As we become more aware of the role hormones play in our body’s actions, we are learning the importance of supplementing low levels of hormones to bring everything back up to its ideal level. But what happens when you try to use two hormone therapies at the same time? HCG and testosterone are two hormones that have conflicting effects on the body, but their combination can help outweigh adverse side effects.
What is HCG?
Human Chorionic Gonadotropin (HCG) is a hormone produced during pregnancy. I know what you may be thinking, pregnancy and testosterone don’t really seem to go together, and you’re right. The fact that these two hormones do different things is what makes their combination effective, but we’re getting ahead of ourselves.
It’s important to understand what HCG does to the body, so bear with me here while we get a little technical. HCG is typically called the pregnancy hormone because it is made by the cells formed in the placenta. Now, the placenta is in charge of nourishing the egg after it has been fertilized, so the placenta plays a significant role in the development of a child. HCG is detected during a pregnancy test since its excretion signals a placenta, which only occurs during pregnancy. However, HCG is also what helps to stimulate the release of an egg during ovulation, so HCG plays an essential role in becoming pregnant and supporting the growth of the fetus.
Now that sounds great for women, but you’re probably wondering what role HCG plays for men. Obviously, HCG is not going to help a man become pregnant, so what exactly does it do? Similar to women, HCG helps men in terms of their fertility. However, instead of helping them release an egg, HCG helps men increase their testosterone production and produce sperm, a vital component of becoming pregnant.
So, when a couple may be having a hard time becoming pregnant, HCG injections may be suggested to increase their HCG levels and encourage egg release and sperm production.
What are HCG Injections?
HCG injections, as the name suggests, involve injecting HCG under the skin or into the muscle. Since HCG is the “pregnancy hormone”, the uses for HCG injections are similar. HCG injections are primarily used as a way to treat infertility in both men and women.
For women, HCG injections can help cause ovulation and treat infertility. For men, HCG injections can help to increase sperm count, thereby increasing their chances of fertilization.
While HCG injections are typically used in cases of infertility, they can also be used in young boys whose testicles have not dropped into the scrotum normally, usually due to a pituitary gland disorder.
As we age, our hormone levels may decline, and for men, one common example is a decrease in testosterone as they get older. By age 40, testosterone levels begin to decline, and by 80 years more than 50% of all men have low levels of testosterone. However, age is not the only factor affecting testosterone levels. Conditions such as type 2 diabetes, obesity, chronic kidney disease, chronic obstructive pulmonary disease, and HIV infection are associated with low testosterone levels.
Everyone likely knows that testosterone is a hormone that is higher in men, whereas women have higher estrogen levels. The higher amount of testosterone in men plays a role in bone mass, fat distribution, and strength.
Some signs of low testosterone levels include:
- depressed mood
- loss of body hair
- hot flashes
- diminished muscle mass
Testosterone therapy is typically recommended only for men with low testosterone levels and clinical symptoms of hypogonadism. Essentially, if things in the bedroom don’t function the way you want them to (i.e., the flag does not rise to full mast), or you are experiencing any of the above signs of low testosterone, it might be a good idea to talk to a doctor about testosterone levels.
However, one of the major side effects of testosterone therapy is that it can cause infertility problems. This is why the American Society of Reproductive Medicine does not recommend testosterone therapy for anyone attempting to initiate pregnancy.
How do HCG Injections Affect Testosterone Therapy?
Now, what happens if we take a hormone therapy that can cause low fertility and combine it with a hormone therapy that can help solve infertility problems?
By cycling between testosterone therapy and HCG injections, many of the side effects of testosterone therapy can be prevented, such as the shrinking of the testicles. HCG can help those undergoing testosterone therapy by preserving their production of sperm. Testosterone therapy often causes men to have sperm that are immobile and thus ineffective in fertilization. What’s even worse is that just stopping testosterone therapy will not immediately undo this effect, and up to 10% of men can continue producing unviable sperm even after stopping testosterone therapy.
HCG helps maintain viable sperm by maintaining the levels of intratesticular testosterone, which can drop by up to 94% during testosterone therapy.
A study on the effects of low-level HCG injections combined with testosterone therapy found that intratesticular testosterone increased by 26% in those who received an HCG injection. In addition, sperm production remained preserved at the one-year follow-up. With these results, HCG may be able to help preserve fertility in those undergoing testosterone therapy.
Once you enter within six months of desiring pregnancy, it is recommended to discontinue testosterone therapy and significantly increase the amount of HCG. Following these guidelines helps to give men the best likelihood of maintaining fertility.
The fact of the matter is that men are experiencing low testosterone levels at earlier and earlier ages while also choosing to bear children at older ages. This combination, however, leads to infertility problems due to the effect of testosterone therapy. By utilizing HCG injections while on testosterone therapy, men can help to preserve their sperm count and mobility, increasing their fertility. Combining HCG injections with testosterone therapy can help you balance your testosterone levels while ensuring that your little swimmers have the best possible chance of making it to the finish line.
 Petering, R., & Brooks, N. (2017). Testosterone Therapy: Review of Clinical Applications. American Family Physician, 96(7), 441-449. Retrieved from https://www.aafp.org/afp/2017/1001/p441.html
 Lee, J., & Ramasamy, R. (2018). Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men. Translational Andrology And Urology, 7(S3), S348-S352. doi: 10.21037/tau.2018.04.11
 Coviello, A., Matsumoto, A., Bremner, W., Herbst, K., Amory, J., & Anawalt, B. et al. (2005). Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression. The Journal Of Clinical Endocrinology & Metabolism, 90(5), 2595-2602. doi: 10.1210/jc.2004-0802
About Dr. Mel Irvine
Dr. Mel Irvine, DNP and Clinical Sexologist specializes in sexual medicine and beauty in Fort Myers Florida. She earned her Doctor of Nursing Practice at Florida Gulf Coast University and her master’s degree at the University of Alabama at Birmingham. In 2018, she completed a preceptorship at San Diego Sexual Medicine with Dr. Irwin Goldstein and obtained her clinical sexologist certification from STII with Dr. Carol Clark. She is passionate about working with singles and couples to learn and explore their sexuality and sexual health needs through providing a comfortable and nonjudgmental atmosphere. As a provider she offers a balanced and holistic approach that encompasses a multimodal care delivery model.