| Monitor for feminizing and adverse effects every 3 months for the first year, then every 6–12 months |
| Obtain baseline hematocrit and lipid profile and monitor at follow-up visits |
| Obtain baseline bone mineral density if a patient is at risk for osteoporosis; routine screening after age 60, or earlier if sex hormone levels consistently low |
| Obtain prolactin at baseline, at 12 months after initiation of treatment, biennially thereafter |
| Monitor serum testosterone during the first 6 months until levels are <55 ng/dL |
| Monitor serum estradiol at follow-up visits; target 100–200 pg/mL |
