Study: hCG Increases Sex Drive and Improves ED in Men

Understanding Testosterone Deficiency (TD)​

Testosterone deficiency (TD) is a condition characterized by insufficient testosterone production by the gonads. Regular morning testosterone (T) readings below 300 ng/dl are indicative of TD. Symptoms of TD can include poor libido, erectile dysfunction, weight gain, fatigue, depression, and concentration difficulties. Approximately 6% of the population suffers from TD, and the prevalence increases with age. Typically, men with TD are treated with external testosterone replacement therapy (TRT), which is recommended only for those who meet specific biochemical and symptomatic criteria. However, the treatment approach for men with low testosterone levels that are still above 300 ng/dl remains less clear, necessitating regular evaluation by healthcare providers for age-appropriate testosterone levels [1, 2, 3, 4].

The Role of Human Chorionic Gonadotropin (hCG)​

Human chorionic gonadotropin (hCG) acts similarly to luteinizing hormone (LH), stimulating the testes to produce more testosterone naturally. The American Urological Association (AUA) suggests the use of hCG to maintain sperm production and as a supplementary testosterone form for birth control in men with TD who wish to remain fertile. However, the effectiveness and safety of hCG monotherapy in males who do not meet the criteria for conventional TRT, particularly those with T levels above 300 ng/dl, have not been well established [5].

The Study's Aim​

The main goal was to find out how hCG monotherapy affected symptoms and side effects in men who had hypogonadal symptoms and starting T levels above 300 ng/dl. This study was conducted following the approval of the University of Miami's Institutional Review Board (IRB). The research involved reviewing the medical records of 31 males, aged between 25 and 79, who commenced hCG monotherapy from October 2017 to August 2020. These individuals were treated for hypogonadal symptoms with an average T level greater than 300 ng/dl and underwent lab testing and clinical consultations at least a month after beginning hCG treatment. Patients received hCG doses ranging from 1000 to 3000 IU twice weekly. The study also involved comprehensive testing for various health conditions and monitoring several health parameters.

Statistical Analysis and Findings​

The study's statistical analysis presented medians with middle and higher quartiles, employing the Mann-Whitney U test for significance. It was observed that patients experienced significant improvements in erectile dysfunction and libido. Notably, no serious side effects like thromboembolic events or common hCG-related adverse effects such as headaches, gynecomastia, or stomach issues were reported.

Evaluating hCG Therapy for TD​

The AUA's current recommendations for TRT are primarily for those with symptoms and T levels below 300 ng/dl. The present study focused on hypogonadal men treated exclusively with hCG, evaluating hormones, symptoms, and side effects. Despite the absence of a substantial increase in testosterone levels, hCG was found to alleviate hypogonadal symptoms without the side effects associated with hCG or synthetic testosterone. This suggests that even a small dosage of hCG may help elevate T levels in patients, albeit not significantly.

hCG for Fertility and Spermatogenesis​

hCG is recommended for men with TD who wish to preserve fertility or boost sperm production after using synthetic testosterone. Various studies support hCG therapy to restore spermatogenesis following testosterone use. Also, hCG therapy caused big changes in the size of the testicles, the amount of testosterone in the body, and the production of sperm in people with isolated hypogonadotropic hypogonadism. Alternative treatments like clomid or anastrozole might be beneficial for men with hypogonadal symptoms and T levels below 300 ng/dl.

hCG's Impact on Hypogonadism​

There have been few studies exploring the effects of hCG on hypogonadism. Notably, research has shown that hCG therapy can improve symptoms (libido and erectile function) in men with psychogenic ED and low sexual drive without significantly increasing testosterone levels. The study under discussion is pioneering in suggesting that hCG might aid in alleviating hypogonadal symptoms in men with normal T levels.

Conclusions and Future Research​

Despite its small sample size and brief follow-up period, the study suggests that hCG monotherapy is a secure and effective treatment for hypogonadal symptoms in men with initial T levels above 300 ng/dl. Patients reported symptom improvement without serious adverse effects. However, a bigger, randomized, blinded study with validated questionnaires is needed to say for sure if hCG alone can treat hypogonadal symptoms in men whose T levels are normal.

Sources​

1. ncbi.nlm.nih.gov - Human Chorionic Gonadotropin monotherapy for the ... - NCBI
2. ncbi.nlm.nih.gov - Efficacy and Safety of Human Chorionic Gonadotropin ...
3. sciencedirect.com - Safety of Human Chorionic Gonadotropin Monotherapy for ...
4. tctmed.com - hCG: The Options for Treating Low Testosterone
5. regenxhealth.com - Using HCG to Raise Testosterone Levels Naturally

Study reference:

Efficacy and Safety of Human Chorionic Gonadotropin Monotherapy for Men With Hypogonadal Symptoms and Normal Testosterone​

Another small study done in 1987.

HUMAN CHORIONIC GONADOTROPIN TREATMENT OF NONORGANIC ERECTILE FAILURE AND LACK OF SEXUAL DESIRE:
A Double-Blind Study

ABSTRACT-Forty-five cases of nonorganic failure (n ::= 39) or lack of sexual desire (LSD, n = 6) were treated for one month, either with human chorionic gonadotropins (HCG, 5,000 JU J.M. twice per week) or with placebo using a double-blind method. HCG gave better results than pla cebo (47% vs 12%, p < 0.05) and improved a higher number of sexual parameters (617) than placebo (217). The HCG effect on sexual behavior did not correlate with the increase in plasma testosterone level: it seems HCG is a useful option in sexologic treatment of erectile failure and LSD.

"The Use of hCG in Men with or Without Testosterone Replacement: Overview and Emerging Data"

Human chorionic gonadotropin (hCG) plays a critical role in maintaining progesterone production during pregnancy.
- hCG is a glycoprotein composed of 237 amino acids with two subunits, alpha and beta, the latter being unique to hCG.
- The lecture will review the current practices and data on the use of hCG in men, beyond fertility, for testosterone supplementation therapy.

HCG in combination with testosterone may prevent fertility loss and testicular atrophy.
- Testosterone supplementation may reduce fertility and cause testicular atrophy.
- HCG mimics luteinizing hormone to stimulate testicular cells, but requires close monitoring for potential side effects.

HCG plus TRT can prevent testicular atrophy and loss of fertility
- HCG dosing and timing varies among clinics and needs monitoring for variables when used with testosterone
- HCG is used for FDA approved and off-label purposes such as treating undescended testicles, low testosterone, infertility, and as an adjunct for anabolic steroid use

HCG in combination with testosterone has added benefits for libido and mood.
- HCG acts similarly to LH and may replace the effects of LH on the body when providing testosterone replacement.
- The non-gonadal expression of LH and HCG receptors suggests potential effects beyond just testicular function.

HCG may reactivate the hormone path affected by testosterone supplementation.
- Testosterone supplementation shuts down LH, which may lead to a decrease in prol and progesterone.
- HCG, an LH mimicker, may reactivate the hormone path and normalize the Cascade.

HCG decreases sex hormone binding globulin and increases free testosterone.
- Potential reasons for increased libido in men on testosterone replacement therapy plus HCG.
- Effect of testosterone therapy plus HCG on intratesticular testosterone and sperm production.

HCG with testosterone prevented decrease in sperm count, motility, and morphology.
- Study demonstrated effectiveness of low dose HCG in maintaining spermatogenesis.
- However, not effective for older men with longer exposure to testosterone.

Using hCG and TRT to preserve testicular function and sperm count
- Recommended protocol for men desiring to maintain fertility while starting testosterone supplementation therapy
- Different approaches based on the desired timing of pregnancy and the use of HCG, Clomiphene, and FSH

Use of hCG and TRT can help prevent testicular atrophy and loss of fertility.
- Recovery of spermatogenesis can range from 50% to 100% based on factors like population, hCG dose, and injection frequency.
- Higher doses of hCG lead to increased and sustained beta HCG levels, which is relevant for comparison with normal luteinizing hormone concentrations.

HCG can complicate assessment of cancer remission in men receiving treatment for testicular cancer.
- Men with testicular cancer may require testosterone replacement and/or HCG which can make it difficult to assess HCG levels for cancer recurrence.
- Higher doses of HCG can lead to increased estradiol levels, and there may be desensitization with prolonged use.

Lack of data on hypothalamic pituitary access normalization protocols for former and current users of anabolic androgenic steroids.
- Stopping hCG usage affects libido and testicular atrophy prevention.
- More information on this topic will be covered in another webinar.

the dosing is always huge in the studies, according to this known study, there is no point in dosing over 250iu eod, especially if used as add on with testosterone.

Mastodont said:

the dosing is always huge in the studies, according to this known study, there is no point in dosing over 250iu eod, especially if used as add on with testosterone.

Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression - PubMed

In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone (T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship...

pubmed.ncbi.nlm.nih.gov

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The above studies used hCG alone to prove the hCG effect.

We have discussed several times the data on TRT plus hCG:

Nelson Vergel said:

The above studies used hCG alone to prove the hCG effect.

We have discussed several times the data on TRT plus hCG:

Best HCG Dose for Men on TRT: Two Studies That Used HCG with Testosterone

Note:HCG mimics LH but it is not LH and it's not picked up by the LH blood test. In fact, it suppresses LH like endogeneous testosterone does. But the amazing thing that the study below found is that HCG can increase sperm production and quality even in the absence of LH AND FSH. Most...

www.excelmale.com

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Yes we have, my point was why would a man using HCG be using those huge doses that are also found in most studies, there is plenty of anecdotal evidence on excelmale on the dreaded leydig cell desensitization, not to mention excess e2 etc. I dont see how the HCG dose should be different when not using testosterone, one would think you get the same ITT response even without exogenous t present.

Mastodont said:

I dont see how the HCG dose should be different when not using testosterone, one would think you get the same ITT response even without exogenous t present.

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Human Chorionic Gonadotropin (hCG) is used in different dosages depending on whether it's used alone or in combination with testosterone therapy, primarily due to its mechanism of action and the desired therapeutic outcomes.

1. hCG Monotherapy: When hCG is used alone, higher doses are often required. This is because hCG mimics the action of Luteinizing Hormone (LH), which is essential for stimulating the testes to produce testosterone naturally. In cases where hCG is the sole agent used to stimulate endogenous testosterone production, higher doses are needed to effectively initiate and maintain this physiological process.
2. hCG in Combination with Testosterone Therapy: When hCG is used in combination with exogenous testosterone therapy, the required dose of hCG is generally lower. This is because the primary role of hCG in this context is not to raise testosterone levels (as the exogenous testosterone is already accomplishing this) but rather to maintain testicular function and size, and potentially preserve fertility. Lower doses of hCG are sufficient for this supportive role.
3. Individual Variability: It's important to note that the appropriate dosage of hCG, whether used alone or in combination, can vary greatly among individuals based on their specific medical condition, baseline hormone levels, and how they respond to the therapy.

In conclusion, the dosage of hCG is tailored based on its intended use and the specific needs of the patient. Higher doses in monotherapy are aimed at achieving adequate testosterone levels, while lower doses in combination therapy focus on maintaining testicular health alongside exogenous testosterone.

Sources​

1. ncbi.nlm.nih.gov - Human Chorionic Gonadotropin monotherapy for the ...
2. ncbi.nlm.nih.gov - Efficacy and Safety of Human Chorionic Gonadotropin ...
3. sciencedirect.com - Safety of Human Chorionic Gonadotropin Monotherapy for ...
4. auanet.org - Testosterone Deficiency Guideline
5. journals.sagepub.com - Testosterone versus hCG in Hypogonadotropic Hypogonadism
6. sciencedirect.com - 233 Human Chorionic Gonadotropin (hCG) Monotherapy ...

Nelson Vergel said:

Human Chorionic Gonadotropin (hCG) is used in different dosages depending on whether it's used alone or in combination with testosterone therapy, primarily due to its mechanism of action and the desired therapeutic outcomes.

1. hCG Monotherapy: When hCG is used alone, higher doses are often required. This is because hCG mimics the action of Luteinizing Hormone (LH), which is essential for stimulating the testes to produce testosterone naturally. In cases where hCG is the sole agent used to stimulate endogenous testosterone production, higher doses are needed to effectively initiate and maintain this physiological process.
2. hCG in Combination with Testosterone Therapy: When hCG is used in combination with exogenous testosterone therapy, the required dose of hCG is generally lower. This is because the primary role of hCG in this context is not to raise testosterone levels (as the exogenous testosterone is already accomplishing this) but rather to maintain testicular function and size, and potentially preserve fertility. Lower doses of hCG are sufficient for this supportive role.
3. Individual Variability: It's important to note that the appropriate dosage of hCG, whether used alone or in combination, can vary greatly among individuals based on their specific medical condition, baseline hormone levels, and how they respond to the therapy.

In conclusion, the dosage of hCG is tailored based on its intended use and the specific needs of the patient. Higher doses in monotherapy are aimed at achieving adequate testosterone levels, while lower doses in combination therapy focus on maintaining testicular health alongside exogenous testosterone.

Sources​

1. ncbi.nlm.nih.gov - Human Chorionic Gonadotropin monotherapy for the ...
2. ncbi.nlm.nih.gov - Efficacy and Safety of Human Chorionic Gonadotropin ...
3. sciencedirect.com - Safety of Human Chorionic Gonadotropin Monotherapy for ...
4. auanet.org - Testosterone Deficiency Guideline
5. journals.sagepub.com - Testosterone versus hCG in Hypogonadotropic Hypogonadism
6. sciencedirect.com - 233 Human Chorionic Gonadotropin (hCG) Monotherapy ...

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So you are saying that even if 500iu eod results in over baseline ITT, it is still not good enough for monotherapy, even when there is no exogenous t suppressing the testes.
The studies you listed do not have a lower dose for comparison, it's always those huge amounts every time, i'm not buying it to be the case that higher doses are required, maybe if you are trying to get more out of the testes that they would ever put out in a natural state, my thing is it makes no sense at all to push the testicles in overdrive, since we know that healthy men got to their baseline ITT with somewhere between 250 and 500iu eod, why would anyone use more longer term. If not enough testosterone is being produced then one can add exogenous t and never desensitize his nuts down the road and remain fertile. Too many doctors are pushing these testicle fryers to guys wanting hcg mono to remain fertile, resulting guys resorting to t only after desensitization. Those high doses should be for months in infertility, not as hrt.

Mastodont said:

So you are saying that even if 500iu eod results in over baseline ITT, it is still not good enough for monotherapy, even when there is no exogenous t suppressing the testes.
The studies you listed do not have a lower dose for comparison, it's always those huge amounts every time, i'm not buying it to be the case that higher doses are required, maybe if you are trying to get more out of the testes that they would ever put out in a natural state, my thing is it makes no sense at all to push the testicles in overdrive, since we know that healthy men got to their baseline ITT with somewhere between 250 and 500iu eod, why would anyone use more longer term. If not enough testosterone is being produced then one can add exogenous t and never desensitize his nuts down the road and remain fertile. Too many doctors are pushing these testicle fryers to guys wanting hcg mono to remain fertile, resulting guys resorting to t only after desensitization. Those high doses should be for months in infertility, not as hrt.

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I'm presently injecting 500 IU of HCG every third day. Along with my testosterone, helps keep my libido super strong.

Mastodont said:

So you are saying that even if 500iu eod results in over baseline ITT,

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I do not think you realize that the ITT data you mention comes from TRT+hCG, not from hCG alone. Best HCG Dose for Men on TRT: Two Studies That Used HCG with Testosterone

Nelson Vergel said:

I do not think you realize that the ITT data you mention comes from TRT+hCG, not from hCG alone. Best HCG Dose for Men on TRT: Two Studies That Used HCG with Testosterone

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Yes i sure do, i just don't get why you would require more hcg without testosterone to get the same ITT. Is the exogenous testosterone helping the ITT in some way?

Mastodont said:

Yes i sure do, i just don't get why you would require more hcg without testosterone to get the same ITT. Is the exogenous testosterone helping the ITT in some way?

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Ah, sorry, I did not understand, but now I do. As I posted before, in cases where hCG is the sole agent used to stimulate endogenous testosterone production, higher doses are needed to effectively initiate and maintain this physiological process (ITT is also normalized when TT is normalized with hCG monotherapy). Testosterone used alone shuts down LH, which shuts down ITT. When hCG is used in combination with exogenous testosterone therapy, the required dose of hCG is generally lower. This is because the primary role of hCG in this context is not to raise testosterone levels (as exogenous testosterone is already accomplishing this), but rather to act as a LH mimicker to maintain testicular function (normalize ITT) and size and potentially preserve fertility. Lower doses of hCG are sufficient for this supportive role.

The average dose in the study above was around 1500 IU twice per week. The goal was to give enough hCG to improve libido and have a TT over 300 ng/dL, not aimed at fertility. The testosterone level attained with this dose was around 450 ng/dL (close to baseline). Most hCG monotherapy studies actually use even higher doses and frequencies, up to 3 times per week to make sure sperm production is enhanced.

Do you guys want me to interview the private investigators from Univ of Miami?

Does using HCG alone shut down natural testosterone production?

DorianGray said:

Does using HCG alone shut down natural testosterone production?

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I’d like a firm answer on this one as well.

I’m currently using HCG only. I’m doing 400iu DAILY, and my TT levels went from 500 to almost 900. E2 went from 19 to 48. I feel amazing honestly.

DorianGray said:

Does using HCG alone shut down natural testosterone production?

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No, but you have to use the right dose to equal your natural endogenous T production. That dose and frequency vary for everyone. As monotherapy, my guess is that 1000 IU hCG every other day is the minimum.

It seems that @JCUSN is showing us that a hCG monotherapy dose of 400 IU daily has booted his T to 900 nd/dL. This total weekly dose is 2,800 IU (close my my guess of total dose of 3,000 IU)

HCG gives me strong libido and erections when I use it for the first time in a couple weeks. Then with continued use maybe e2 goes up (I'm not sure) and I get weak libido and erections. Cialis helps, so weird any thoughts on why this happens and why ped5 inhibitors come in so clutch?

Nelson Vergel said:

No, but you have to use the right dose to equal your natural endogenous T production. That dose and frequency vary for everyone. As monotherapy, my guess is that 1000 IU hCG every other day is the minimum.

It seems that @JCUSN is showing us that a hCG monotherapy dose of 400 IU daily has booted his T to 900 nd/dL. This total weekly dose is 2,800 IU (close my my guess of total dose of 3,000 IU)

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Indeed…the 2800iu per week has definitely boosted T levels, and also increased E2. But overall feel really, really good. I was doing 1000iu EOD, but I switched to daily 400iu to try to promote more stable levels.

@Nelson Vergel
So when I stop taking the HCG, will my natural LH production come back on its own, or will that require a SERM?

JCUSN said:

Indeed…the 2800iu per week has definitely boosted T levels, and also increased E2. But overall feel really, really good. I was doing 1000iu EOD, but I switched to daily 400iu to try to promote more stable levels.

@Nelson Vergel
So when I stop taking the HCG, will my natural LH production come back on its own, or will that require a SERM?

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A SERM might quicken the process of turning you HPTA back on. I'm sorry for stepping on toes and Nelson correct me if I am wrong pls

Fernando Almaguer said:

A SERM might quicken the process of turning you HPTA back on. I'm sorry for stepping on toes and Nelson correct me if I am wrong pls

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I think you are right also! Just posting to get some confirmation on if it’s really necessary. I know it’s needed after T injections, but not sure if after HCG it’s necessary.