HPTA restarts - how successful are they?

[Jedi1337]

Hi all,

I have, in the past, come across HPTA restart threads, or dug them out of forums on a google search. Quite often the threads die and no one successfully comes out the other end and says "After x years of test abuse, I tried x protocol for a HPTA restart and it worked!".

I understand there are a few protocols out there which people talk about a lot, but is there any quantitative research to show these protocols to be reliable and effective?

Thanks for input in advance.

[Youthful55guy]

I've not done much research into this topic since I'm not a former AAS abuser, but your post got me interested in seeing what kind of information is out there in the medical literature. I did a search in PubMed for the phrase "treatment of male anabolic steroid abuse" and came up with 261 hits after limiting the search to humans. I scrolled through the hits and found one article that seemed to be interesting and available Open Access.

Rasmussen, J.J., Selmer, C., Ostergren, P.B., Pedersen, K.B., Schou, M., Gustafsson, F., Faber, J., Juul, A., and Kistorp, C. (2016). Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study. PloS one 11, e0161208.

They don't paint a pretty picture for recovery. Here's an extract from their introduction:

Anabolic androgenic steroid-induced hypogonadism (ASIH) is common among former AAS abusers and usually presents as hypogonadotropic hypogonadism due to abrupt decreases in plasma androgen levels following AAS cessation [1, 2, 5, 8]. Scientific data on ASIH are limited, but the condition is characterised by symptoms and signs of hypogonadism such as: testicular atrophy, low plasma testosterone levels, impaired spermatogenesis, erectile dysfunction, fatigue, decreased libido and depressive symptoms; and is considered to resolve spontaneously within 6 to 12 months [2, 5]. Studies investigating the recovery phases of young men with ASIH are, to our knowledge, virtually non-existent. A growing number of studies reporting cases, in which ASIH manifestations persisted years after AAS cessation, suggest ASIH is a more permanent condition in a substantial proportion of former AAS abusers [9–16]. This emerging group of young men may become a considerable public health concern in the coming years.

I think the term PCT comes primarily out of the bodybuilding world and generally involves 3 elements in hopes of restarting endogenous testosterone production and spermatogenesis.
1) Stimulation of endogenous gonadotropins (usually with Clomid)
2) Restoration of normal testicular size and function (usually with HCG)
3) Lowering blood estrogen concentrations (usually with anastrozole)

To my knowledge, these protocols have no medical research behind them and from what I've seen posted in forums and what this paper I found states, they have limited effectiveness. That the symptoms of hypogonadism persist for months and years past cecession of AAS abuse.

[assguy22]

IMHO it's a waste of money. Recovery takes one year or maybe more if you suffer other pathologies (hypothyroidism/chronic fatigue syndrome/obstructive sleep apnea/insulin resistance/etc), HPTA restart protocols only will increase your T temporarily, after months they come back to low levels. Recovery comes with time, that's the way it is. Of course be sure you don't have any other undiagnosed condition like previous ones I mentioned.

[Jedi1337]

I've not done much research into this topic since I'm not a former AAS abuser, but your post got me interested in seeing what kind of information is out there in the medical literature. I did a search in PubMed for the phrase "treatment of male anabolic steroid abuse" and came up with 261 hits after limiting the search to humans. I scrolled through the hits and found one article that seemed to be interesting and available Open Access.

Rasmussen, J.J., Selmer, C., Ostergren, P.B., Pedersen, K.B., Schou, M., Gustafsson, F., Faber, J., Juul, A., and Kistorp, C. (2016). Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study. PloS one 11, e0161208.

They don't paint a pretty picture for recovery. Here's an extract from their introduction:

Anabolic androgenic steroid-induced hypogonadism (ASIH) is common among former AAS abusers and usually presents as hypogonadotropic hypogonadism due to abrupt decreases in plasma androgen levels following AAS cessation [1, 2, 5, 8]. Scientific data on ASIH are limited, but the condition is characterised by symptoms and signs of hypogonadism such as: testicular atrophy, low plasma testosterone levels, impaired spermatogenesis, erectile dysfunction, fatigue, decreased libido and depressive symptoms; and is considered to resolve spontaneously within 6 to 12 months [2, 5]. Studies investigating the recovery phases of young men with ASIH are, to our knowledge, virtually non-existent. A growing number of studies reporting cases, in which ASIH manifestations persisted years after AAS cessation, suggest ASIH is a more permanent condition in a substantial proportion of former AAS abusers [9–16]. This emerging group of young men may become a considerable public health concern in the coming years.

I think the term PCT comes primarily out of the bodybuilding world and generally involves 3 elements in hopes of restarting endogenous testosterone production and spermatogenesis.
1) Stimulation of endogenous gonadotropins (usually with Clomid)
2) Restoration of normal testicular size and function (usually with HCG)
3) Lowering blood estrogen concentrations (usually with anastrozole)

To my knowledge, these protocols have no medical research behind them and from what I've seen posted in forums and what this paper I found states, they have limited effectiveness. That the symptoms of hypogonadism persist for months and years past cecession of AAS abuse.

Thank you. Very good reply