HCG for Men

TRT for men can have some side effects, such as Testicular Atrophy or Sperm Damage. Could HCG offset these sides?

Testosterone is perhaps one of the most well known sex hormones. After all, it is the “male” hormone. To scientist and doctors, it is known as an androgen, types of hormones that give men their deepened voice, hair, and increased muscle mass.

Testosterone is primarily produced in the testicles of men, and to a smaller extent, the ovaries of women. This hormone helps preserve muscle mass, bone density, and sex drive.

If levels get low, it can lead to a number of health issues such as low sex drive, erectile dysfunction, fatigue, and even depression. Testosterone replacement therapy (TRT) is a treatment option for men with low testosterone levels.

While TRT can be effective in treating the symptoms of low testosterone, it can also lead to some unwanted side effects. This is where hCG comes in.

Many people, mostly women, are familiar with this hormone due to its significant role during pregnancy. This hormone is produced by the placenta and helps support a growing embryo. Not only does it tell the female body to stop menstruation, but it also thickens the lining of the womb.

But, fun fact, it also plays an important role in men’s health, specifically when used alongside testosterone replacement therapy (TRT).

It has quickly caught attention in the TRT community for its ability to prevent the loss of natural testosterone production and its ability in maintaining fertility.

In this post, we will be breaking down the role of hCG for men, how it is used in TRT, and where you can get it.

Key Takeaways

  • Human chorionic Gonadotopin (hCG) is very similar luteinizing hormone (LH).
  • hCG is typically used alongside testosterone replacement therapy.
  • Studies show hCG to be effective at preventing and restoring the effects of long-term testosterone replacement therapy.

What is the Human Chorionic Gonadotropin (hCG)?

hCG, or human chorionic gonadotropin, is a hormone the mimics LH (luteinizing hormone) in both structure and function. But, it is not LH.

In the brain, there is a small little pea-sized part right below the hypothalamus called the pituitary gland. This is the part of the brain that stimulates production of LH and FSH (follicle stimulating hormone). LH is what tells the testis to produce testosterone while FSH is what promotes production of sperm.

HCG for Men
Figure 1: The HPG Axis

LH is then released into the bloodstream and travels down to the testicles. In the testicles, LH binds to receptors which signals the testicles to produce testosterone.

It is the similarity of hCG acts like LH in the body and stimulates the testicles to produce more testosterone. The body is tricked into thinking LH is present.

hCG and Testosterone Replacement Therapy

While testosterone replacement therapy is the gold standard in treating men with low testosterone (hypogonadism) levels, it doesn’t come without its fair share of side effects.

The hypothalamus-pituitary system is sensitive to changes, particularly when exogenous testosterone (testosterone that is not naturally produced in the body) is introduced.

There are two common side effects of long-term testosterone replacement therapy.

Testicular Atrophy

One common side effect is testicular atrophy, or shrinkage. This is one of the effects of long-term use of injectable testosterone replacement therapy, which is a result of the decrease in LH production from signaling error to the pituitary gland.

Infertility

Men on testosterone therapy may experience a decrease in sperm production. This is because testosterone suppresses the production of both LH and FSH, which are the two fundamental hormones responsible for the production of testosterone and sperm.

LH initiates testosterone production in the testis, while FSH stimulates sperm production.

The good news is that hCG helps prevent both testicular atrophy and improve fertility for many men.[1]

One thing to keep in mind here is that hCG therapy when used as a therapy alone has been seen to be ineffective over long periods of time in helping improve testosterone production. A study showed hCG did help testosterone and sperm quality when used as a monotherapy, but parameters decreased quickly after a year on hCG injections. [2]

Length of Use

Typically, men who are in the process of trying to conceive a child will take hCG for a number of months, while on TRT. Evidence has shown that men who wish to maintain sperm quality while on testosterone replacement therapy should take hCG for 6 to 12 months with a gradual decrease in dose of hCG.[3]

Why should I care about hCG?

Testosterone replacement therapy is common among men, and many people will undergo this treatment without the use of hCG. However, when men are on testosterone therapy, they are receiving exogenous testosterone.

As explained above, exogenous testosterone suppresses the body’s ability to produce its own testosterone because the body thinks it doesn’t need to. And, since the body is no longer producing testosterone naturally, the signal to produce LH in the brain when natural testosterone production is low, it is stopped.

One study that looked at men on testosterone replacement therapy, who received even low-doses of hCG, found that testosterone levels improved rather quickly (3-weeks) and stayed at healthy quantities upon on continued use after.[4]

Serum T during the treatment phase by group [4]
Figure 2: Even low dose HCG improves Serum T levels

Therefore, hCG becomes critical for those who plan to have children to prevent fertility problems and help men maintain adequate sperm production and function.

HCG for Men
Figure 3: HCG is an effective tool to boost Test levels, due to it being an Analogue of LH

Where can I get hCG?

It is of most importance to note that hCG is available through prescription only and hCG drops or supplements that might be advertised through health websites as an alternative are not available.

For men, the FDA has approved hCG injections for use with TRT in men who desire treating low testosterone and maintain fertility.

The single best way to get hCG is through the clinic you are receiving your HRT/TRT from, such as Evolve Telemed.

hCG and TRT: The Final Thought

You might be asking yourself right now, “Do I really need to be on hCG while on testosterone therapy?”.

Well, it really depends on you as an individual and what your goals are.

hCG can certainly help increase natural testosterone levels and improve sperm production while still allowing men to maintain their testosterone levels. It is available through clinics like Evolve HRT and is considered safe and effective with mild side effects.

For more information on hCG or TRT, please contact us. We would be happy to help you through your journey to optimizing your hormone health!

How much does hCG increase testosterone levels?

The amount of testosterone will vary by individual but one study showed testosterone levels to have increased >50%. [5]

Can hCG help with my erectile dysfunction (ED)?

Since low testosterone levels have the potential to affect libido and impact sexual function, it is possible that hCG can help with erectile dysfunction. But, since hCG is most commonly administered together while on testosterone replacement therapy, not enough studies have been published to outline whether hCG alone will help with ED.

Are there side effects of hCG?

As with most medications, there are side effects that come with hCG. However, the most commonly reported side effects of hCG injections are mild and include pain or swelling at the injection site, nausea, stomach pain, and vomiting. Any concerns about these side effects should be discussed with you care team.

Kim ED, Crosnoe L, Bar-Chama N, Khera M, Lipshultz LI. The treatment of hypogonadism inย men of reproductive age. Fertil Steril. 2013 Mar 1;99(3):718-24. doi: 10.1016/j.fertnstert.2012.10.052. Epub 2012 Dec 7. PMID: 23219010.

Depenbusch M, von Eckardstein S, Simoni M, Nieschlag E. Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone. Eur J Endocrinol. 2002 Nov;147(5):617-24. doi: 10.1530/eje.0.1470617. PMID: 12444893.

Lee JA, Ramasamy R. Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men. Transl Androl Urol. 2018 Jul;7(Suppl 3):S348-S352. doi: 10.21037/tau.2018.04.11. PMID: 30159241; PMCID: PMC6087849.

Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, Amory JK, Anawalt BD, Sutton PR, Wright WW, Brown TR, Yan X, Zirkin BR, Jarow JP. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab. 2005 May;90(5):2595-602. doi: 10.1210/jc.2004-0802. Epub 2005 Feb 15. PMID: 15713727.

Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol. 2013 Feb;189(2):647-50. doi: 10.1016/j.juro.2012.09.043. Epub 2012 Dec 20. PMID: 23260550.

Jimmy Diaz M.S.

Hi I'm Jimmy. I was born and raised in sunny Los Angeles, California and love everything about the west coast lifestyle - the beach, the mountains, and the desert. Like many California natives, I can be a bit of a lot of things. Completed my undergraduate studies in Chemistry from University of California, San Diego and pursued a masters in Reproductive Clinical Science from Eastern Virginia Medical School. I primarily work as a clinical scientist and am also a baby maker (through IVF). I'm also a freelancer, ghostwriter, former D1 athlete, and enjoy everything I do.

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