Medically Reviewed by Dr. George Touliatos
Human chorionic gonadotropin (hCG) is a hormone primarily produced in the female placenta. Its primary function is to stimulate ovulation and maintain fertility. HCG was first discovered in the early 1900s, and since then much research has been done on this fascinating hormone.
Scientists realised that injections of hCG could help improve fertility in women who were unable to get pregnant. Later on, researchers realised that hCG was a suitable treatment for hypogonadism in men. This is because it can help stimulate endogenous testosterone production. HCG is also administered in young boys with undescended testicles.
In men, the testosterone production process begins when the hypothalamus in the brain detects that the body needs testosterone. After this, it sends a signal to the anterior pituitary gland to secrete gonadotropin hormones: luteinising hormone (LH) and follicle-stimulating hormone (FSH). These hormones stimulate sperm and testosterone production in the testes.
The process will start over again once the hypothalamus detects the body needs testosterone. This is known as the HPTA (hypothalamus pituitary axis) feedback loop.
HCG closely resembles the molecular structure of luteinising hormone. As a result, hCG mimics the action of lutenising hormone in the male body, leading to sperm production (spermatogenesis) and testosterone production The primary difference between LH and hCG is their half-life, i.e. the time it circulates in the body.
LH has a circulating half-life of around 25-30 minutes. Whereas hCG has a half-life of around 37 hours, making it an ideal prescription for hormone replacement therapy… after all, you definitely don’t want to be injecting every 30 minutes!
How Do You Use HCG?
In men, hCG can raise endogenous (natural) levels of testosterone. As mentioned, it behaves in a similar manner to the body’s own gonadotropin hormones. This sends signals to the testes to produce testosterone.
By comparison, testosterone replacement therapy uses exogenous (i.e. not made in the body) testosterone, which in turn shuts down the body’s own natural supply. This is because the body detects that there is enough testosterone in the bloodstream and subsequently stops producing its own.
For men using hCG as part of hormone replacement therapy to boost their own testosterone levels, there are two options.
The first treatment option is to use hCG alongside testosterone replacement therapy. This treatment option is ideal for men who want to maintain fertility while experiencing the benefits of TRT. Men who aren’t concerned about fertility may also choose this option because exogenous testosterone tends to shrink the testes, whereas maintaining fertility through hCG will help maintain normal testicle size.
In certain instances however, using hCG alongside testosterone replacement therapy may require an aromatase inhibitor (AI) in order to manage oestrogenic side effects such as bloating and water retention.
The combination of hCG and testosterone can lead to elevated oestrogen levels. This is because testosterone converts into oestrogen via the aromatase enzyme – a process known as aromatisation.
Essentially, the more testosterone you have, the more oestrogen you tend to have too. And because more is medication involved, this requires close management and monitoring by the doctor.
Nevertheless, as long as treatment is closely monitored by your doctor; hCG in combination with testosterone therapy can be an effective treatment protocol.
The second treatment option for hCG is monotherapy. That means using hCG only to raise intratesticular (i.e. natural) testosterone levels without exogenous testosterone (TRT).
This option works well for men who prefer to maintain their natural testosterone levels only. It may also suit someone who wants to remain on one form of medication only.
In most cases, only men who have secondary or hypogonadotropic hypogonadism (low testosterone) will respond well to hCG as a monotherapy.
Secondary hypogonadism is where there is a problem in the hypothalamus or pituitary area of the brain. These parts of the brain are responsible for sending a signal to the testes to produce testosterone.
In primary hypogonadism, the brain functions normally and sends a signal to the testes to produce testosterone. However here, the testes fail to respond to this signal and produce testosterone. This generally indicates that there is a problem with the reproductive tissue in the testes.
As mentioned, hCG acts in a similar manner to luteinising hormone in the male body. If the testes don’t respond to a strong LH signal, it is unlikely they will respond to hCG.
Research on hCG’s ability to both maintain fertility and boost testosterone levels is promising. One randomised control study of 29 men looked at the effects of 200mg of testosterone enanthate weekly in combination with either; a placebo, 125, 250, or 500iu hCG every other day.
The introduction of testosterone enanthate resulted in suppressed gonadotropin levels (i.e. LH and FSH) in all subjects. However, the use of hCG increased endogenous (natural) testosterone production. Endogenous testosterone levels increased in line with the dose of hCG , with the 500 iu group seeing the greatest increase.
This study indicates that low-dose hCG is able to maintain endogenous testosterone production within the normal range in men with gonadotropin suppression.
According to research, hCG restores fertility in up to 70% of patients with hypogonadotropic hypogonadism (i.e. secondary hypogonadism – a failure in the hypothalamus or pituitary gland). For the remaining patients who fail to restore their fertility, hMG (human menopausal gonadotrophin) – which behaves in the same way as follicle-stimulating hormone (FSH) – is often a good alternative.
One three-month randomised double-blind placebo controlled study looked at the effects of 5000iu hCG bi-weekly in 40 healthy males. The average age of participants was 67 years old. Each had to have a serum testosterone of below 420 ng/dL to participate in the study.
The researchers noted that lean body mass improved in all participants. Average testosterone and estradiol levels increased to 145% ( 778 ng/dL) and 157% (89 pg/mL) respectively. Two men had testosterone levels over 1000 ng/dL, and three developed nipple tenderness (i.e. high oestrogen side effects).
The results from the study were overall very positive and demonstrated that hCG alone is capable of raising endogenous testosterone levels.
Having said that, hCG can also potentially raise estradiol levels. This must be managed properly by the doctor to avoid oestrogenic side effects such as nipple tenderness, gynecomastia, moodiness and bloating.
HCG has been used for many years to help stimulate fertility in women. However, it’s still relatively new as a hormone therapy treatment for men.
The only way you can legally obtain hCG in the UK is through a doctor’s prescription – whether that’s private or via the NHS.
Many doctors have little to no experience with hCG in the UK. As a result, it’s unlikely you’ll find an NHS doctor willing to prescribe it as an adjunct to testosterone replacement therapy. And what’s more, highly unlikely you’ll find a doctor willing to prescribe hCG as a monotherapy in the UK.
HCG must be injected subcutaneously (i.e. into fat tissue) in the stomach. If hCG is used with TRT, then the hCG injections would typically be separate on separate days to the testosterone injections.
Anecdotally, there are some individuals who inject both hCG and testosterone at the same time. In theory, this is to improve efficiency. However, in practice, it’s never a good idea to combine two different pharmaceutical substances in such a manner.
HCG comes in a dry powder form and must be mixed with bacteriostatic water. The dose of hCG depends on the patient’s goals – whether they want to maintain fertility or simply maintain testicular since. This typically ranges from 250-500iu three times per week.
As with testosterone replacement therapy, there are no standard doses of hCG, because we are biochemically unique. The patient would usually start out on a small, manageable dose of hCG.
From there, it’s a case of experimentation and monitoring via blood tests and symptom resolution. Then the doctor can adjust the dose based on feedback from the patient.
Monday – Testosterone injection of 100mg of sustanon
Tuesday – hCG injection of 500iu of pregnyl
Wednesday – non-injection day
Thursday – hCG injection of 500iu of pregnyl
Friday – Testosterone injection of 100mg of sustanon
Saturday – hCG injection of 500iu of pregnyl
Sunday – non-injection day
The injection protocol for hCG as a monotherapy would be similar to the above. With monotherapy however, there would obviously be no testosterone injections.
The dose for hCG monotherapy is case-dependent. But for most men, this will be anywhere from 1500-3000iu per week.
HCG is an excellent treatment option for men looking to increase their testosterone levels. Nevertheless, as with testosterone, using hCG may require some iteration and experimentation until you find the correct dose for your treatment.
Your suitability for hCG will first depend on your current situation. To begin with – do you have low testosterone? If you have low testosterone, do you have primary or secondary hypogonadism? As this will determine whether hCG is right for you or not.
It also depends on what you want to achieve. Do you want to maintain your fertility and raise your testosterone levels? Or perhaps you’re not concerned about fertility, and only want to boost your testosterone levels?
To find out more about hCG and whether it’s the right choice for you, get in contact with us today.
Our experienced team of doctors, some of whom are on hCG themselves, can go through your treatment options with you with no obligation.
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.
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