I’m 26 and was put on TRT by an endocrinologist due to secondary hypogonadism as a result of pituitary damage from head injury. It has been 7 months since I initially started testosterone, and it has changed my whole world in so many ways for the better. However, recently, I started having some erectile dysfunction to the point where it has become embarrassing with my girlfriend. My endocrinologist couldn’t help with this and wouldn’t entertain HCG so I went to a mens clinic recently. I began injecting 200 iu hcg twice as week - each time a day before my twice weekly testosterone injection of 65 mg (130 mg/wk). It has already helped increase my testicle size slightly and erection quality but I’m getting irritable, tired and really anxious. I got my blood work done a couple days ago and here are the results.
Any obvious issues because I truly don’t know? - or perhaps I just can’t tolerate HCG? My baseline total T without any medication was below 300 over three years and 8 separate blood tests - so I really need the T support. I avoided TRT for a very long time because of a perceived stigma. I thought I was being smart but actually there’s no need to suffer as a young dude with low T and I feel worlds better on testosterone so I plan to stay on it. Clomid monotherapy is also not an option because I tried it first and it messed with my vision and I became even more emotional on it.
Does anyone have a dosing suggestion that might maintain intratesticular testosterone while mitigating negative HCG side effects?
The knee jerk reaction when ED occurs on TRT is more T, your complaint is a common one and what’s needed is less T, not more and that’s what you’ve done by introducing HCG.
Not every man needs to have the T at the top of the normal ranges to fully benefit from TRT, some do remarkably better at or about midrange (500-600). For me as long as I’m at or slightly above 500, I do very well in this range, even in the muscle department.
You also are getting estrogen from two different sources, aromatase and within the testes whereas on TRT in isolation you were only getting estrogen via aromatase.
You didn’t need HCG, you needed to lower your dosage and/or inject more frequently.
This may not be in the cards for you, at any dosage. The majority of guys run into problems on HCG and do better without it.
Hey, thanks for your reply. I am definitely open to lowering my T dosage, although here is my blood work prior to HCG and at 120 mg/wk. I inject subcutaneously twice per week.
I have felt much better / more stable emotionally on just testosterone. I would continue this approach if erection issues could be sorted out any other way. I have taken viagra in the past, and it definitely works, but I get a lot of side effects (headache, congestion, insomnia).
Just to be clear, you were taking 130mg once a week and these were your levels when you began to notice ED? You added hCG and noted improvement in testicular size and ED and you had these levels:
While there are times when men feel better decreasing the dose, more times than not they do better increasing the dose. It appears this would apply to you as you are reporting improvement with the increased levels due to the addition of hCG. You could try discontinuing the hCG and simply increasing the testosterone. Maybe to 150mg?
This is all correct, but the 600 ng/dl level was on 120mg, split dosage into 2x week administration sub q.
HCG has improved testicular size and ED but it comes with emotional side effects, mainly anxiety. I’ve been on a low dose (200 iu 2x per week) for 18 days. I am wondering if emotional side effects will subside over time if I just get used to it - that’s what I’m going to try for at first at least.
I switched to a men’s clinic because endo did not care about testicular size or libido and wouldn’t consider HCG use. Honestly the endo was much more intelligent than my current provider at the men’s clinic but didn’t really care about anything other than that I had enough test to meet normal levels of reference range. I could drop HCG but I like the idea of keeping testes stimulated since I’m 26.
I struggle to see any passion or enthusiasm in any of my doctors, they seem to busy to care about the little things, don’t advocate for their patients and most of what they do all day is look at lab ranges and are basically data monkeys now.
I’ve been searching for someone managing side effects using 100 mg Viagra/sildenafil. My urologist said two aspirin one hour before taking the pill. Not on it,yet, but considering asking for it. I’ve read excellent results from 100 mg but migraines are in my medical history. Desperately want erectile function, again. Currently 100 mg Test E, IM, E5D. Sex drive is good but only short life erectile function in late evening. No nocturnal erections or morning wood. I should add my wife has worsening dementia and, separate to that, our love life ended over a decade ago. I’m her caregiver. Just want Mr. Johnson up and running.
At 72, don’t care about how my scrotum looks. It’s all about sexual function. Never used HCG. Any benefits per erectile function or is a dose increase of T more beneficial?
HCG has way more benefits for sexual function than increasing T dose. Way more. Increasing T dose alone hasn’t helped me one bit. I still have to take Cialis to have even a 1/2 functioning Johnson at 160mg per week of test. My total testosterone is well over 1,000 ng/dl. Don’t listen to anyone on this forum, experiment for yourself and listen to your body. HCG is the only thing that used to work for me.