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Testicular Shrinkage in Secondary Hypo

Does the testicular shrinkage happens in case of secondary hypogonadism if LH and FSH are at the very low end?

Absolutely. If your testicles aren’t being called on to work, they shrink. The good news is that, with proper treatment, they can come back.

I have done blood work recently and found that my Prolactin is very high. 49.6 ng/mL ( Range 2.6 - 13.1 ng/mL) and LH is very low. 1.3 mIU/mL (1.2 - 8.6 mIU/mL) and i am waiting for MRI results of my pitutary. Does fixing prolactin level brings back my testosterone levels back and restores testicular atrophy?

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Elevated prolactin does lower LH. Fixing this with Cabergoline should increase your T.

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My prolactin was 42 at my last appointment… I’ve been referred to An endo… Hopefully I can get my levels back to normal and get test back up too! Let me know if you find anything out… I’ll keep you updated with my results

I have 3.3mm benign tumor on my pituitary and my endo prescribed Cabergoline for 1 month and hope it will decrease prolactin and increase Testostetone . I am
Nervous to start Cabergoline by considering the side effects it causes. I will let you know the outcome . Please keep posed your updates . All the best .

Good luck. Good to hear you found your problem.

The side effects of the low doses [0.5mg/week] seem to be non-existent. There are side effects from literature where Dostinex/cabergoline were used in high doses to treat Parkinson’s disease. Please do not trouble yourself with this.

We have had some guys go trough this and have T levels recover.


If you are feeling better and your testes are improving, that process will take weeks to get competed. So don’t rush out to get labs too soon and not see something that represents the end point.

Your dopamine will increase and prolactin will drop. You might have a brighter mood and maybe see some depression resolved. During this period of plasticity, try to have a positive outlook on things as you are setting new mental patterns that will later on be solidified. So things that are good for your mind and body.

I take 8mg/week (4mg twice per week) and have no side effects. My prolactin wouldn’t come down on a standard dosage. With this higher dosage it has slowly come down over the last year and is just now in range. Parkinson’s Cabergoline dosages are >=12mg/week. You should be good.

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What was your prolactin level before taking cabergoline? How long did you use it? Was it increased your LH and FSH once the prolactin level become normal.

@KSman I started first dose of 0.5mg Cabergoline and I didn’t see any side effects so far. I will try for another few weeks before run the blood test again. Do you think 0.5mg is enough to decrease prolactin which is at the level of 50 ( standard range 2-18) . Is the prolactin level 50 is considered as high which reduced my LH to almost lower end. My LH was 1.3 ( standard 1.2-8).

When I upped my dosage my prolactin was around 120. Last checked it was 15. I’ve used cabergoline (before that the brand Dostinex) for 12 years. Only the increased dosage finally worked for me. (doctors are weary of off label prescriptions) But before I had my prolactinoma removed it was in the 1000s. Some people don’t respond to cabergoline for some reason. Most people will respond but like me, some just take a heavily increased dosage.

My FSH and LH are still at the low end of normal. My total T and free T are the highest I’ve ever had measured, just below normal. lol

Did you tried HCG or clomid since your LH and FSH are low ?

We have seen 0.5mg/week work well several times in this forum. So that is where to start. No side effects expected.

Prolactin=50 is not really high for a prolactin secreting adinoma. So your problem is then probably minor and may not be driving low LH, but other things can do that. Prolactin is released during orgasm and that might affect labs.

What could be the other reason for low LH and FSH if it is not due to High prolactin . So far I have taken 3 doses of 0.5mg Cabergoline and I see little improvement on erections. Still my testicles looks small . My next endo visit is due in 2 weeks will run the blood test again ? If Cabergoline is not improving my LH can I use HCG to raise my LH and FSH.

hCG does not increase LH/FSH, it is a replacement for LH and that will improve testes and T. Can be a form of TRT for younger guys.

Also refer to the HPTA restart link found here: About the T Replacement Category

@KSman I got the latest blood work results. Prolactin got reduced significantly after using 4 doses of 0.5mg Cabergoline . (once per week). My endo did not tested LH and FSH this time. My libido is very great for the first two days after taking Cabergolone and it was not great for the last 5 days of the week. My endo asked me to take 0.25mg of Cabergoline twice per week to increase the libido.

My total testosterone jumped from 100 to 345 , i think my pituitary is releasing LH now. Earlier my LH was at lower end of the scale at 1.2 ( range 1.3-9.0)

My testicles are reduced by half of the original volume . How long does it take for testicles to recover fully and produce normal Testosterone. Should i consider using Clomid or HCG to stimulate testcles?

Total T 345 ( Earlier it was 100)
Prolactin 2 ( earlier it was 50)

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Sounds like you are getting great results. I’d stay the course until your cabergoline treatment is over.

It took over a month for my testicles to recover (and they may still be) with clomid. BUT you are in a different situation. As the tumor shrinks, you can hope that the rest of your system comes back online, as it seems to be doing now.

Not sure about how it works, but thinking out loud. Prolactin is now low! Test LH/FSH to see how they have improved. If normal, there could be a some testicular problems going on. If still low, maybe you can try an hpta restart.

How do you feel now? Any improvement ? If your body was used to higher levels below you’ll still feel bad even if levels are 500 for example.

@equalo212 For the first two days after taking Cabergoline , libido was great then body become normal. No mood , fatigue and low libido. What is HPTA restart? Can you explain. Before using cabergoline my Total T was @100 now it is 350 a great improvement but not for my age. I am 32 years old. My endo will prescribe Clomid if things are not improving by a month.