Bob recently asked about using hCG (human chorionic gonadotropin) rather than clomiphene to increase testosterone. As I explained in How Clomid Works in Men, clomiphene stimulates the pituitary to make luteinizing hormone (LH), which then acts on the Leydig cells in the testis to make testosterone. So why not use LH directly?
One way to take over the pituitary’s production of its reproductive hormones is to use human chorionic gonadotropin (hCG), which looks like LH to the body. It effectively stimulates the Leydig cells to make testosterone. But it’s expensive and must be injected. So if the pituitary is working, clomiphene may be a better choice to start. If the pituitary isn’t working, hCG can be tried. But if the man’s LH is already very high, neither clomiphene or LH will help all that much, as the man’s body is already trying that strategy by itself.
The pituitary also makes follicle stimulating hormone (FSH), which acts on the Sertoli cells around the developing sperm cells. To help stimulate the making of sperm in the testis, recombinant FSH (rFSH) or human menopausal gonadotropin (hMG) may be used. Like hCG, these drugs are expensive and must be injected.
Thanks for the question, Bob!
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Are there any long term solutions to increasing a man’s low testosterone without decreasing their future fertility? I understand that Clomid is not considered a long term solution.
Hi Kelly, wander around the other posts on this blog, and you’ll find that while clomiphene is off-label for use in the male, that doesn’t mean that under a doctor’s supervision it can’t be considered to be used long-term.
What is your opinion on using both Clomid and hCG at the same time
for male infertility. And do you have a contact email for my urologist
to contact you?
Please read the FAQ regarding questions about combining drugs.
Am I clear in understanding the pituitary must be fully functioning in order for Clomid to raise testosterone levels? What lab tests indicate whether or not the pituitary is working?
Not necessarily fully functioning, but functioning to some degree. Read through the other posts on this blog to learn about how pituitary hormones are assessed.
I’d be interested to know how many of your patients had taken minocycline (Solodyn) long term for acne treatment when they were teens.
I can’t really talk about patient care on this blog. Please read the FAQ.
Thanks a lot Doc for your clarification
Awesome Blog