You're past fertility concerns; do you take T alone or add HCG?

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Melody68

Active Member
I'm 68, don't want kids anymore, on T monotherapy and nothing else. But should I also be on HCG? I've read that HCG is not just helpful for fertility and the prevention of testicular atrophy, but for a host of other hormonal benefits. Should everyone who starts TTH also take HCG? How many of you are NOT taking HCG and "doing just fine"? Would hate to think that I'm making a mistake by not exploring it . . .
 
Defy Medical TRT clinic doctor
How many of you are NOT taking HCG and "doing just fine"?
The great majority of men do fine on TRT in isolation. Some men have negative responses to hCG as the LH receptors were not meant to be stimulated in this way.

The LH receptors were meant to be stimulated in a pulsatile fashion.

If you’re not having any problems, I would leave your TRT protocol alone.

Never mess with success.
 
Hey Systemlord, thanks very much for your response. It's a relief to find out that a majority are on T monotherapy, I really had no idea. I'm looking forward to my first complete set of test results in July, I'll share the results when I get them . . .
 
I'm 69 and been using testosterone with HCG for over 9 years now. Hcg keeps testicles full and my libido strong. Presently I'm injecting 500 IU of hcg every third day. I really like the affect I get from.

 
I just starting on injections and declined HCG at the start, just to get a feel for Test only. If you start with two drugs, you really don't know what effect each is giving. i'm only 42. I'll add in the future if needed.
 
45, done with kids. libido and overall feeling is just way better with HCG, not sure why, maybe its the e2? doing good on 50ng/dl e2. my trial/error hcg regimen is 3x1000IU/week in addition to T
 
Ok, from what I gather, a majority are T alone, but some benefit greatly from HCG supplementation. For the benefit of men like 42HRT (above) and myself, how would we know if HCG would benefit us? Is there a blood test result that would determine if we were candidates for it? Or is HCG something that you simply try for a while if you're not satisfied with the results of T alone?

I had a tough enough time getting my doctor to prescribe T; I can't imagine trying to get him to give me HCG also . . .
 
I'm 68, don't want kids anymore, on T monotherapy and nothing else. But should I also be on HCG? I've read that HCG is not just helpful for fertility and the prevention of testicular atrophy, but for a host of other hormonal benefits. Should everyone who starts TTH also take HCG? How many of you are NOT taking HCG and "doing just fine"? Would hate to think that I'm making a mistake by not exploring it . . .

Trial and error!

I started on a T only protocol and remained on such for a while before jumping on hCG.

Had no interest in maintaining fertility from the get-go.

Was not too concerned with testicular shrinkage.

Even then before you decide to take the plunge you need to wait until you get a new set of labs seeing as you recently lowered your T dose after starting T therapy.

As I stated in your previous thread you need to wait until your blood levels stabilize (4-6 weeks) on your new protocol.

I would wait 6 weeks then have your labs done.

Keep in mind hCG is not covered by OHIP so you would be paying out of pocket.

There are numerous uros that will prescribe hCG with a T protocol if one wishes to maintain fertility or prevent testicular atrophy.





My reply from a previous thread where the poster asked if hCG was needed:


Depends on the individual.....Is hCG needed?

*To preserve/maintain fertility then yes.

*To prevent/minimize testicular atrophy then yes.

*To enhance mood/libido it is not a given as some may experience such effects whereas others may feel worse off.


*To maintain upstream hormones and possibly prevent long-term consequences for health/wellbeing.....you be the judge!





*Take-home point:

A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long-term consequences for health and well-being. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.




 
Even then before you decide to take the plunge you need to wait until you get a new set of labs seeing as you recently lowered your T dose after starting T therapy.

Madman never forgets.

I would wait 6 weeks then have your labs done.

Agreed. Will test near end July.

Madman, you said you were on T alone for a while before adding HCG. Did you feel something was missing, or were you content but hoping for even more improvement?
 
Even then before you decide to take the plunge you need to wait until you get a new set of labs seeing as you recently lowered your T dose after starting T therapy.

Madman never forgets.

I would wait 6 weeks then have your labs done.

Agreed. Will test near end July.

Madman, you said you were on T alone for a while before adding HCG. Did you feel something was missing, or were you content but hoping for even more improvement?

Felt great overall on a T only protocol.

Ended up throwing in the hCG to maintain ITT and minimize testicular atrophy.
 
Felt great overall on a T only protocol.

Ended up throwing in the hCG to maintain ITT and minimize testicular atrophy.
From a past post you wrote . . . "The main reason for the addition of hCG is to preserve ITT (intra-testicular testosterone) which will help preserve/maintain fertility and minimize/prevent testicular atrophy."

Presuming that a T therapy patient didn't care about fertility, then the issue comes back to testicular atrophy. I've read some about shrinking balls; of course it's not a pleasant subject. I've been on T about six months and have lost, say, 20% in size, which doesn't bother me . . . yet. Is that the max that I can expect to lose? Or could one lose more as time goes on? I think I read something once about a man who contended that his balls shrunk to the size of a raisin (shudder), but I don't know if he was exaggerating. How much shrinkage can be expected?
 
How much shrinkage can be expected?
This will be different depending upon who we are talking about. You’re looking for a lot of definitive answers and you’re not going to find them in the TRT world because everybody’s response to therapy is so unique.

No two people respond exactly the same.
 
From a past post you wrote . . . "The main reason for the addition of hCG is to preserve ITT (intra-testicular testosterone) which will help preserve/maintain fertility and minimize/prevent testicular atrophy."

Presuming that a T therapy patient didn't care about fertility, then the issue comes back to testicular atrophy. I've read some about shrinking balls; of course it's not a pleasant subject. I've been on T about six months and have lost, say, 20% in size, which doesn't bother me . . . yet. Is that the max that I can expect to lose? Or could one lose more as time goes on? I think I read something once about a man who contended that his balls shrunk to the size of a raisin (shudder), but I don't know if he was exaggerating. How much shrinkage can be expected?

On average around half the size but it's variable as some will experience less atrophy.

Even then the only way for an individual to truly know would be to have testicular volume measured using a prader orchidometer or ultrasonography pre/post TRT.

You would never truly know playing the guessing game!




 
I've been on and off HCG (varying doses) while on TRT (varying doses) for about 15 years. Several others have said it best- how it affects you and whether you 'need' it is very dependent on the individual and trial and error is probably the only way to know.
Here are a few things I've learned:

  • TRT w/ No HCG:
    • My estrogen was too low (no e2 mgmt, just naturally low, in the 12-17 range). This is on 30mg test cyp 2x/week. Which kept TT in the 650-800 range and Free T at the very top of the normal range while on danazol (Free T assessed from multiple diff assays, including the most accurate one). I'm on danazol due to very high SHBG from t3-only thyroid replacement for hashis.
    • Libido was not great (maybe estrogens)
    • Cognition, motivation, mood was not great (maybe estrogens, other upstream hormones?)
  • TRT w/ HCG:
    • Estrogens are better (25-40 e2 while on 250-350 hcg 2-3x/week)
    • Libido is better
    • Cognition much better
    • Doing hcg at night seems to mess up my sleep even though it's not something I notice during the night. Even low dose (100-250 iu), so I feel worse overall if doing it at night.
    • Doing hcg first thing in the morning works much better
    • My current regimen is 350 iu 1x/week Sundays and 180 iu weds, 180 iu Fri. I've tested many different regimens. I need the 350 iu to create enough of a surge of T to drive E2 higher to feel good, but if I do this more than 1x/week I have too many negative side effects (primarily from sleep disruption). So the 180 doses hold me over but don't drive estrogens really at all- just slight boost in T those days and perhaps upstream hormones.
      • Fwiw: I tested many different dose regimens. 125 iu every other day gave some mild subjective benefit but zero increase in estrogens and minimal increase in testosterone. 250 3x/week was mild but notable increase in estrogens and somehow I felt worse on this. 350 1x/week with 125 2x/week was better estrogen and testosterone increase than 250, with the most subjective benefit.
 
I've been on and off HCG (varying doses) while on TRT (varying doses) for about 15 years. Several others have said it best- how it affects you and whether you 'need' it is very dependent on the individual and trial and error is probably the only way to know.
Here are a few things I've learned:

  • TRT w/ No HCG:
    • My estrogen was too low (no e2 mgmt, just naturally low, in the 12-17 range). This is on 30mg test cyp 2x/week. Which kept TT in the 650-800 range and Free T at the very top of the normal range while on danazol (Free T assessed from multiple diff assays, including the most accurate one). I'm on danazol due to very high SHBG from t3-only thyroid replacement for hashis.
    • Libido was not great (maybe estrogens)
    • Cognition, motivation, mood was not great (maybe estrogens, other upstream hormones?)
  • TRT w/ HCG:
    • Estrogens are better (25-40 e2 while on 250-350 hcg 2-3x/week)
    • Libido is better
    • Cognition much better
    • Doing hcg at night seems to mess up my sleep even though it's not something I notice during the night. Even low dose (100-250 iu), so I feel worse overall if doing it at night.
    • Doing hcg first thing in the morning works much better
    • My current regimen is 350 iu 1x/week Sundays and 180 iu weds, 180 iu Fri. I've tested many different regimens. I need the 350 iu to create enough of a surge of T to drive E2 higher to feel good, but if I do this more than 1x/week I have too many negative side effects (primarily from sleep disruption). So the 180 doses hold me over but don't drive estrogens really at all- just slight boost in T those days and perhaps upstream hormones.
      • Fwiw: I tested many different dose regimens. 125 iu every other day gave some mild subjective benefit but zero increase in estrogens and minimal increase in testosterone. 250 3x/week was mild but notable increase in estrogens and somehow I felt worse on this. 350 1x/week with 125 2x/week was better estrogen and testosterone increase than 250, with the most subjective benefit.
Great share! When are you dosing testosterone cypionate in relation to your current HCG regiment?
 
The great majority of men do fine on TRT in isolation. Some men have negative responses to hCG as the LH receptors were not meant to be stimulated in this way.

The LH receptors were meant to be stimulated in a pulsatile fashion.

If you’re not having any problems, I would leave your TRT protocol alone.

Never mess with success.
I've never taken HCG. 77 now. Been on T 10 years or so. No shrinkage of my balls or my wallet.
 
On average around half the size but it's variable as some will experience less atrophy.

Even then the only way for an individual to truly know would be to have testicular volume measured using a prader orchidometer or ultrasonography pre/post TRT.

You would never truly know playing the guessing game!




As a 77 y/o Nurse practitioner working in mens health I have seen some considerable shrinkage while others will say "they're the same as always" even though, to me, they seem decidedly small. Once read that men who start off with some size to begin with are less likely to experience significant atrophy but don't know how to quantify that.
 
I have been on TRT for 10 years. At first went to PCP and was T only, he did not know about hcg. After a number of years things shrunk up but all else was good. Switched to defy, they out me in hcg from Empower. No effect. Tried it off and on for a few years. A year ago we decided to give it a try again and went with Pregnyl. I noticed testicle size increase, libido went up, but the main thing is mental. At 61, I had begun to do alot of what if type of thinking creating some internally made anxiety. With the hcg, that falls almost completely away! To the point my wife notices it.
So for me it is working, but o ly with name brand stuff, not the compounded unfortunately as it is more expensive
 
Beyond Testosterone Book by Nelson Vergel
I have been on TRT for 10 years. At first went to PCP and was T only, he did not know about hcg. After a number of years things shrunk up but all else was good. Switched to defy, they out me in hcg from Empower. No effect. Tried it off and on for a few years. A year ago we decided to give it a try again and went with Pregnyl. I noticed testicle size increase, libido went up, but the main thing is mental. At 61, I had begun to do alot of what if type of thinking creating some internally made anxiety. With the hcg, that falls almost completely away! To the point my wife notices it.
So for me it is working, but o ly with name brand stuff, not the compounded unfortunately as it is more expensive
How many iu’s of pregnyl do u inject per week? How many injections do u do per week of it?
 
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