Bring the items below, on paper or on your phone.
| Bring | Why it helps |
|---|---|
| Copies of every lab report | Shows results with the lab’s own reference ranges and units |
| Draw dates and times | Testosterone is highest in the morning; afternoon results can read low |
| A symptom log | Shows how sex drive, energy, mood and sleep have changed over weeks |
| A full medication list | Some medicines interact with testosterone or can lower it |
| Your health history | Heart, blood clots, sleep apnea, prostate and urinary problems all matter |
| Your plans | Children, surgery, travel and new medicines change the conversation |
Be complete about your medicines. The label for a common testosterone injection warns that testosterone can make blood thinners taken by mouth work more strongly.
Also mention opioids, glucocorticoids (steroid medicines such as prednisone) and any past anabolic steroid use. The Endocrine Society lists all of these as causes of low testosterone.
What will the prescriber ask and check?
Expect questions about your symptoms, health history and plans, and possibly a physical exam. The Endocrine Society lists situations where it recommends against starting testosterone. Your prescriber will want to rule these out:
- Planning children in the near term.
- Breast or prostate cancer, a prostate lump, or a raised PSA (prostate-specific antigen, a blood test).
- A high hematocrit, the share of your blood made up of red cells.
- Untreated severe sleep apnea or severe urinary symptoms.
- Uncontrolled heart failure, or a heart attack or stroke in the last 6 months.
- A clotting disorder (thrombophilia).
This list is for your prescriber, not a self-test. If any of it applies to you, say so early.
Your prescriber will also check your blood pressure. In 2025 the FDA required every testosterone product to add a warning that testosterone can raise blood pressure. Monitoring studies had shown the effect across the whole drug class.
Our guide to TRT side effects covers the full list.
Which blood tests come before starting TRT?
Diagnosis comes first. The Endocrine Society recommends a total testosterone test taken fasting in the morning, then repeated to confirm the result.
Free testosterone (the part not tied to proteins) is added when the total is borderline or when SHBG, a protein that binds testosterone, is likely to be off. LH and FSH, the brain’s signals to the testes, help show whether the cause is in the testes or the pituitary.
Our guide to how low T is diagnosed covers each step.
Before treatment, the guideline’s monitoring plan also includes a baseline hematocrit, meaning a first reading to compare against later.
For men aged 55 to 69, the Endocrine Society suggests talking about whether to check prostate cancer risk with a PSA test. Men aged 40 to 69 at higher risk should be offered the same talk. That includes Black men and men whose father or brother had prostate cancer.
Good questions here:
- Were my tests done in the morning and fasting? Do we need to repeat any?
- Which of my results are outside the lab’s range, and what might explain them?
- Do you recommend a PSA for me, and what would we do with the result?
Ask for a copy of every result, with the lab’s reference ranges, so you can follow along.
How will TRT affect fertility, and what should you ask?
Ask this before the first prescription, not after. Testosterone from outside the body tells the brain to stop sending LH and FSH, and your testes need those signals to make sperm.
The Endocrine Society recommends against starting testosterone if you plan to have children in the near term. The American Urological Association (AUA) says testosterone should not be prescribed to men who are trying to conceive right now.
The AUA also recommends a reproductive health check before treatment for men who care about fertility. The Endocrine Society adds that if you’re unsure about future children, you may want to bank sperm. A semen analysis before starting can also show whether you need contraception.
Questions to ask:
- If I might want children in the next few years, should we wait, or are there other options?
- Should I have a semen analysis before starting?
- If I stop later, how long could it take for sperm production to come back?
Our guide to TRT and fertility explains the research in detail.
What do the heart and prostate studies mean for your questions?
Two large studies shape the talk today. The first is TRAVERSE, which followed 5,246 men aged 45 to 80 who had heart disease or a high risk of it.
Major heart events happened in 7.0% of men on testosterone gel and 7.3% of men on placebo. The testosterone group did have more atrial fibrillation (an irregular heartbeat), acute kidney injury and pulmonary embolism (a blood clot in the lung).
After TRAVERSE, the FDA removed the boxed warning about heart outcomes. It added the blood pressure warning.
The second is a closer look at the prostate results from TRAVERSE. In carefully screened men, rates of prostate cancer and urinary problems were low and similar on testosterone and placebo. PSA did rise more on testosterone in the first year.
The authors recommend a baseline risk check and a set monitoring plan. Then a rise in PSA leads to a sensible next step rather than an unneeded biopsy.
Questions to ask:
- Given my heart history and blood pressure, how do these results apply to me?
- What is our plan if my PSA rises?
- What symptoms should make me call you, and which mean urgent care?
What should you ask at a TRT follow-up visit?
The Endocrine Society recommends a standard plan for the first year. Your prescriber checks your symptoms, side effects and whether you’re taking treatment as prescribed. They measure testosterone and hematocrit.
If you choose prostate monitoring, they check your prostate risk too. Testosterone and hematocrit checks come 3 to 6 months after you start (depending on the product), then at 12 months and every year after that.
That makes the 3 to 6 month visit the big one. Bring your symptom log and your hematocrit and testosterone results.
For each blood draw, note the date, the time and the days since your last injection. Our blood test timing tool shows why the timing matters.
Expect different changes to arrive at different speeds. In the Testosterone Trials, men 65 and older with low testosterone who took treatment saw better sexual function and mood. Their physical function, vitality and thinking skills did not improve.
What should you know about a telehealth TRT consultation?
Telehealth can work well, but ask how the practical parts are handled.
Under the Ryan Haight Act, prescribers normally need at least one in-person visit before they prescribe a controlled medicine remotely. Temporary federal rules waive this through December 31, 2026. The DEA is still working on permanent rules.
Questions for a telehealth provider:
- Where and when will my blood be drawn, and who reviews the results?
- Who will check my blood pressure and do any exams?
- Who will teach me to inject in person, if I’m using injections?
- How do I reach a clinician between visits, and what happens if I have side effects?
- Can I get copies of all my records and labs if I switch providers?
Why is testosterone a controlled substance, and what does that mean for refills?
Testosterone is an anabolic steroid, and federal law lists it as a Schedule III controlled substance. A Schedule III prescription can’t be filled more than six months after it was written. It also can’t be refilled more than five times.
After that, your prescriber must write a new one.
In practice, your follow-up visits and your refills tend to run on the same clock.
Ask how far ahead to request refills, and what happens if a visit has to move. Federal law gives way to state law only where the two clash, so your state can add its own rules.
What should you do after the appointment?
Before you leave, read the plan back to the clinician: what was decided, which tests come next and when, and what to watch for. Then write it down. People forget a lot of what they hear in a visit, and a partner or friend taking notes helps.
Note the warning signs. The label for a common testosterone injection asks patients to report nausea, vomiting, changes in skin color, ankle swelling, and erections that come too often or last too long. It also mentions blood clots in the legs and lungs.
Get emergency help for chest pain, sudden shortness of breath, or a painful, swollen leg. For what comes next, see starting TRT, step by step, which ends with a checklist for your first 90 days.
Which questions should you print and bring?
Here are the questions to ask your TRT doctor, grouped by visit. Print this section, tick the questions that matter to you, and bring it along.
First visit (before any treatment)
- How was my low testosterone confirmed, and do we need to repeat any tests?
- What do you think is causing it? Is anything reversible?
- Which of my symptoms is treatment most likely to change, and which might not?
- I may want children in the future: how does that change the plan?
- Do any of my conditions or medicines make testosterone a bad idea for me?
- Which forms of testosterone could suit me, and what are the trade-offs?
- If injections: who will teach me in person, and who checks my technique?
Results visit
- Which results are outside the lab’s range, and what do they mean for me?
- Do I need a PSA or a prostate exam before starting?
- What’s my baseline hematocrit and blood pressure?
- What are my options, the benefits and harms of each, and how likely are they?
3 to 6 month follow-up
- Is my testosterone where you expected, given when my blood was drawn?
- Has my hematocrit changed? Has my PSA?
- Which symptoms have improved, and which haven’t?
- Are any side effects worth acting on?
- When are my next labs, and how should I time them?
Yearly review
- Is treatment still doing what we hoped?
- Do any new health problems or medicines change the picture?
- Are my prostate checks still right for my age and risk?
- What’s the plan for the next year?
Practical questions
- How do refills work, and how far ahead should I ask?
- How do I reach you between visits?
- What symptoms mean I should call you, and which mean emergency care?