T Nation

The Lowdown on HRT and Fertility


Hello aging friends and counterparts

It's a matter of time before NeelyDan is in need of some supplemental testosterone and I have one question that I can't seem to get a concrete answer to:

How does HRT affect fertility?

In other words, if a fella wants to have a family, but also wants to raise his levels, can he have his testy cake and eat it too?


I'm hypogonadal and use Androgel. When I want a kid, my andrologist-urologist will be prescribing me HCG or Clomid. We spoke about this.

Actually, the first time I tried Clomid, my T level was 240.

My doc put me on HALF A TAB OF CLOMID and that brought me to 790 ng/dL!

NeelyDan jocks!


I'm hypogonadal and use Androgel. When I want a kid, my andrologist-urologist will be prescribing me HCG or Clomid. We spoke about this.

Actually, the first time I tried Clomid, my T level was 240.

My doc put me on HALF A TAB OF CLOMID and that brought me to 790 ng/dL!

NeelyDan jocks!


It's not an issue. Use T+HCG+AI like everyone else and you'll be fine. If you try to conceive and it becomes a problem have your Dr throw in HMG and problem solved.


You recommended THREE drugs! Meanwhile, all most infertile men need is half to one tab of Clomid! People think they are fucking pseudo-pharmacists these days.


C'mon Brick... are you saying that there is no use for T, AI or HCG? I agree that people make HRT a little more complicated than it needs to be, but this is a widely accepted protocol, especially as it pertains to fertility issues.


I don't know. I do know that HALF a tab of Clomid raised my T level from 240 to 790 in ONE month! It also turned my pituitary back on but I forgot the lab values for LH and FSH from back then; that was 6 years ago.

When I want a kid one day - since I'm infertile - all I'll be using is 1/2 to 1 tab. I'm NOT a pharmacist. But I THINK from what I do remember, that Clomid binds to estrogen receptors on the pituitary. So what is the point of an AI if clomid is taken?


T, AI, HCG can be taken long term. Clomid can be used for a short period of time for reasons such as fertility, but no SERM should be used long term.

The reason that Brent suggested all three is because they are usually necessary for healthy HRT. AI controls E2 levels and HCG keeps your nuts working for fertility and pregnenelone production.

How have you been controlling your E2 for the last six years if you aren't taking an AI? Are you supplementing with pregnenelone?


Yo Brick get a clue. T+AI+HCG is proper TRT where you don't need to worry about fertility. The HCG keeps your nuts up to form and functional. HCG has action at LH AND TO A LESSER DEGREE FSH RECEPTORS. Many, many guys have have had children while on this TRT protocol issue free. The AI is to control E2 which is always an issue with TRT.

If your preference is to rub androgel all over yourself, watch your nuts turn into raisins, watch your E2 sky rocket, and then use a weak estrogen (Clomid) that makes you feel like shit to bring your nuts back to life have at it. The rest of us will use a protocol that makes sense.



I never once had abnormal estradiol levels from taking 7.5 to 10 grams of Androgel.

Again, I'm not an MD or pharmacist. But I don't see why I would have abnormally high estradiol if my T level always stays about 700 to 900.


It seems that you are one of the fortunate ones who respond very well to androgel without the negative sides. You are definitely in the minority.

Transdermals have a tendency to convert to estrogen at a higher rate than injected T. For instance, after taking 10% compounded T cream, my T level was at 46 in a range of 45-85, so barely in range. My E2 was over the top of range though; 7.2 in range of 0-7. If I were to increase my dose, my T levels would eventually be at good levels, but my E2 would be extremely high. I convert T to E2 very easily so an AI was necessary.

Do you know what your E2 levels are? Just because they are in range doesn't necessarily mean that they are at optimal levels. Research chemical liquidex is dirt cheap and very effective. It's fairly easy to fine tune your E2 levels to exactly where they should be with liquidex.


Abnormal E2 will be the case 99% of the time on TRT. (Personally I feel 100% of the time with a transdermal like Androgel which covers such a large surface area exposing large amounts of T to aromatase.) Anything over 30 is cause for concern. Let me make my point.... is a T level of 260 with a reference range of 250-1200 a problem? It's the same thing because "in range" means nothing.


Today, I'm picking up a copy of lab values for a blood test that was taken last week.

The only problem I've ever had with Androgel was when my level skyrocketed to 1,500 ng/dL while taking 10 grams of gel per day. I broke out with pretty bad acne on my lower back and I had this sense that something was "off" mentally as well. I went down to 7.5 and the acne went away within days.

Androgel absorbs in the skin very slowly. I've heard that the products from compounding pharmacies, especially creams, absorb very quickly and cause abnormally high estradiol levels.


A T value 260 is a problem; most urologists and endocrinologists worth their salt - like the ones I go to - will agree with this. Both have said, "I don't like to see anyone under 400."

Have you tried Androgel yourself? I don't give a rat's ass if no one else uses it; I'm not a Unimed sales rep. I just really don't understand all the bashing of the drug since I know a few people who use it and feel and function fine.


I have used it and people bash it because it's a poor product. It absorbs poorly, it's horrible to deal with (slow drying), it's expensive if your insurance won't cover it, and it covers to much surface area leading to high DHT and high E2.

A superior transdermal is a compounded T gel or cream. You can have them compounded at 5%-20% as opposed to the ridiculous 1% Androgel. The compounded products absorb much better, dry faster, and cover much less surface area leading to fewer E2 and DHT issues.

Beyond that it's now being widely accepted that T cyp can be injected in small amounts SC which is the most convenient TRT available. Personally I've used every TRT regimen available to see what worked well for me. I've been on Androgel, compounded T cream, compounded T gel, HCG mono-therapy, and Arimidex as a standalone treatment. I've found that for someone my age, 36, the best route is to administer the maximum dose of HCG that can be used before side effects or desensitization become an issue and top off the balance with a little compounded T gel if needed. For older guys, who don't produce much T with HCG, T cyp is by far the most convenient with a small amount of HCG to keep the testes functional.


Androgel dries in 30 to 60 seconds on me! LOL!


The compounded cream I was using dried extremely quick, but absorbed slowly, like it should. The only time I have heard of creams absorbing too quickly is when people are inappropriately using them with DMSO.


Androgel leaves a white crust behind and you have to smear it all over yourself. In general guys hate the stuff. It's actually a shame that most people start with it because it gives transdermals a bad name when the compounded products are ok. I've read this countless times. "I started Androgel and now my T levels are lower!". If you like Androgel you're by far in the minority but to each their own. People don't bash it because they have nothing better to do, they bash it because it's a poor product that could be very much improved.

If Androxal works as advertised and hits the market this year as proposed it's going to change TRT all together. If your testes are up to speed TRT is going to become 1 Androxal and 1/4mg of Adex every other day.


By the way fast absorption has little to do with elevated E2 levels. The application area and size of the application area used with Androgel creates the E2 issue. For example the ideal application location for compounded T cream and gel is the forearms. The skin is thin there and the application area is small leading to a smaller exposure to aromatase. Try applying 7.5mg of Androgel to your forearms. Unless you're Popeye that might be a small problem.


This is all interesting stuff. I have just finished up the first bottle of Androgel at it's lowest doseage.

I'm 53 and had a 193 T level, the last lab I had done was 240. That increase was after a low dose of T cyp for 6 weeks.

I have gained about 5 lbs of muscle mass since I went on the androgel and am slightly leaner or more vascular. Could that be a change in my training regime?

Maybe. I do agree the gel is kinda hard to use up just on your arms and I have large arms. I smear it on my arms, shoulders, abs and if there's still some left it goes on my quads. I never got my E2 level checked. I asked and it got put on the the form and the damn lab didn't do it!

So I wonder if it is high....what are signs of high E2 level? My sex drive is very good. I have very little bodyfat. I have heard fat develops around the pecs. I don't have that problem. I do suffer from the skrinking balls though. That happened right after first taking the gel. That doesn't really bother me. Only my wife sees them and she says they are cute and makes the neighboring part look even bigger! LOL!