Duration of HCG therapy was approximately 29 weeks and no adverse events or effects were noted. While improvement in symptoms was not the primary outcome study of this investigation, the use of HCG to raise testosterone levels was evident.
A study by Sato Y. Mean male age was At 8 weeks symptoms were assessed. Results found improvement in sexual symptoms, especially spontaneous morning erections. Patients who had morning erections were found to have more pronounced vigor and libido during daily activity and more self-confidence. The use combination therapy of HCG with Clomid clomiphene citrate has been well studied as an option to improve testosterone levels. Injections of hCG are also sometimes used as an alternative to testosterone products in men with testosterone deficiency.
These include:. According to the American Urological Association , hCG is appropriate for those men with testosterone deficiency who also desire to maintain fertility. Testosterone products boost levels of the hormone in the body but can have the side effects of shrinking the gonads , altering sexual function , and causing infertility. Bodybuilders who take anabolic steroids such as testosterone also sometimes use hCG to help prevent or reverse some of the side effects steroids cause, such as gonad shrinkage and infertility.
In men, hCG acts like luteinizing hormone LH. LH stimulates Leydig cells in the testicles, which results in the production of testosterone. LH also stimulates production of sperm within structures in the testicles called seminiferous tubules. As hCG stimulates the testicles to produce testosterone and sperm, the testicles grow in size over time.
In a small study of older men with partial hypogonadism, hCG increased testosterone levels compared to a placebo control. However, hCG had no effect on sexual function. In one study , men taking testosterone along with hCG were able to maintain testosterone production in the testicles. In a study , men taking testosterone along with hCG were able to maintain adequate sperm production. As already explained, LH is the primary pituitary hormone that stimulates the Leydig cells of the testes to produce testosterone.
Therefore, the use of HCG helps to preserve some testicular function and subsequent production of intra-testicular testosterone. It would therefore seem logical to maintain function, rather than rely solely on exogenous testosterone to normalise your male androgen levels. Testosterone monotherapy is a rather short-sighted and dogmatic approach to treating Testosterone Deficiency TD when we know other hormones are suppressed through treatment.
TD is typically as a result of either a primary hypogonadism, which is an issue with the testes, or a secondary problem which indicates an issue with the brain. There is also a tertiary cause for TD, which is a disproportionate amount of oestrogen that negatively influences the negative feedback loop. HCG is used to maximise natural intra-testicular production of testosterone through stimulation of the Leydig cells 9 , it also allows the other physiological mechanisms within the testes to continue.
Whilst spermatogenesis is primarily under the influence of FSH stimulating the Sertoli cells of the testis, intra-testicular testosterone and oestrogen are also integral to this process.
Spermatogenesis is the process by which haploid spermatozoa are formed from germ cells. Testosterone helps maintain the blood-testis barrier which is necessary for maturation of the sperm and their subsequent release from the testis Intra-testicular testosterone is converted to oestradiol by the aromatase enzyme, oestrogen exerts its effects by aiding germ cell proliferation, differentiation and the final maturation of spermatids, as well as germ cell survival and apoptosis Clinicians under-appreciate the complexities and importance of maintaining normal physiological function.
It is obviously logical to treat TD with testosterone, however not appreciating the importance of addressing hormones that are directly affected from using exogenous testosterone, demonstrates a short-sightedness.
The use of HCG alongside testosterone is supported by the American Urological Association 12 and its role in maintaining fertility whilst on testosterone is well documented in the literature 13 , 14 , 15 , In my own practice, we have now had 21 successful pregnancies reported by patients on TRT with HCG, two of which have had two successful conceptions.
It is worth keeping in mind that the positive effects of HCG in maintaining testicular functions is very dependent on the viability of the testes at the time of diagnosis. HCG is less likely to be as effective as a fertility aid if the patient has low testosterone as a result of a primary hypogonadism an issue with the testes. However, reassuringly a primary hypogonadism rarely signifies complete testicular failure Despite the science and extremely positive outcomes we have had from using HCG alongside TRT, there are no certainties in medicine and so if you are concerned about fertility whilst on TRT, I would recommend having a semen sample frozen as a precautionary measure.
Irrespective of whether your family is complete, or you do not wish to preserve fertility using HCG alongside TRT, HCG will help preserve testicular size and function This may seem like a purely aesthetic consideration, however testicular atrophy can cause significant discomfort and distress Homeostasis is a about maintaining physiological stability through feedback systems.
As a part of hormone replacement therapy. Weight loss, as increasing testosterone levels can help with exercise. Maintaining your testicular size. Repairing sexual dysfunction. Male sexuality is heavily linked to testosterone levels.
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