As the title says... after years and years I have figured out this vicious cycle and I do not understand it. Every 6 to 9 months my libido just tanks and I need to go on HCG monotherapy for 3/4 weeks at 1000iu MWF. My sex drive begins to build by the end of week 1 and then comes raging back towards the end of week 2. I keep this going for another week or 2 then resume TRT at 50-70mg + 500iu HCG e3.5d and am great for another 6 to 9 months and then the cycle repeats. Does anyone know wtf is happening here and how to fix this? My guess is that it has something to do with my other hormones that TRT is shutting down and it takes 6 months to turn out the lights even though I am using 500iu e3.5d during TRT. Any ideas? I know that Lipschultz was an advocate of this in his papers to "keep TRT working" but I dont know what he meant by this.
I have to switch from TRT to HCG monotherapy every 6 to 9 months to get my libido back. Does anyone know what is happening and how I can avoid this?
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This is why I started doing this... I read a paper where Dr. Lipschultz said the following.
"Finally, hCG has also been used to reduce some of the side effects of TRT, mainly preventing testicular atrophy and helping maintain response to TRT by “cycling off” TRT with a periodic replacement of therapy with hCG."
This is the AI reasoning behind it. For those of you chasing the honeymoon, try this. It has worked for me although I use 1000iu of HCG MWF for 3-4 weeks instead of 3000iu MWF.
THIS IS THE FRIGGING SMOKING GUN. Why nobody does other than me that I know of is beyond me.
You’ve identified a key passage from that 2018 review. While much of the literature focuses on fertility, that specific excerpt highlights the clinical utility of cycling for men who aren't necessarily trying to conceive but want to avoid the "plateau" or "shutdown" effects of long-term TRT.
Understanding the "Response to TRT"
When Dr. Lipshultz mentions "maintaining response," he is addressing a common clinical observation where some patients feel a decrease in the subjective benefits of TRT (libido, energy, well-being) after several years of continuous use.
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The logic behind the 6-month "reboot" is based on three main physiological goals:
- Up-regulating Receptors: Constant, exogenous (external) testosterone can lead to a "down-regulation" or desensitization of androgen receptors. A 4-week washout with HCG allows the body to clear the synthetic esters and rely on endogenous (natural) production, essentially "resetting" the receptor sensitivity.
- Maintaining "Cross-Talk": Testosterone isn't the only hormone the testes produce. They also create precursors and neurosteroids (like pregnenolone and DHEA). By cycling TRT off and using HCG every 6 months, you ensure the Leydig cells stay active and continue producing these "upstream" hormones that contribute to the overall "response" or feeling of the therapy.
- Preventing Irreversible Atrophy: Long-term suppression can lead to "interstitial fibrosis"—a thickening of the tissue in the testes that makes it harder for them to ever wake up again. The 6-month cycle acts as a "stress test" to ensure the machinery is still functional.
The Specific "Cycling Off" Protocol
Based on the paper you quoted, here is how that specific "periodic replacement" usually looks in a clinical setting:- Duration: The "off" period typically lasts 4 weeks.
- HCG Dosage: During these 4 weeks, TRT is stopped entirely and replaced with 3,000 IU of HCG every other day.
- Monitoring: Clinicians often check LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) at the end of this month to see how quickly the "natural axis" is responding before restarting the TRT.
A Note on Subjective Experience
Many patients find that during that 4-week "off" period, they feel a different kind of "energy" because their body is producing its own testosterone along with the accompanying neurosteroids. When they restart TRT after the month is up, they often report that the "honeymoon phase" of the therapy returns.Comparison of the "Reboot" vs. "Maintenance"
| Phase | Duration | Testosterone | HCG Dosage |
| "The Reboot" | Weeks 1–3 | None | 1,000 IU EOD |
| "The Transition" | Week 4 | Resume TRT | 1,000 IU EOD |
| "The Maintenance" | Week 5+ | Standard TRT | 500 IU E3.5D |
I would prefer not to have to do it. I only know that it works and for every guy who has been on TRT for some length of time and is struggling this is probably the answer. I just wonder WHY and if there is a way around it such as supplementing with neurosteroids.
FunkOdyssey
Seeker of Wisdom
I'm going to guess probably not, because your baseline protocol already includes substantial hCG, and few men on TRT report any net benefit with direct neurosteroid supplementation. I suspect it has more to do with this:
You could test this by dropping both the TRT and hCG for your next reset and see if there's any difference in outcome.
If a complete withdrawal seems too harsh then there's a chance you would get similar or better results with a switch to testosterone nasal gel for a period of time. HCG can still be pretty suppressive, which possibly limits the recovery of GnRH production, and maybe kisspeptin as well. Experimenting with gonadorelin showed me that GnRH can be a factor in libido.
Alternatively, if you don't mind being a lab rat then try using enclomiphene and cistanche extract with your TRT for a period. I've already demonstrated that you can restore some LH production by adding gonadorelin and enchomiphene to TRT. The hypothesis is that cistanche extract would obviate the need for gonadorelin by attenuating the negative feedback of androgens at the hypothalamus.
Encomiphene is a double-edged sword, because it's possible that too much antagonism of off-target estrogen receptors has negative effects on libido.
Alternatively, if you don't mind being a lab rat then try using enclomiphene and cistanche extract with your TRT for a period. I've already demonstrated that you can restore some LH production by adding gonadorelin and enchomiphene to TRT. The hypothesis is that cistanche extract would obviate the need for gonadorelin by attenuating the negative feedback of androgens at the hypothalamus.
Encomiphene is a double-edged sword, because it's possible that too much antagonism of off-target estrogen receptors has negative effects on libido.
I always thought it became dogma that receptor downregulation was a myth but in my case seems not to be.
FunkOdyssey
Seeker of Wisdom
It might not even be androgen receptors that are downregulated; it could be something else downstream, related to dopamine neurotransmission maybe. I think that's actually what happens with the honeymoon period: some kind of dopamine-related adaptation, as the brain seeks to maintain homeostasis and return to baseline.
I am telling you guys that this puts.me back into the honeymoon period for months and months everytime which is why I am wondering why nobody else is doing this.
Nelson Vergel
Founder, ExcelMale.com
LH and FSH will be shut down while on hCG,so it is a waste of time to check LH and FSH in the presence of hCG. Confusing for most. hCG is a LH mimicker that also has some FSH-like properties. The blood tests for LH and FSH were not designed to measure a mimicker. hCG does not increase LH even if the molecule has LH-like properties.
Nelson Vergel
Founder, ExcelMale.com
I would recommend reading these threads about the effects of hCG on upstream hormones (which impact mood and sex drive)
Than ks for chiming in, Nelson. That was my thought as well but I have never actually tested this. With regards to the second post, when I am not on HCG monotherapy as a reset protocol, I am still using 500iu twice per week instead of 1000iu 3x per week so I am not sure it is the neurosteroids. I also begin to feel less emotionally flat and my libido comes raging back (usually by the middle of week 2 so that is 10-11 days from the last cyp injection) before the testosterone from my last testosterone shot clears completely.
Another poster here thought it had something to do with androgen receptor sensitivity. Do you have any thoughts on the reason this works for me?
I am wondering if I could just stay on testosterone and blast HCG MWF at 1000iu MWF for 3 weeks and get the same result. I have never tried it though bc I just assumed that 500ius 2x per week plenty while on the T.
I am nearly convinced I just may be better off on HCG monotherapy long term. The physical benefits are not as good with regards to athleticism/physique enhancement but I do feel great when doing this. I just wonder how I would be doing 2 or 3 months in is the real question. What a bunch of lab rats we are.
I do recall having a pregnenolone test done once while on TRT and my levels were rock bottom. My DHEA/DHEAS were middle of the road.
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I can't get any of my doctors to prescribe TRT with hCG (I've been on both over the years, but not at the same time). I keep telling them that I don't feel the same just being on TRT. How do you guys convince your doctors to prescribe both? And how do you get insurance to pay for both?
I just told my doctor what I was doing and he said fine let's keep doing it if you feel good. Insurance covers my HCG but not my testosterone for whatever reason. I would get a new doctor and it does help when you come to them already on a protocol IMO.
Nelson Vergel
Founder, ExcelMale.com
Print this study from Lipshults or email it to him:
If a complete withdrawal seems too harsh then there's a chance you would get similar or better results with a switch to testosterone nasal gel for a period of time. HCG can still be pretty suppressive, which possibly limits the recovery of GnRH production, and maybe kisspeptin as well. Experimenting with gonadorelin showed me that GnRH can be a factor in libido.
Alternatively, if you don't mind being a lab rat then try using enclomiphene and cistanche extract with your TRT for a period. I've already demonstrated that you can restore some LH production by adding gonadorelin and enchomiphene to TRT. The hypothesis is that cistanche extract would obviate the need for gonadorelin by attenuating the negative feedback of androgens at the hypothalamus.
Encomiphene is a double-edged sword, because it's possible that too much antagonism of off-target estrogen receptors has negative effects on libido.
Awesome that your insurance covers HCG. Which brand of HCG do you use? I assume its Pregnyl?
Thanks, but since I've had a vasectomy the response I will get is that this article is to preserve fertility not related to other aspects of sexual functioning.
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