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Blood Work: Where, When, Why and How We Monitor

Where can I have my labs drawn?

Labs can be drawn either at your local Planned Parenthood health center or at an outside lab location. For in-person appointments, you may be able to have your labs drawn during your appointment, if the timing is appropriate with your medications. For virtual appointments, you may schedule a lab-only visit at a PPCWNY health center, or request a lab order to take to an outside lab location. All GAHC labs drawn at PPCWNY health centers are sent to CDD Labs for processing.

Of note, lab slips are generated with one’s legal name as recorded in the electronic medical record, for correlation with insurance and your electronic medical record file. 

When should I have labs drawn?

Lab work is usually done more frequently in the first year of hormone therapy and less frequently as time passes. You can expect labs every three months when starting hormones; some health conditions and circumstances require more frequent bloodwork. 

How should my lab draws be timed?

After your initial baseline lab tests, we recommend that you use your medications consistently for at least 4-6 weeks before having hormone levels drawn. Your clinician will make a recommendation for when your next lab testing should be performed based on whether you are starting on a new regimen, making adjustments, or maintaining a stable regimen. 

Medication type  Lab timing 
Daily gels, patches  Any time of day. Do not draw blood from an area where you applied medication. 
Pills twice daily  Mid-day, ideally 3-4 hours after pill use (but not a strict requirement) 
Weekly injections  3-4 days after your weekly injections
Every other week injections  Approximately 7 days after your weekly injection(s)

For folx using hormone injections, labs should be drawn approximately halfway between injections; if you desire to have labs drawn at your in-person Planned Parenthood appointment, please consider the timing of your injections when booking your visit. 

Why do folx on hormones need to have labs drawn?

Checking labs helps us to optimize hormone regimens and ensure safety. Checking hormone levels also helps to guide dosing changes in line with an individual’s embodiment goals.  

Some of the labs we follow:

  • Hemoglobin, hematocrit: Testosterone can increase red blood cell counts; when red blood cell counts are very high, there could be an increased risk of blood clots. Use requires monitoring of red blood cell count levels (hemoglobin, hematocrit). 

  • Estradiol: For people taking estradiol (estrogen), we follow estradiol levels; for most individuals 100-200 pg/mL is an appropriate estradiol level for feminizing hormone therapy. We do not follow estriol or estrone levels. 

  • Additional labs such as an A1C (diabetes screening), lipid panel (cholesterol screening), or liver function testing may be recommended. 

Testosterone: For people taking testosterone, we follow testosterone levels; for most individuals 320-900 ng/dL is an appropriate level for masculinizing hormone therapy. At higher levels extra testosterone is converted by the body into estradiol. For people using medications to block testosterone production, the goal testosterone level is typically less than 55 ng/dL. 

Spironolactone: Spironolactone should only be used by people with normal kidney function, and in rare cases people taking it can develop high potassium levels. Use requires monitoring of kidney function (creatinine) and potassium levels.  

How will I get my results?

After having your labs done, unless there is an abnormal result, we will not be contacting you with lab results. But, if desired, you can view your own results on your patient portal

How are lab costs billed?

If you do not have insurance, you will pay PPCWNY directly for lab costs for labs ordered by a PPCWNY clinician that are drawn either at PPCWNY or Quest Labs. If you have insurance, Quest will bill your insurance for your labs; you may receive a bill from your insurance company — the amount is dependent on your insurance plan (and PPCWNY cannot quote a cost). If you have a special circumstance and are having labs drawn at another facility (such as a hospital lab), you or your insurance will be billed directly by that facility for the lab costs (and PPCWNY cannot quote a cost).