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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Testicle Size: Testosterone Injections vs hCG vs T gel
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<blockquote data-quote="madman" data-source="post: 193006" data-attributes="member: 13851"><p>Keep in mind the piss poor protocol used for the patients injecting esterified T.</p><p></p><p></p><p><strong>*28 patients treated with IM injections of an oil-based blend of four esterized testosterone (TE) compounds</strong> (Sustanon 250 mg Organon; Organon Schering-Plough Corporation, Istanbul, Turkey; 30 mg testosterone propionate, 60 mg testosterone phenylpropionate, 60 mg testosterone isocaproate, and 100 mg testosterone decanoate) <strong><u>once every 3 weeks</u></strong></p><p></p><p></p><p></p><p></p><p></p><p>Treatment of hypogonadotropic hypogonadism is required to initiate androgenization and fertility. While the former can be achieved by testosterone replacement, the latter can only be succeeded by gonadotropins or pulsatile GnRH treatment.39 In either condition, testicular growth is highly important. <strong><u>One of the major findings in this study was that TV increased significantly after either gonadotropin or testosterone treatment, being more remarkable in the hCG-treated group</u>. </strong>Our results with hCG treatment is in accordance with the previous data.40,41 However, several authors reported reduced testicular size after testosterone treatment.42 It should be emphasized that the patients included in these studies were older in comparison with our patients. Moreover, in our study, both TE and TG treatments caused increases in TV, suggesting that the resultant effect was not accidental. In younger patients, testosterone treatment was not shown to cause a negative effect on the hypothalamic-pituitary-testicular axis and to increase growth hormone and IGF1 levels.43 GH upregulates IGF-I secretion, IGF-I receptor numbers, and LH receptors in Leydig cells in vivo. 44 Absolute or testosterone adjuvant effect of GH may increase TV in patients treated with testosterone. Nevertheless, the long-term effects of testosterone treatment on TV are unknown. <strong><u>Administration of hCG increases intratesticular testosterone level via a direct effect on the Leydig cells,4 which can cause enlargement of the testes</u>. </strong>Burris et al. 40 found a two-fold increase in TV after hCG treatment. In another study, satisfactory responses were achieved even in patients with very small initial testicular size.39 <strong><u>On the other hand, in our study, the efficacy of hCG treatment was inferior to the previous results reported in most of these studies; however, low responsiveness to hCG treatment in terms of testicular growth was also reported in IHH</u>.17</strong> Interestingly, a predictive role for initial TV in terms of achieving optimal testicular size on gonadotropin administration was also described in several investigations.39,40,45,46 <strong><u>Nevertheless, sample size, heterogeneous pretreatment TV values, ethnicity, and differences in the duration of treatment might have caused discrepant results in clinical trials</u>. </strong>Although there were significant differences in TV after testosterone and hCG treatments, the magnitude of these differences is quite small, and the clinical importance of these differences is not completely known. <strong><u>The low patient number seems to be the main limitation of this study</u>.</strong> Due to narrow selection criteria, the overall sample size remained small to represent all subjects with hypogonadotropic hypogonadism treated for hormone replacement. However, most previous studies had the same drawback; therefore, evaluation of the past and present data collected is required to make clearer comments. Also, a 6-month follow-up period may not be optimal to examine the long-term effects of these treatments, but we were not able to extend this course due to certain official issues. Probably some changes, mainly with hCG, may/will occur later.</p></blockquote><p></p>
[QUOTE="madman, post: 193006, member: 13851"] Keep in mind the piss poor protocol used for the patients injecting esterified T. [B]*28 patients treated with IM injections of an oil-based blend of four esterized testosterone (TE) compounds[/B] (Sustanon 250 mg Organon; Organon Schering-Plough Corporation, Istanbul, Turkey; 30 mg testosterone propionate, 60 mg testosterone phenylpropionate, 60 mg testosterone isocaproate, and 100 mg testosterone decanoate) [B][U]once every 3 weeks[/U][/B] Treatment of hypogonadotropic hypogonadism is required to initiate androgenization and fertility. While the former can be achieved by testosterone replacement, the latter can only be succeeded by gonadotropins or pulsatile GnRH treatment.39 In either condition, testicular growth is highly important. [B][U]One of the major findings in this study was that TV increased significantly after either gonadotropin or testosterone treatment, being more remarkable in the hCG-treated group[/U]. [/B]Our results with hCG treatment is in accordance with the previous data.40,41 However, several authors reported reduced testicular size after testosterone treatment.42 It should be emphasized that the patients included in these studies were older in comparison with our patients. Moreover, in our study, both TE and TG treatments caused increases in TV, suggesting that the resultant effect was not accidental. In younger patients, testosterone treatment was not shown to cause a negative effect on the hypothalamic-pituitary-testicular axis and to increase growth hormone and IGF1 levels.43 GH upregulates IGF-I secretion, IGF-I receptor numbers, and LH receptors in Leydig cells in vivo. 44 Absolute or testosterone adjuvant effect of GH may increase TV in patients treated with testosterone. Nevertheless, the long-term effects of testosterone treatment on TV are unknown. [B][U]Administration of hCG increases intratesticular testosterone level via a direct effect on the Leydig cells,4 which can cause enlargement of the testes[/U]. [/B]Burris et al. 40 found a two-fold increase in TV after hCG treatment. In another study, satisfactory responses were achieved even in patients with very small initial testicular size.39 [B][U]On the other hand, in our study, the efficacy of hCG treatment was inferior to the previous results reported in most of these studies; however, low responsiveness to hCG treatment in terms of testicular growth was also reported in IHH[/U].17[/B] Interestingly, a predictive role for initial TV in terms of achieving optimal testicular size on gonadotropin administration was also described in several investigations.39,40,45,46 [B][U]Nevertheless, sample size, heterogeneous pretreatment TV values, ethnicity, and differences in the duration of treatment might have caused discrepant results in clinical trials[/U]. [/B]Although there were significant differences in TV after testosterone and hCG treatments, the magnitude of these differences is quite small, and the clinical importance of these differences is not completely known. [B][U]The low patient number seems to be the main limitation of this study[/U].[/B] Due to narrow selection criteria, the overall sample size remained small to represent all subjects with hypogonadotropic hypogonadism treated for hormone replacement. However, most previous studies had the same drawback; therefore, evaluation of the past and present data collected is required to make clearer comments. Also, a 6-month follow-up period may not be optimal to examine the long-term effects of these treatments, but we were not able to extend this course due to certain official issues. Probably some changes, mainly with hCG, may/will occur later. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Testicle Size: Testosterone Injections vs hCG vs T gel
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