Hormone Medications
Clomiphene Citrate
Clomiphene Citrate (Clomid) is a medication that elevates certain hormones (LH and FSH) released by the pituitary gland in the brain. These hormones will stimulate both the production of testosterone and the production of sperm within the testes. This medication can treat symptoms of low testosterone and increase sperm counts. Large-scale studies have shown that Clomid can lead to sustained increases in testosterone, increases in strength, reduction of fatigue, and improvement of erectile function. Studies have also found that Clomid can help improve sperm counts in men with fertility issues. In men with no sperm in the semen, Clomid can potentially help increase the chances of finding sperm in the ejaculate or through a surgical procedure.
- Mood swings or increased aggression
- Male pattern baldness
- Increase in hematocrit (red blood cell concentration), which can increase the risk of blood clots
- Enlargement of the prostate gland, which can cause urinary symptoms
- Headaches
- Blurry vision
Anastrozole
Anastrozole (Arimidex) is a medication that alters hormone levels within your bloodstream. Specifically, it reduces the production of estrogens by preventing the conversion of testosterone into a particular estrogen, estradiol. By doing so, testosterone levels rise, and estradiol levels are lowered. This can help with the symptoms of elevated estrogen, such as breast tissue growth and nipple tenderness.
By raising testosterone levels, Arimidex has been found to reduce the symptoms of low testosterone, such as low energy, reduced muscle mass, low libido (sex drive), and erectile dysfunction. It has also been found to improve sperm production and sperm recovery rates in men with low sperm counts.
- Nausea
- Insomnia
- Bone or joint pain
- Cough
- Increase in hematocrit (red blood cell concentration), which can increase the risk of blood clots
- Elevated liver enzymes
- Cataracts
- Stevens-Johnson Syndrome, a serious rash (rare)
Human Chorionic Gonadotropin
Human Chorionic Gonadotropin (hCG) is a hormonal treatment that can be used to increase testosterone levels in men. It is a treatment option for men who are suffering from symptoms of low testosterone. hCG stimulates the body’s own production of testosterone, which contrasts with direct testosterone replacement like testosterone injections and gels. Preserving the body’s production of testosterone is particularly important for testicular function and fertility, as testosterone made by the testicle is required to maintain testis size and sperm production.
Research has found hCG to improve energy, libido (sex drive), strength, and mood in men with low testosterone. In men who were previously on testosterone replacement medication, hCG can help treat symptoms of low testosterone while preserving or increasing sperm counts. By increasing intratesticular testosterone, hCG has been found to increase the likelihood of sperm retrieval in men with no sperm in the ejaculate.
hCG is a medication that is administered as a subcutaneous injection (underneath the skin) in the abdomen. We will teach you how to administer the injections.
- Mood swings or increased aggression
- Male pattern baldness
- Pain, bruising or both at the injection site
- Weight gain
- Increase in hematocrit (red blood cell concentration), which can increase the risk of blood clots
- Enlargement of the prostate gland, which can cause urinary symptoms
Recombinant Follicle Stimulating Hormone
Follicle-stimulating hormone (FSH) is a hormone released by the pituitary gland in the brain. In males, FSH stimulates testicular growth and sperm production. When a male has a low sperm count, it is helpful to check an FSH level. Elevations in FSH (>7.5) indicate that the brain is trying harder to stimulate the testicles to produce sperm. In males who have low sperm counts and low FSH levels, starting FSH therapy can stimulate sperm production. Low FSH can be from a variety of causes, including pituitary gland dysfunction and testosterone/anabolic steroid use. Some men have a genetic condition, such as Kallmann syndrome, which causes low FSH production from the brain, requiring replacement therapy.
Recombinant FSH is given as an injection and common brand names include Follistim or Gonal F. This is often prescribed with hCG injections, which helps stimulate your body to produce more testosterone.
- Headache
- Nausea or vomiting
- Abdominal pain
- Injection site reaction: pain, redness, bruising, irritation
- Skin rash
- Acne
- Breast enlargement