Can HCG Monotherapy Reverse Testicular Atrophy Caused by Varicocele?

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MidwesternGuy

New Member
I have read through many stories on here about individuals who successfully reversed TRT-induced testicular atrophy using HCG. I have also read a litany of medical studies that demonstrated a similar result. While this is certainly encouraging, I am left wondering whether HCG can also reverse testicular atrophy caused by a varicocele. I have never taken TRT and my testosterone is still within the normal range. I have seen no studies on whether HCG is effective at reversing atrophy for someone without hypogonadism and who has never taken TRT. Do any of you know whether HCG is a viable treatment in this situation? Is it dangerous to take HCG when my hormones are already at relatively normal levels?

The full story: A few years ago I discovered what appeared to be a varicocele and had my doctor take a look at it. She confirmed that it was a varicocele, but assured me that they are common and that I didn't need to worry about it. A year later I was experiencing pain and some testicular atrophy (particularly on the left side), so I went to a different doctor who immediately set me up for an ultrasound. The ultrasound confirmed both that I had a stage 3 varicocele and that my left testicle was now much smaller than my right. I had a varicocelectomy and the varicocele has thankfully not come back. However, both of my testicles have continued to experience progressive atrophy in the year and a half since the surgery. My left testicle has declined in volume by about 40% and my right by about 25%.

I do not yet have children (but plan to within the next couple of years if possible) and don't want to lose the ability to have them (if I haven't already lost it). My doctor initially thought that I might have hypogonadism, but testing showed that my testosterone is slightly over 500 ng/dl. This is down from the mid-700s when I was in my mid-20s. I am in my early 30s now. My LH (2.5 mIU/ml) and FSH (2 mIU/ml) were low, but slightly above the low end of their respective normal ranges. My Estradiol is in the low 30s. Multiple members of my clinic have acknowledged that the imaging shows a steady and significant decline in testicular volume across several ultrasounds over the past year and a half, but I was told that I shouldn't worry about the atrophy until my testosterone falls below 250. Since the atrophy began, I have developed gyno, less frequest morning wood, smaller ejaculation volumes and reduced muscle mass. I fear that if I do nothing, these new symptoms will continue to get worse as my testicles further atrophy.

I'm interested to hear from some of you as to whether taking HCG would even work to reverse the atrophy in my case. Also, by taking HCG while my hormones are relatively normal, am I risking destabilizing my hormones?
 
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StepbyStep

Active Member
My thoughts,

If I were to go the HCG route to reverse testicular atrophy I would shoot for a short 4-8 week cycle of HCG at moderate dosages with labs after a few weeks to see how you're responding. Some guys can do pretty well at 500iu a few times a week, whereas other need 1000iu EOD to get anywhere. It took me 1000iu EOD to get to 600ng/dL. Keep in mind also that HCG will suppress your LH and FSH, so importantly FSH will drop to near 0. Your testicles have Leydig and Sertoli cells. Leydig cells are stimulated by LH(HCG will stimulate these too), and FSH will stimulate your Sertoli cells. When your testicles aren't getting FSH, your Sertoli cells will atrophy. This is why not all guys get back their full testicle volume on HCG. Worth a try though.

I would also consider a Clomid restart. Clomid will max out your LH and FSH, which will in turn stimulate both your leydig and sertoli cells as much as possible, hopefully reversing any atrophy. Side effects can suck on clomid though.
 

Mr S

Active Member
Let’s keep in mind that HCG affects the HTPA (shuts you down) whereas Clomid doesn’t. Clomid in younger men has proven to be effective however, I don’t know what age is the cut up to be considered “younger ».
 

MidwesternGuy

New Member
Thank you very much for sharing your thoughts on this StepbyStep and Mr S. I hadn't considered the possibility of further Sertoli cell atrophy when on HCG. I have considered Clomid as an alternative, but had previously ruled it out due to the unpleasant side effects that it could cause. It sounds, however, that both of you think it may be an effective way to go if I am willing to put up with the side effects. I have an appointment in 2 weeks and will discuss both options with the doctor. I am still leaning toward trying HCG first (maybe starting at 500iu 2 or 3 times a week), but will consider switching to Clomid afterward if the HCG is ineffective or if I need to get my LH and FSH levels back up.
 

MidwesternGuy

New Member
I can't find any research on the impact of Clomid or HCG on testicles that atrophied due to varicoceles (or any non HPTA shutdown related reason). Given that I already have relatively normal hormone levels and don't seem to have an issue with my HPTA, do you think that Clomid or HCG will still be able to stimulate testicular regrowth?
 

StepbyStep

Active Member
Just to make sure that I'm reading correctly your current LH/FSH is ~2 with a Total Testosterone of 500. Clomid will take your LH/FSH to their physiological maximum, likely around 10. That will stimulate your testicles to their max also, and there are reports of guys saying that their testicles got bigger on Clomid if you search the various forums.
 

Robotics

Active Member
I had a varicocele embolization. about 4 months later i started on nolvadex after coming off trt (works similar to clomid) and the atrophied testicle seemed to improve in size, quite similar to the right one, cant say if it is permanent because i am still on it.

I had taken clomid before i had the embolization and it didn't improve the varicocele teste size much. So I would say it is worth a try.
 
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