hCG vs SERM

What is a HH?

Pulsating secretion of gonadotropin-releasing hormone (GnRH) in the hypothalamus is necessary for the initiation and maintenance of the human reproductive axis.

Pulsating GnRH stimulates the biosynthesis of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn initiates endogenous testosterone production and spermatogenesis as well as systemic testosterone secretion and masculinization.

Hypogonadotropin hypogonadism (HH) results from an occasional failure of GnRH secretion or interruption of gonadotropin secretion.

The use of anabolic androgenic steroids (AAS) is a functional form that can cause HH, known as secondary acquired hypogonadotropin hypogonadism. It is diagnosed by low testosterone levels, low sperm count, or abnormal serum concentrations of LH and FSH.

There are usually two treatments for HH symptoms in this condition. Gonadotropin therapy and selective estrogen receptor modulator (SERM) therapy.

Gonadotropin therapy

In this treatment, human chorionic gonadotropin (hCG) is the first choice.

hCG acts in the same way as the pituitary LH. Stimulation of testosterone production by the testes with hCG occurs independently of exogenous hormones and/or the inhibition of HPTA that has been found. As a result, it directly stimulates endogenous testosterone production, spermatogenesis and an increase in testicular volume.

The primary goal of the first few weeks of the pct is to quickly restore testicular volume and function, so hCG is usually used during the first few weeks of the pct cycle.

SERM treatment

Selective estrogen receptor modulators, such as clomid and Nolvadex, increase pituitary secretion of LH by blocking negative estrogen feedback on HPTA. In the case of testicular atrophy, SERM may not be enough to offset the sexual condition caused by the severe imbalance of androgen to estrogen ratio following the steroid cycle. Thus, in the PCT cycle, SERM is used both as an anti-estrogen and to continue stimulating the pituitary to produce LH after hCG is discontinued.

HCG is mainly found in the pct cycle of male bodybuilder. If the inhibitory effect of AAS is not serious, HCG is generally not used. When the endogenous testosterone level of male bodybuilder is recovered, HCG is required. And SERM is a mandatory drug for male bodybuilder pct cycle.