T Nation

TRT for 10+ Years Same as Chemically Castrating Yourself?

Somtimes ive been accused of being “panicked” about the whole situation, but I think i am very worried for good reason. See , i can see TRT being a good option when youre 50 years old… but at 26 I am really concerned. Currently baseline T is about 350… i have A MILLION symptoms of low t, horrible ED, terrible sleep, inability to build/weak muscles, high body fat percentage that i cant lower despite diet/exercise, chronic inflammation/ gum disease (look it up, its linked), weak joints, just like… everything and its uncle… my life is totally unbearable.

I have secondary hypo, i know this because Clomid works to raise my T levels, even very low dose like 6mg twice a week will raise my levels into the mid 600s… problem is… clomid gives me horrible vision sides, floaters, the whole deal, so bad its scary, even at those doses. So its like, i cant take clomid at all, Nolvadex for some reason fails to raise my T to normal levels taking it 2.5 mg 2 -3 time a week, i can only get to the high 400s, and im not getting the same symptomatic relief as with clomid.

HCG mono seems awful, its expensive, must be refrigerated, must be injected every day, is perishable and loses potency quickly, best ive heard it being described as a “ball and chain”, basically would stifle any freedom I have in my life to travel, meet new partners, how can I meet a new female, come to her house, and ask to keep my HCG injections in her fridge so my dick doesnt fall off the next morning.

I would LOVE to go on TRT/HCG combo. I say HCG combo because I know with TRT HCG only needs to be injected like twice a week instead of daily, Also TRT can be injected twice a week and can be done in same injection, that would bring me down to just two injections a week, and if i happen to miss the HCG one time it wouldnt be the end of the world. This i feel would give me sufficient freedom to go and live life.

Problem is, Im only 26, and I am absolutely unwilling to sacrifice my potential fertility. I want to have children, always wanted to, and due to my life progress, i dont want to have any till after 35, absolutely no way i can have any any time soon. Also, I am afraid that if my current levels are 350, if i go on TRT for a few years, If anything ever happens where i need to come off, even temporarily, after years of testicular inactivity, it would make me in fact “primary” and my new permanent baseline would be like 100, and I would literally be unable to even barely live without TRT at all at that point.

What are thoughts on this fertility, TRT/HCG combo, doing it for 10+ years and still wanting to have kids? Also i know things like Androxal are still pending in Europe, and new things might come out in the next 10 years, I wouldnt want to make myself primary and then never be able to benefit from those things when they arrive. Also I dont want to destroy my freedom/quality of life by going on HCG mono, primarily i feel like this would make having a healthy adventurous life and sex life of a 20s man impossible, going from fridge to fridge needle to needle every single day.

Please help with any input/suggestions. Yes im negative about the whole thing, but why shouldnt I be, my predicament sucks. I did all my labs, everything comes out normal except that I have low T, im 95% sure this is from a head trauma I had when i was born, I had low T symptoms my whole life, but now in my mid 20s my body is really like, fuck this ive had enough, and my symptoms have gotten much worse. Please give me any insight/ suggestions. Thank you guys.

hCG mono therapy as you say is an expensive and inconvenient route to the same thing. It will induce secondary hypogonadism as LH=0 on it. T+hCG is good combination as fertility is well maintained in most cases and we have more control over how much T is getting inside our body.

I do not think that when one is having hypogonadism symptoms, the numbers on the test have any meaning. I may be wrong, but I do not think having all symptoms at 350 means that you are going to have more symptoms at 200. Many get good raised from SERMs but still don’t feel that there symptom relief matches the number on the test. So that’s there, I do not think one who’s already suffering at 350 should be thought of as suffering less than someone with TT=250 as well. Everyone’s cut off for when they get symptoms of hypogonadism could be different but once you have a condition, you’ll have the symptoms.

On the fertility aspect, I am also young and it’s the most difficult decision I have had to make. But there’s no point living your young years suffering from all this as well. Personally, I think hCG with T is the way to go for fertility purposes but when it comes down to it 10 years down the line, you never know how will it worked for YOU. So there’s always an element of risk in this. To avoid this, I had my semen cryopreserved for potential IVF, If sterile. I also did this as my sperm count while normal was not great at 25, and my testes seem to have problems with part primary hypogonadism and even without any treatment I could see my semen count going down in the next 5 years so I did that so I don’t have regrets later. But it’s quite expensive and not really an option for most, I just didn’t want to take any chances and regret not doing this 10 years down the line.

What are the probabilities of infertility after 10 years on HCG/ Test? … ive heard stories of people say theyve had kids on hcg/test… but i want to know what the risks and probabilities are

I had a urologist tell me like dont worry about it, you can go on just TRT pure as much as you want, and all you have to do is come off later and youll recover back to your normal levels and normal fertility

I think he was full of shit…

shitty doctors will just tell you something to get you out of their office so they can see their next patient and go to lunch which might affect the rest of your life and they dont really think about it…

if it wasnt for this damn fertility shit id jump on TRT in a heartbeat tommorow,

how much is that semen preservation stuff cost?

damn i dont even care about feeling 100% or great or liek a million bucks or whatever, i just want to feel acceptable and be able to keep wood and have sensitivity, even if i need cialis the rest of my life, whatever… just want decent quality of life, to be able to sleep well and get some benefit from exercise, thats it… ive totally stopped even working out now cuz there is literally no point…

Yea man, we are all on the same boat, we will come out better for it.

For preservation, it depends on where you live and you may need to consult with infertility centres to enquire about what it may cost you. But I doubt it will be anything other than astronomical when it comes to a 10 year period. It’s relatively a lot cheaper in my country so I can afford it.

There’s good chances that T and hCG will preserve your fertility. The probabilities are good, the probability that when you want to conceive and you come off, your sperm count will come in a matter of months. But if you cannot give a guarantee for it, I wouldn’t say go for it. There’s always a risk as everyone’s capacity to recover is not equal. Probabilities are the best you can do.

here is some apparent study which tracked like 1500 men who came off TRT and said that at 2 years sperm recovery was 100% guaranteed…

but i ALWAYS hear people saying how risky it is and it may never recover

wondering, anyone else have insights on the probabilities here? especially when adding HCG?

How did you settle on nolva 2.5mg a 2-3 times a week? That’s well underneath any suggested dose I have seen.

Some have side effects on clomid, nolva is a good alternative, and far more convenient than pinning.

If you have other side effects, you need to watch your E2 levels. The vision sides are most likely from the clomid though.

You talk about chemical castration… wtf good are your nuts if they’re not serving their purpose? If you’ve got low T symptoms wouldn’t you be better off to supplement and feel better rather than leave things “as intended” and feel like a eunuch?

Personally, if I got cancer and had both nuts lobbed off tomorrow, I wouldn’t be any less a man… thanks to the wonders of modern medicine (and TRT).


I kind of agree with you, not to say that there’s no reason to be concerned and one should jump into HRT, it’s a very involving treatment and one cannot afford to be passive and lacklustre in their treatment and needs to thoroughly understand their symptoms and implications in their life while weighing pros and cons and infertility is one of the major points of consideration especially for OPs(and mine) age. Looking at 40 years or more of relying on synthetic hormone gives some sleepless nights. However, i am pretty adamant that i do not intend to live with these symptoms, age is even more of a reason to get treatment for me, as this is not the way a person should spend his 18-30 years which never come back.

As i suggested to OP, hCG+ T is a relatively safe treatment in terms of maintaining fertility. However, guarantees in this world don’t exist for anything. So, we can only look for the next best thing. I definitely would not live with this problem for the sole reason of the chance that i become infertile.

hmmm… what dose of nolva is a good one to take? im always weary of taking higher doses, i happen to be VERY sensitive to clomid and 6mg twice a week brings me up to 600+ level, unfortunately cannot take clomid due to vision sides… ,i know nolva is like twice as strong thats how i settled on the dose…

Im weary of taking higher doses becuse i know the more you take, the more nasty serm sides you can get, especially with nolva people experience zero libido type problems… i try to take as little as possible to get as much t and as little serm effects as possible

will try to jump to 2.5 mg EOD and see what happens…

also gonna order Torem and try that, anyone tried Torem?

You can do TRT+hCG+AI and can monitor sperm quality. You can occasionally swap hCG to Nolvadex or Clomid to get some LH+FSH as a tune up.

If Clomid dose was too high, you testes might have been producing a lot of E2 that interfered with effects of T. To know what is going on, you should have tested: TT, FT, E2, LH/FSH. In any case, with TRT, it sometimes take 6 weeks to start to show results. After 10 years, it might take longer to turn the ship around.

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Thanks for your response KSman… so are you saying that you still HAVE a sperm count while running TRT assuming youre taking HCG/Nolva etc…??

yes, several TRT guys here have had babies on T+hCG

From the HPTA Restart sticky, 20mg nolva EOD. You are a little more than 10% of the recommended dose. If that works, I’ll be amazed.

The sperm count is really for your peace of mind.

" You are a little more than 10% of the recommended dose. If that works, I’ll be amazed. "

If you increase my suggested dosing by a factor of 10:

  1. LH can be high - most of the time if hypothalamus+pituitary function is working
  2. T–>E2 in the testes will be very high and serum E2 will be high, if not primary
  3. anastrozole cannot control T–>E2 inside the testes basics of a competitive drug
  4. high SERM E2 will increase SHBG, liver reacts to high estrogens
  5. high LH can desensitize LH receptors in the testes

What outcome do you want?

Whose recommended dose? - some bro-science experts? Many doctors are clueless about the above factors.

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He was on nolva 2.5mg a 2-3 times a week. That’s close to 10% of your recommended dose.

OK, I have to agree with you on that. He needs to find a dose that shows some effect on LH/FSH labs if fertility is a concern. TRT seems to be an option that is not been considered seriously.


Trt will not chemical castrate you. I have read several trt books and also talked with scandinavias best endocrinologist dr.ken purvis who specialices in testosteronr, male health, fertility and steroids.
He told me to use hcg along with testosterone to keep you fertile. He also said that even if you dont you hcg you can just go off when you want kids and use hcg, clomid or hmg and eventually u will be fertile again. He also daid that alot of guys makr their wife pregnant. Even bodybuilders who are on extreme doses of androgens for several years without pause have children when on and make their wifes pregnant. He told me to freeze down my sperm…just in case…but hcg while on trt or a complete pause from testosterone when trying to have kids will make you fertile:)

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No, some will be damaged and with time more likely.

I’m on trt only, HCG is almost impossible to get here - it can be done though but it unfunded and has to be purchased from fertility clinic at very high prices. Urologist believes that 6 months after coming off trt, sperm will return to normal - in any case I’ve been on trt now for 7 months and I haven’t noticed my testicles change size at all, if they have its very, very minor difference as I cannot tell