hCG: The Options for Treating Low Testosterone

Generally speaking, there’s no treatment more effective at providing relief from the symptoms of clinically diagnosed Low Testosterone than Testosterone Replacement Therapy (TRT). However, TRT may not be ideal for every patient’s circumstances.

hCG (human chorionic gonadotropin) monotherapy may provide an alternative solution for some situations.

A middle-aged man in a blue shirt sits on a sofa in a doctors office. Doctor is in the foreground, where her hands can be seen holding a clipboard. She may be explaining the options for treating low testosterone with hCG.

Is hCG Monotherapy an Effective Low Testosterone Treatment?


Men hovering near the borderline where Low T levels trigger their symptoms may benefit from hCG monotherapy.

hCG on its own can induce testosterone production in the male body by mimicking LH (luteinizing hormone), which stimulates the Leydig cells in the testicles to produce both testosterone, leading to the promotion of the natural production of sperm.

One small study examined the clinical charts of 37 male subjects who presented with low libido, low energy, erectile dysfunction, and insomnia—all symptoms of hypogonadism, (the medical term for Low T), but who had a serum testosterone level greater than 300ng/DL, one measurement used to diagnose low testosterone.

These men were administered hCG monotherapy for approximately 29 weeks for their condition and symptoms. Their testosterone levels improved by as much as 263 ng/DL (42.8%), with no adverse events reported.

While larger, more extensive studies are needed, this research project provided evidence that hCG potentially increases testosterone levels.

Unfortunately, in our clinical experience, this indirect route of stimulating natural testosterone production through hCG monotherapy isn’t as effective as TRT. It may not restore testosterone to the therapeutic levels needed to alleviate symptoms, but hCG monotherapy might be the option best for you and your particular situation.

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Is hCG Monotherapy the Answer to My Concerns About TRT-Related Infertility?

It’s difficult to answer that question without the details of your situation, but a common side effect of TRT is a drastic reduction in sperm production that can result in infertility.

Let’s look at the problem more carefully.

Normal sperm production is interrupted when the TRT injection introduces additional testosterone into your system.

Normally, the hypothalamus produces GnRH (gonadotropin-releasing hormone) in order to trigger the pituitary gland to generate two key fertility hormones:

  • LH (luteinizing hormone)
  • FSH (follicular stimulating hormone)

However, as testosterone levels are restored to a more optimum range for your body through TRT treatments, your hypothalamus will recognize that sufficient testosterone is present in your system, regardless of whether that testosterone was naturally produced or introduced as an injected medication. The brain then signals your pituitary gland to slow the production of FSH and LH.

Reduced FSH and LH levels are the signals for your testes to decrease both natural testosterone and sperm production. The result is a reduced sperm count and lower odds for impregnating your partner.

If you’re already past the stage of life where you intend to have children, this isn’t a major concern, but some men experience the symptoms of Low Testosterone while still hoping to increase the size of their family.

This puts some younger men in a difficult position, caught between feeling unwell each day and having a family.

The American Urological Association has deemed hCG therapy an appropriate alternative to TRT for men suffering from low testosterone but still planning to have children.

hCG monotherapy is one option, but there may be an even more effective approach available.

hCG and TRT in Tandem—Learn More

It’s possible that the best course of treatment for your situation might be to undergo both hCG and TRT treatments simultaneously, as opposed to choosing hCG monotherapy instead of TRT.

The hCG benefits of slightly increased fertility are often used to compliment a TRT regimen—the 2 therapies used simultaneously can effectively address the symptoms of Low Testosterone while potentially lessening the side effect of disrupted sperm production.

We invite you to learn more. Our informative video on hCG answers the following important questions:

  • What is hCG and why might it be recommended for a patient instead of traditional injections of testosterone cypionate?
  • Are there benefits to using hCG beyond maintaining fertility?
  • What does hCG monotherapy look like?
  • Is hCG ever combined with other medicines?

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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