Should You Stop Testosterone Before Knee Surgery? (TRT Q&As)
Timeline
The member is taking about 100 mg of testosterone per week and is scheduled for knee replacement surgery. Dr. O’Connor says he would not automatically stop testosterone based on the member’s current hematology results, but emphasizes that orthopedic surgery carries significant clotting risk and that anticoagulation decisions must be coordinated with the surgical and cardiovascular teams.
The member reports that previously well-controlled blood pressure has climbed despite no obvious lifestyle changes. Dr. O’Connor discusses increasing telmisartan rather than returning to amlodipine, which had caused ankle swelling, while continuing to monitor blood pressure and cardiovascular health.
The member asks about the more detailed coronary imaging Dr. O’Connor recently discussed. Dr. O’Connor favors coronary CT angiography for identifying both calcified and noncalcified plaque and explains that a calcium score alone can miss important coronary disease.
The member reports hematocrit above 54 despite reducing his testosterone dose and previously donating blood regularly. Dr. O’Connor investigates whether the elevation existed before TRT, discusses hereditary hemochromatosis and iron studies, and emphasizes determining the underlying cause rather than relying indefinitely on repeated phlebotomy.
The member says the imaging provider indicated that a prescription is required in California. Dr. O’Connor confirms that he should contact the office so the appropriate order can be provided.
The member reports severe forearm pumps after increasing Anavar before a strongman competition and worries they will interfere with his grip. Dr. O’Connor explains that Anavar-related pumps can be problematic for strongman events and discusses backing down rather than escalating drug use immediately before the competition.
Video Summary
Participants raise follow-up questions about testosterone therapy and how their symptoms are changing over time. The clinician explains how reported symptoms and side effects are evaluated together to understand treatment response. Sexual function is discussed when erectile dysfunction concerns are raised by participants. The discussion emphasizes recognizing meaningful patterns rather than reacting to isolated changes.
As the conversation continues, attention turns to dosing and injection practices during follow-up. The clinician explains how consistency and timing influence perceived response. Side effects are addressed only when participants explicitly mention them. Clear symptom descriptions are encouraged to support accurate interpretation.
Later questions revisit erectile dysfunction and broader quality-of-life considerations. Sexual function is framed as part of overall treatment response rather than a standalone issue. The clinician reinforces the importance of monitoring changes between visits. The session closes with guidance on what details are most helpful to report during follow-up.
Drug Callouts
Condition Callouts
Key Takeaways
- Testosterone therapy follow-up relies on symptom patterns rather than isolated impressions.
- Dosing and injection practices influence how response is experienced.
- Erectile dysfunction is discussed when explicitly raised by participants.
- Side effects are evaluated based on what is reported clearly.
- Consistent monitoring supports better follow-up decisions.