Brief Answer:
Hi XXXXXXX

Detailed Answer:
Hello XXXXXXX

Good day.
Before answering your question, I would like to explain little bit of physiology.

Testicular production of testosterone and sperm is under the control of pituitary gland. Pituitary gland is further controlled by hypothalamus. This is a complex system.

LH hormone secreted by pituitary stimulates testes to produce Testosterone and FSH hormone produced by pituitary stimulates testes to produce sperm. Testes secretions ( testosterone and Inhibin) negatively feedback pituitary. This means, when testosterone is in excess, pituitary production of LH and FSH is inhibited.

This explains your problem. You took synthetic anabolic steroids which has structural similarity to testosterone. This would have negatively inhibited LH and FSH production in pituitary. Lack of LH and FSH stimulation of testes causes testicular cells to atrophy. So testosterone production and sperm production will be reduced. However, once you stop these steroids, over a period of weeks to months, the whole process is likely to reverse back to normal. However, reversibility depends on the degree of testicular atrophy.

HAVE YOU NOTED A REDUCTION IN SIZE OF TESTES ?? Have you had a recent semen analysis or blood tests for Testosterone and LH done??

hCG ( human chorionic gonadotropin) has structural similarity to LH hormone and that stimulates testes to produce testosterone. The fact that testes responded to hCG ( you had improvement) means that, there is high likelihood of your problems getting reversed over a period of time. Please do not ask me how long does it take. It varies from weeks to months.

You should get your testes examined by an endocrinologist to asses testicular volume.

Hope you understood my explanation. I realize that it is difficult to understand. Please feel free to write to me if you need further clarifications.

In the interim, please avoid use of further anabolic steroids.

Good luck

Regards
Binu

---

Brief Answer:
Hi

Detailed Answer:
Well, what you should do is to get a fasting ( between 8-9 am) testosterone, LH, and FSH again now. ( I noted that you got them checked 1.5 yrs ago) . These are blood tests. We can decide further based on these..

When was the last dose of hCG ? HAve you met an endocrinologist ?

---

Brief Answer:
hello

Detailed Answer:

hCG is used in 1500 to 2000 units two to three times a week. As you correctly pointed out, there will be conversion of testosterone to estrogen which will cause enlargement of breasts etc. Only in that case, we start on drugs like Letrazole to block conversion of testosterone to estrogen.

I realize your difficulty of access to an endocrinologist. However, it is always better to consult one to examine you before embarking on such a treatment. I am an endocrinologist and can advice you, but can not prescribe medicines which is illegal. If you think you have given enough time for your body to recover by itself and your current testosterone levels are low, we can start on hcg treatment.

However, I must remind you that HCG treatment is only required if you desire fertility. If you are not planning to father a child, we can avoid hCG and start on Testosterone treatment.

---

Brief Answer:
Hi

Detailed Answer:
Again the decision is based on how soon you want to father a child. If you are planning in near future, it is better to avoid Testosterone treatment. HCG is the best option then.

I really can not say if hCG will provide a permanent relief or not ( HCG acts via stimulating leydig cells of testes to produce testosterone). We will have to wait and watch that aspect. How ever, we surely need a baseline Testsoterone, LH, FSH ( all fasting and between 8-9 pm), Prolactin and a semen analysis report before starting treatment.

---