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Reasons to Use hCG with TRT

Reasons to Use hCG with TRT

By Mike Kocsis | 7 minutes read | Last updated: May 7, 2024
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    Human chorionic gonadotropin (hCG) is a hormone found in both men and women in small amounts. Its normal serum concentration is below 5 mIU/mL in non-pregnant women and 2 mIU/mL in men. It is also known as the “pregnancy hormone” because of its role in maintaining pregnancy. Levels of hCG increase within 10 days of conception, and they keep on increasing during the first three months and then start declining gradually. Men use hCG injections for different purposes, such as to improve testosterone levels, reduce symptoms of hypogonadism, and improve sexual function. Seeing the effectiveness of hCG injections, many physicians have started using them with testosterone replacement therapy (TRT). But, what are the benefits of combining TRT and hCG? What does science say about it? Should you take hCG injections or not? Read the article to find out.

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    TRT and its effects

    Many people see testosterone as a mere sex hormone, but it plays many different roles in the body, such as:

    These processes will keep happening in your body as long as there is enough testosterone (300 to 1000 ng/dL) in it. Some men develop a genetic issue, a disease, or another health-related issue that reduces testosterone production. As a result, their testosterone levels fall below 300 ng/dL, and they become testosterone deficient – a condition called low testosterone or hypogonadism. Due to low testosterone levels, their bodies become unable to perform testosterone-dependent activities.

    This is where TRT comes to help.

    It delivers exogenous testosterone to your body and increases your serum testosterone levels back to normal. The therapy not only boosts testosterone levels but also reduces low T symptoms. TRT can produce the following positive effects on your body.

    Though TRT is beneficial in many ways, like many other medical processes and therapies, it comes with some side effects. When you start receiving testosterone from external sources, it interrupts the natural process of testosterone production. Your testes stop generating testosterone, and over time, they may reduce in size.

    Typically, testes receive signals from the pituitary gland (located in the brain) to begin testosterone production. This signal comes in the form of luteinizing hormone (LH) produced by the pituitary gland. LH works with the FSH (follicle-stimulating hormone) to produce testosterone and maintain its levels. FSH is also required for the production of sperms.

    Exogenous testosterone is known to halt the production of LH and FSH by the pituitary gland. As a result, the testosterone level and sperm count decline and men become infertile.

    Men planning to have children or make their partner pregnant cannot do so if they are on TRT. But fortunately, scientists have come up with a solution for this TRT side effect. hCG injections can help men on TRT improve their natural testosterone and sperm production.


    Using hCG with TRT

    HCG has been approved by The Food and Drug Administration (FDA) to be used for certain male and female health issues. It is commonly used to treat infertility in women and improve symptoms of hypogonadism in men.

    hCG has a molecular structure similar to LH, due to which it can mimic the action of LH. It stimulates the formation of testosterone and sperm within the testes and helps maintain fertility.

    LH has a biological half-life of 20 minutes. This makes it a poor medication as you would have to take its injection every 20 minutes to maintain its levels in the blood. In contrast, the biological half-life of hCG is 24 to 36 hours. It means you will have to take this injection around 2 times per week to keep its levels stable in your blood. This makes hCG a favourable alternative.

    When you combine hCG with TRT, you don’t experience TRT symptoms like testicle shrinkage and low sperm count. Your testes start producing testosterone naturally, and your serum testosterone level stays normal. TRT without hCG can reduce intra-testicular testosterone levels by 94%. But, when you take hCG with testosterone, you may notice only a 7% decline in testosterone levels.

    Men report the following effects of using hCG with TRT.

    • Improvement in libido
    • More sperm count
    • Better sleep
    • Mental alertness
    • Improvement in exercise capacity


    What does the research say about it?

    Some small-scale studies have been done on hCG and testosterone. In a 2013 study, researchers gave testosterone injections to 19 men with low T and transdermal testosterone gel to 7 men with low T. All participants also received 500 IU hCG every 2 days. Researchers measured serum hormone levels of free testosterone and estradiol and semen parameters before and during treatment.

    They concluded that no men experienced a change in semen parameters and their hormone levels rose during the treatment. Low-dose hCG helped men on TRT preserve their fertility. In a 2018 study, researchers concluded that hCG could treat hypogonadism in men, whether you give it alone or with TRT. They said that it could restore spermatogenesis (conversion of germ cells into sperm in testes) in men whose fertility is affected due to the consumption of steroids.


    What are the other benefits of hCG injections?

    Enlisted below are a few more benefits of hCG injections.

    • HCG injections are used to improve sexual function in men who do not find any improvement in their sexual function even after taking testosterone.
    • They are used to treat undescended testes, an abnormality where testes do not descend from the abdomen to the groyne during foetal development.
    • Bodybuilders often take steroids to increase muscle mass fast. They also take hCG injections with steroids to prevent their side effects like infertility.
    • HCG injections are used to restore testosterone levels that have been affected by surgery and medical treatment you recently had.
    • Some people also take hCG supplements for weight loss as a part of the “hCG diet.” In this diet plan, they reduce their calorie intake to 500 calories per day and take an hCG supplement every day. Though this method is gaining popularity among the masses, there is no evidence that hCG can help with weight loss.


    Is hCG safe?

    hCG injections are approved by the FDA and are safe for both men and women. However, hCG comes in the form of drops and supplements as well. They are not approved by the FDA and are not a viable alternative to injections. hCG can only be purchased by prescription and should only be taken under the supervision of a healthcare provider. You can buy it only by prescription. You should not take these injections if you have prostate cancer or a brain tumour, as it may worsen your condition.


    How to take an hCG injection?

    The recommended dose of hCG is 350 to 500 IU two to three times a week. Your doctor will adjust it according to your body’s response and your testosterone concentration. HCG injections are taken like insulin injections. It means you inject them into your lower abdomen, where fat is accumulated. Before taking the injection, add 5ml bacteriostatic water to the dried hCG vial. Do not shake the mixture vigorously, or the molecules will get destroyed on the spot. Fill your syringe and inject the mixture into your abdomen.

    HCG will take up to 6 hours to show its effect. It will stay in your bloodstream for up to 2 days, and then its level will start declining. You will have to take another injection to keep hCG levels stable. Keep your hCG kit in the refrigerator and out of the reach of children. Once an hCG vial has been opened, you will have to use it within 30 days as it will expire in a month after mixing water in it.


    Are there any side effects of hCG injections?

    Generally, these injections are well tolerated by men, but some may experience a few side effects. Here are the common side effects of hCG injections.

    • Increase in the breast size (gynecomastia)
    • Acne
    • Redness of skin at the injection site
    • Headaches
    • Nausea and vomiting
    • Stomachache

    Some of these side effects will go away on their own in a short time period when your body becomes used to hCG. However, some may take more time and require a doctor’s attention. Your doctor may lower your hCG dose to tackle such side effects. In very rare cases, the recipient may develop blood clots, mild skin rashes, and anaphylactic reactions. Contact your doctor immediately if you notice these side effects.

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    hCG injections are FDA approved and have many beneficial effects on the body. Men who are on testosterone but worry about their declining sperm count can restore their fertility by combining hCG injections with TRT.

    If you have been diagnosed with hypogonadism at a young age and want to have children while you are on TRT, you should talk to your doctor about hCG injections and find out if they are right for you. Share your fertility woes with your healthcare provider so they can design the best treatment plan for you.


    References/Bibliography/Further Reading/Scientific Studies

    Hsieh, T.C., Pastuszak, A.W., Hwang, K. and Lipshultz, L.I., 2013. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. The Journal of urology189(2), pp.647-650.

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    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject. You can read more about our Editorial Process by clicking here.

    We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.

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    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

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