3 months on HCG Monotherapy - more questions than answers

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aneuman

New Member
Hello folks,

I'm totally new here and not well versed in forums and stuff, so pardon me if I'm not following any expected procedures. A little bit of context and history to help explain my situation:

58 yo male. Have been experiencing ED for about 10 years now that has been resolved primarily with Cialis daily 5 mg. No other health issues, however, I've been experiencing low libido, lack of penile sensitivity, long time to ejaculate with very short orgasm, lack of general will and energy, like not having energy to do stuff, but no depression. Been to many doctors in these 10 to 15 years and all diagnosed me with different things, from ADD to lack of B12, to depression. Even though my T was ar 283 ng/dL in 2019, my PCP told me it was in the "normal range". Early this year it was at 492, but curiously my problems were getting worse, particularly the libido, which was almost non-existence (my libido used to be extremely high all my life, until about 5 years ago).

I went to visit an andrologist which prescribed me HCG 1ml per week (that's exactly what he said). Doing the calls, he prescribed Empower HCG 12,000 UI to be mixed with 6 ml of bacteriostatic water, so I assume it makes about 2000 UI per ml, so that's what I was getting every week (every Friday night to be precise) since august 27. Doctor did not order any tests, but my most recent labs at the time showed:

T= 492 ng/dL
Free T = 55.6 pg/ml
E2= 27 pg/ML
Prolactin= 7 ng/ml
LH = 2.6 mIU/ml

For the first few 2 to 3 weeks, my life changed dramatically. Morning erections returned, my testicles felt fuller and bigger, my penis was ganging fuller as well, my libido returned, my ability to ejaculate in a reasonable amount of time, the pleasure of orgasm, a general sense of well-being, confidence. Bottom line, I felt like I was 10 or 15 years younger. I was even able to urinate better, bigger and stronger flow. I was definitely

Unfortunately this lasted 2 or 3 weeks and by the end of September I started losing the effects. My testicle were going back to their previous size, morning erections disappeared, flaccid penis was shrinking, libido was drastically reduced, my energy went away. By now, I believe that I am at a worse state than I started. My testicles feel smaller, my penis look like a 5 year old, my libido like that of an eunuch, my urine flow went back to how it was. My energy and well-being dramatically reduced.

Question: any one experience anything similar? I have been reading the forum and people recommend not injecting more than 500 IU in a 24 h period, so now I have changed to 500 UI 3 times a week (which adds up to 1500 a week, not 2000 like prescribed) Any suggestion? Could it be like some people say that the Leydig Cells were destroyed by too much HCG at once?, that the feedback loop kicked in and HCG has stopped working? That the quality of Empower HCG has changed (they called me and said they won't sell HCG anymore going forward)

Any advice would be greatly appreciated

A.N.
 
Defy Medical TRT clinic doctor

Systemlord

Member
You need to provide reference ranges for your labs (Free T).

HCG isn't a good treatment for low T, especially for older men. A lot of guys that use HCG in conjunction with their TRT feel a benefits at first, but run into problems after continued use.

Your levels might be in the normal range but according to the guidelines your levels are low enough to qualify for TRT.

You need a doctor that specializes in this area of medicine and clearly your PCP does not.
 
Last edited:

aneuman

New Member
You need to provide reference ranges for your labs (Free T).

HCG isn't a good treatment for low T, especially for older men. A lot of guys that use HCG in conjunction with their TRT feel a benefits at first, but run into problems after continued use.

Your levels might be in the normal range but according to the guidelines your levels are low enough to qualify for TRT.

You need a doctor that specializes in this area of medicine and clearly your PCP does not.

Thanks Sytemlord. Really appreciate your prompt response. Like I said, the doctor that prescribed the HCG is a urologist specialist in andropause (an andrologist), not my PCP, and he did not order any labs prior to starting the HCG mono. The labs I got are from mid last year, before I started HCG. This is all I have

Free T: 64 pg/mL
PRL: 7 ng/mL
T: 492 ng/dL
TSH: 1.86 mIU/L
FSH: 7.1 mIU/mL
LH: 2.6 .IU/mL
Total CHOL: 190 mg/dL
LDL CHOL: 119 mg/dL
Triglic: 141 mg/dL
Glucose: 93 mg/dL
Hemoglobin: 15.6 g/dL

So according to your experience, HCG mono therapy might not work well for older people like me, any experience with clomiphene or a combination of clomiphene + HCG, or is it the best option discussing T-Cypion + HCG? I'm concerned about cost too.

Really appreciate your answer, because the reality is that I again feel like s**t, after having felt really good for 2 or 3 weeks. It really had my hopes up, and now I'm totally disappointed. I don't have another appointment with him until next year, so I was hoping, probably incorrectly, that a simple dose adjustment would help.

Thanks,
A.N.
 

Systemlord

Member
So according to your experience, HCG mono therapy might not work well for older people like me, any experience with clomiphene or a combination of clomiphene + HCG, or is it the best option discussing T-Cypion + HCG? I'm concerned about cost too.
If your have low testosterone, then you need testosterone. Clomid typically has a lot of side effects.

Testosterone cypionate is the cheapest route.
 
Last edited:

Systemlord

Member
I don't have another appointment with him until next year
It's crazy that a doctor prescribe you HCG instead of TRT at 58 years old.

Like I said, the doctor that prescribed the HCG is a urologist specialist in andropause

Just because a doctor specializes in a particular field of medicine doesn't mean the doctor is good at it or is up to date on current medical literature. A lot of doctors still believe TRT causes prostate cancer, heart attacks and strokes.
 
Last edited:

CKO

Member
You need labs to show how the HCG is affecting you. I also tried HCG monotherapy with some success, however, it usually leads to high estrogen levels. For me high estrogen leads to loss of libido, insensitivity during sex, lowered mood. Doses of HCG above 1000iu to 1500iu a week can cause your natural production of testosterone to begin shutting down, due to negative feedback with the HPTA.
 

Cataceous

Super Moderator
In line with what @CKO is saying, it seems likely that you had a nice honeymoon period from the additive effects of your natural LH production and the hCG. But then your natural production of LH, FSH and other upstream hormones was suppressed, making things worse overall. Even men on conventional TRT may experience problems from this HPTA shutdown, in spite of having plenty of testosterone.

There are at least a couple ways to get more testosterone without having these issues with HPTA suppression. One is to use a SERM. If you go this route then enclomiphene is preferred over Clomid/clomiphene. The problem with SERMs is that although many men end up with good numbers, the subjective results are often poor. Thus I recommend looking into Natesto or a generic testosterone nasal gel as a first-line treatment. This method of testosterone delivery is so short-acting that significant HPTA suppression is avoided; you continue to get an additive effect. The product is relatively new, so anecdotal reports are fairly sparse. Nonetheless, the reviews are largely favorable. The main complaint seems to be about having to squirt the stuff up your nose. But it may be a small price to pay if the results are good.
 

aneuman

New Member
In line with what @CKO is saying, it seems likely that you had a nice honeymoon period from the additive effects of your natural LH production and the hCG. But then your natural production of LH, FSH and other upstream hormones was suppressed, making things worse overall. Even men on conventional TRT may experience problems from this HPTA shutdown, in spite of having plenty of testosterone.

There are at least a couple ways to get more testosterone without having these issues with HPTA suppression. One is to use a SERM. If you go this route then enclomiphene is preferred over Clomid/clomiphene. The problem with SERMs is that although many men end up with good numbers, the subjective results are often poor. Thus I recommend looking into Natesto or a generic testosterone nasal gel as a first-line treatment. This method of testosterone delivery is so short-acting that significant HPTA suppression is avoided; you continue to get an additive effect. The product is relatively new, so anecdotal reports are fairly sparse. Nonetheless, the reviews are largely favorable. The main complaint seems to be about having to squirt the stuff up your nose. But it may be a small price to pay if the results are good.
Thank you all. I agree that it seems like a negative feedback problem. I spread the 2000 UI EOD but results are the same. The honeymoon seems to be over. I’m afraid stopping it suddenly may cause more problems.

I thought about natesto a while back, not sure what the side effects might be, I also have bph. And there’s price and insurance.

Thank you all.

AN
 

aneuman

New Member
You need labs to show how the HCG is affecting you. I also tried HCG monotherapy with some success, however, it usually leads to high estrogen levels. For me high estrogen leads to loss of libido, insensitivity during sex, lowered mood. Doses of HCG above 1000iu to 1500iu a week can cause your natural production of testosterone to begin shutting down, due to negative feedback with the HPTA.
That may be what's happened to me. I take 2000 UI. I have an appointment on 7 December. I'll check with him. I did not have a baseline labs before treatment however, and he has not ordered any for the next appointment.
 

aneuman

New Member
It's crazy that a doctor prescribe you HCG instead of TRT at 58 years old.



Just because a doctor specializes in a particular field of medicine doesn't mean the doctor is good at it or is up to date on current medical literature. A lot of doctors still believe TRT causes prostate cancer, heart attacks and strokes.
One of the authors of this study is the doctor I'm seeing.


According to the protocol, they recommend 2000 UI weekly, which is what I was prescribed.
 
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