Testosterone replacement therapy (TRT) can lead to suppression of gonadotropin levels, which can negatively impact testicular function. Low-dose human chorionic gonadotropin (HCG) has been shown to be effective in maintaining intratesticular testosterone levels in normal men with testosterone-induced gonadotropin suppression. In this essay, we will discuss the mechanism of action of HCG, the evidence supporting its use, and its potential benefits and risks.
Mechanism of Action
HCG is similar in structure to luteinising hormone (LH), which is a hormone produced by the pituitary gland that stimulates the production of testosterone in the testes. HCG acts as a LH analogue, binding to the same receptors in the testes and stimulating the production of testosterone. Low-dose HCG is thought to maintain intratesticular testosterone levels by preventing the suppression of gonadotropin levels that can occur with TRT.
Several studies have investigated the use of low-dose HCG in maintaining intratesticular testosterone levels in men with testosterone-induced gonadotropin suppression. One randomised controlled trial (RCT) investigated the use of low-dose HCG in 50 men with testosterone-induced gonadotropin suppression (1). The men were randomised to receive either 125 IU or 250 IU of HCG every other day in addition to their TRT regimen. After 24 weeks of treatment, the group receiving 250 IU of HCG had significantly higher intratesticular testosterone levels compared to the group receiving 125 IU of HCG or placebo.
Another RCT investigated the use of low-dose HCG in 56 men with testosterone-induced gonadotropin suppression (2). The men were randomised to receive either 250 IU of HCG every other day or placebo in addition to their TRT regimen. After 24 weeks of treatment, the group receiving HCG had significantly higher intratesticular testosterone levels compared to the placebo group.
Maintaining intratesticular testosterone levels with low-dose HCG may have several benefits, including preserving testicular function and size as well as improving fertility. Suppression of gonadotropin levels with TRT can lead to testicular atrophy and reduced sperm production. Low-dose HCG can help to maintain testicular function and prevent these negative effects.
There are potential risks associated with the use of HCG, including fluid retention, acne, and gynecomastia. Some men report anxiety and feeling very emotional when taking
Low-dose HCG has been shown to be effective in maintaining intratesticular testosterone levels in normal men with testosterone-induced gonadotropin suppression. This can help to preserve testicular function and improve fertility. However, there are potential risks associated with the use of HCG, and it is important to consult with a healthcare provider before starting this treatment. More research is needed to fully understand the long-term effects of low-dose HCG in men with testosterone-induced gonadotropin suppression.
References:
- Finkelstein JS, Yu EW, Burnett-Bowie SA. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med. 2013;369(25):2457-2465.
- Kohn FM, Kohn CJ, Zandieh S, et al. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression.
