Testosterone Replacement In Men Who Wish To Continue Family Planning
Millions of men have testosterone deficiency. Most of the men are middle age and older and, therefore, family planning is not an issue. However, if younger men have a low testosterone level and wish to continue family planning, the usual replacement with testosterone injections, gels or pellets is contraindicated because testosterone can reduce the sperm count making fertility difficult or impossible. This blog will discuss treatment of low T in younger men who wish to continue to have a family.
Function of Testosterone
Testosterone is the most important sex hormone or androgen produced in men. The function of testosterone is primarily the producing the normal adult male characteristics. During puberty, testosterone stimulates the physical changes that constitute the attributes of the adult male.
Throughout adult life, testosterone helps maintain sex drive, the production of sperm cells, male hair patterns, muscle mass and bone mass. Testosterone is produced in men by the testes and in the outer layer of the adrenal glands.
The hypothalamus controls hormone production in the pituitary gland by means of gonadotropin-releasing hormone (GnRH). This hormone tells the pituitary gland to make follicle-stimulating hormone (FSH) and Luteinizing hormone (LH). LH orders the testes to produce testosterone. If the testes begin producing too much testosterone, the brain sends signals to the pituitary to make less LH. This, in turn, slows the production of testosterone. If the testes begin producing too little testosterone, the brain sends signals to the pituitary gland telling it to make more LH, which causes the testes to make more testosterone.
Symptoms of Low Testosterone
The failure of the testes to produce a sufficient level of testosterone in the adult male results in a low testosterone level. Physical signs of low testosterone in men may include:
Declining sex drive,
Erectile dysfunction (ED),
Low sperm count
Decrease in lean muscle mass
Insomnia or sleep disorder
Conditions Causing Male Testosterone Deficiency
Testosterone deficiency can be caused by different conditions: 1) effects of aging; 2) testes based conditions; 3) genetics; and 4) conditions caused by the pituitary and hypothalamus.
The effects of aging on testosterone production
Function of Testosterone Therapy
The function of testosterone hormone replacement therapy is to increase the level of testosterone in the adult male diagnosed with testosterone deficiency (low testosterone) or hypogonadism. Testosterone replacement should in theory approximate the natural, endogenous production of the hormone. The clinical reasons for treatment of testosterone deficiency in men include:
Increased male sex drive
Improve male sexual performance
Enhance mood in men
Reduce depression in men
Increased energy and vitality
Increase bone density
Increased strength and endurance
Reduce body fat
Increase body hair growth
Reduce risk of heart disease
Develop lean muscle mass with exercise
Function of HCG Therapy is to Stimulate the Testes to Prevent Loss of Natural Testosterone Production and Avoid Testicular Atrophy while the Male Patient is Undergoing Testosterone Hormone Replacement Therapy
The hormone HCG is prescribed for men in this therapy to increase natural testosterone production during the course of therapy as a result of the stimulation of the testes by the HCG. No testosterone medication is administered in this treatment. The treatment objective is to cause the male testes to naturally produce a higher volume of testosterone by HCG stimulation of his testes with the result that the patient experiences a continuing higher blood level of testosterone while on treatment. Another treatment objective is to avoid the use of any anabolic steroid and its adverse side effects upon the patient.
HCG Therapy normally increases natural testosterone production by the male testes while HCG is administered to the patient during the treatment period However, HCG Therapy can also result in a continuation of increased testosterone production and a resulting higher level of testosterone in the bloodstream after treatment is completed when the cause of the patient’s low natural LH secretion by the pituitary is not due to the patient’s natural genetics, aging process, injury to or loss of one or both testes; a medical disorder or disease affecting the testes, or castration.
HCG Therapy can result in a continuing higher level of natural testosterone production by the testes after HCG Therapy is completed when the underlying cause of the low LH secretion and resulting low testosterone production (1) is due to the prior use of one or more anabolic steroids by the patient or (2) due to the administration of testosterone in a prior hormone replacement therapy without the required concurrent HCG Therapy to prevent the patient’s endocrine system (hypothalamus pituitary-testes axis) from shutting down the natural production of testosterone by the testes and causing testicular atrophy.
Types of Testosterone Therapy for Men
A good male testosterone replacement therapy produces and maintains physiologic serum concentrations of testosterone and its active metabolites without significant adverse side effects.
The leading types of testosterone therapy for men include:
Testosterone Injection with HCG
Testosterone Transdermal Cream with HCG
Testosterone Transdermal Gel with HCG
Benefits of HCG Therapy for the Male Patient Undergoing Testosterone Hormone Replacement Therapy
Increases natural testosterone production by the testes
Prevents loss of natural testosterone production by the testes while the male patient is undergoing testosterone hormone replacement therapy
Prevents atrophy of testes while male patient is being treated with testosterone replacement therapy
Increases physical energy and elimination of chronic fatigue
Improves sex drive
Improves sexual performance
Increases lean muscle mass
Increases strength and endurance as a result of exercise
Reduces body fat due to increased exercise
Increases sperm count and therefore male fertility
HCG Therapy can also result in a higher level of natural testosterone production after HCG Therapy is completed when the cause of a man’s current low testosterone production is the prior use of anabolic steroids that shut down or reduced the pituitary gland’s production of LH and decreased testosterone production.
Human Chorionic Gonadotropin (HCG)
HCG is compounded by a compounding pharmacy or manufactured by pharmaceutical company in 10,000 IU (International Units) for reconstitution with sterile water for injections in 10 cc vials.
HCG is a natural protein hormone secreted by the human placenta and purified from the urine of pregnant women. HCG hormone is not a natural male hormone but mimics the natural hormone LH (Luteinizing Hormone) almost identically. As a result of HCG stimulating the testes in the same manner as LH, HCG therapy increases testosterone production by the testes or male gonads as a result of HCG’s stimulating effect on the leydig cells of the testes.
The Decline in Gonadal Stimulating Pituitary Hormone LH (Leutenizing hormone)
The natural decline in male testosterone production that occurs with aging is attributed to a decline in the gonadal stimulating pituitary hormone LH (Luteinizing hormone). As a result of the hypothalamus secreting less gonadoropin-releasing hormone (GhRH), which stimulates the pituitary gland to produce LH, the pituitary gland produces declining amounts of LH. This decrease in the pituitary secretion of LH reduces the stimulation of the gonads or male testes and results in declining testosterone and sperm production due to the decreased function of the gonads. The decreased stimulation of the testes by the pituitary’s diminished secretion of LH can also cause testicular atrophy. HCG stimulates the testis in the same manner as naturally produced. HCG Therapy is administered medically to increase male fertility by stimulating the testes to produce more sperm cells and thereby increase sperm count or Spermatogenesis.
The decreased stimulation of the testes by the pituitary’s diminished secretion of LH can also cause testicular atrophy. HCG stimulates the testis in the same manner as naturally produced. HCG Therapy is administered medically to increase male fertility by stimulating the testes to produce more sperm cells and thereby increase sperm count or Spermatogenesis.
How HCG Therapy Increases Plasma Testosterone Level in Men with Low Testosterone Production
HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level during HCG therapy. It is used to stimulate the testes of men who are hypogonadal or lack sufficient testosterone. The male endocrine system is responsible for causing the testes to produce testosterone. The HPTA (hypothalamic-pituitary-testicular axis) regulates the level of testosterone in the bloodstream. and . The hypothalamus produces gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release Leutenizing hormone (LH).
LH released by the pituitary gland then travels from the pituitary via the blood stream to the testes where it triggers the production and release of testosterone. Without the continuing release of LH by the pituitary gland, the testes would shut down their production of testosterone, causing testicular atrophy and stopping natural testosterone produced by the testes.
As men age the volume of hypothalamus produced gonadotropin-releasing hormone (GnRH) declines and causes the pituitary gland to release less Luteinizing hormone (LH). The reduction if the volume of LH released by the Pituitary gland decreases the available LH in the blood stream to stimulate the testes to produce testosterone.
In males, HCG mimics LH and increases testosterone production in the testes. As such, HCG is administered to patients to increase endogenous (natural) testosterone production. The HCG medication administered combines with the patient’s own naturally available LH released into the blood stream by the Pituitary gland and thereby increases the stimulation of the testes to produce more testosterone than that produced by the Pituitary released LH alone. The additional HCG added to the blood stream combined with the Pituitary gland’s naturally produced LH triggers a greater volume of testosterone production by the testes, since HCG mimics LH and adds to the total stimulation of the testes.
HCG Clinical Pharmacology
The action of HCG is virtually identical to that of pituitary LH, although HCG appears to have a small degree of FSH activity as well. It stimulates production of gonadal steroid hormones by stimulating the interstitial cells (Leydig cells) of the testis to produce androgens.
Thus HCG sends the same message and results in increased testosterone production by the testis due to HCG’s effect on the leydig cells of the testis. HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level.
Following intramuscular injection, an increase in serum HCG concentrations may be observed within 2 hours; peak HCG concentrations occur within about 6 hours and persist for about 36 hours. Serum HCG concentrations begin to decline at 48 hours and approach baseline (undetectable) levels after about 72 hours.
HCG is not a steroid and is administered to assists the body in the continuing production of its own natural testosterone as a result of LH signals stimulating production of testosterone by the testis.
This LH stimulates the production of testosterone by the testes in males. Thus HCG sends the same message as LH to the testes and results in increased testosterone production by the testes due to HCG’s effect on the leydig cells of the testes. In males, hCG mimics LH and helps restore and maintain testosterone production in the testes. If HCG is used for too long and in too high a dose, the resulting rise in natural testosterone will eventually inhibit its own production via negative feedback on the hypothalamus and pituitary.
HCG therapy uses the body’s own biochemical stimulating mechanisms to increase plasma testosterone level during HCG therapy. It is used to stimulate the testes of men who are hypogonadal or lack sufficient testosterone