hCG Works! ... Estrogen, Progesterone, and Gynecomastia

[phaedo]

Hey all,

I brought this up in another thread but the question was buried and I'd like your input on this quagmire.

Quick back-story: started TRT quite young through an incompetent doctor - five doctors, actually, without hCG or estrogen monitoring. Four years later, I have a semen analysis proving azoospermia (infertility).

Now, under the care of one competent physician and a mediocre fella, I started a high-dose protocol of hCG and hMG (3000 IU, 3x weekly and 75 IU, 3x weekly, respectively). Within two weeks, I dropped exogenous testosterone all together, and within another two weeks I drop the hMG because the size of my testicals were enormous. lol. It's clear I'm not primary hypogonadotropic.

Within six weeks, I was having outrageous high-E2 side effects and checked my levels:

TT: 1487 ng/dL
E2: 92 pg/mL

I dropped the protocol all together and I'm now on 60 mg testosterone cypionate 2x weekly (120mg total/week), 300 IU hCG 3x weekly, and just started 0.5 mg of Arimidex 2x per week (1 mg total/week).

There's a good and a bad part to this story. First, I performed another semen analysis and have 6 million lil swimmers! Not loaded, but nothing to something is good progress. I can certainly provide enough for IUI. So hCG certainly induces fertility, even after several years of TRT. I will follow up in another couple of months, as I presume the count will only go higher.

The bad part is I've developed gynecomastia for a second time. Last year, I had my plastic surgeon remove what occurred under care from my original doctor (prescribed something like 350 mg/week... don't ask). So... for anyone who tells that you that if the "whole gland is removed, gynecomastia cannot come back," well, they're wrong. I'm lean (~10%) and the surgeon removed the entire gland without fear of caving or any other deformities. But here I am again, with bi-lateral masses around what was originally removed, along with what appears like "ropes" radiating upwards toward my armpit. I assume this is proliferation of the breast duct.

Here are my latest labs:

TT: 1046 ng/dL
E2: 31 pg/mL
Progesterone: 0.96 ng/mL

I think my E2 levels are somewhat "high," but certainly not enough to keep agitating the gynecomastia I have present. I'm still experience extreme tenderness, pain, and sensitivity. The high progesterone is bothersome, too. I'm thinking from excess hCG? It's an older lab (4 weeks), when I was injecting 500 IU 3x weekly.

Is there a relationship between progesterone and hCG via excess stimulation of pregnenolone? Once gynecomastia has began to form, can mid levels of E2 continue stimulation and growth? Could excess progesterone be fault, since an AI is ineffective at this junction?

I'm seeing my the plastic surgeon for another consult this coming week, I think, but my concern is for this not to happen again.

[austinite]

That's correct, gynecomastia can absolutely recur after surgery. hCG most certainly aids in fertility as testosterone is part of the equation. Excess progesterone can accelerate gynecomastia development, generally in the presence of elevated e2, even slightly. It can also cause e2 to elevate.

I assume that's a sensitive panel, if so, e2 can be put in range with DIM. Did you have prolactin pulled?

[phaedo]

I am taking DIM, at 200 mg/day, along with Zinc at 50 mg/day.

Unfortunately, no, I didn't run a recent prolactin lab. Four months ago I had a follow-up MRI and checked prolactin -- the result was low-normal (I'd have to dig it up for the specifics).

[dreadnok89]

Wait how much hcg in one shot?

[dreadnok89]

I would have just kept doing hgc and hmg with exestamane

[kelkel]

Get some Raloxifene for your gyno.

[dreadnok89]

I'm gonna check that out too kelkel. Im not sure if I have gyni or just fat

[ctenosaura]

Would Raloxifene help with gyno that happened 22 years ago?

[austinite]

Would Raloxifene help with gyno that happened 22 years ago?

It's been proven effective in pubertal gynecomastia cases that are several years old. Not sure about 22 years, but most certainly worth a try when compared to surgery prices. I'd also confirm that it's gynecomastia and not pseudogynecomastia.

[ctenosaura]

It's been proven effective in pubertal gynecomastia cases that are several years old. Not sure about 22 years, but most certainly worth a try when compared to surgery prices. I'd also confirm that it's gynecomastia and not pseudogynecomastia.

1) If I were to stop Ralox would it come back (saying it worked)?

2) What dosage for a 175 lbs guy?

3) Whats pseudogynecomastia?

Thanks!

[austinite]

1) If I were to stop Ralox would it come back (saying it worked)?

2) What dosage for a 175 lbs guy?

3) Whats pseudogynecomastia?

Thanks!

1. No, not unless aggravated by excess e2 or progesterone.
2. 60 mg daily until lump is reversed.
3. Psuedo is fatty tissue, not breast tissue.

[phaedo]

Wait how much hcg in one shot?

3,000 IU 3x weekly at the time of monotherapy, titrated now to 300 IU 3x weekly

I would have just kept doing hgc and hmg with exestamane

Chronic dosing of hCG at such high levels would cause leydig cell desensitization and likely permanent damage.

Get some Raloxifene for your gyno.

I would, but considering the liquidex [anastrozle] AND liquid tamox [tamoxifen] were bunk... big disappointment :-/

[powerlifterty16]

1. No, not unless aggravated by excess e2 or progesterone.
2. 60 mg daily until lump is reversed.
3. Psuedo is fatty tissue, not breast tissue.

breasts are all adipose

[austinite]

breasts are all adipose

Don't be a dummy.

[NWIron]

I had the SAME exact thing happen to me. On trt young, had slow growing gyno evern with low e2 numbers. Left side have the rope type thing. Had surgery and now it's back. Very frusturating. In the process of coming off TRT all together, it's been nothing but issues for me and a lot of money. Toremifene worked very well but I ended up being allergic so I had to drop it. Might be worth a shot.

[dreadnok89]

3,000 IU 3x weekly at the time of monotherapy, titrated now to 300


Chronic dosing of hCG at such high levels would cause leydig cell desensitization and likely permanent damage.



I would, but considering the liquidex [anastrozle] AND liquid tamox [tamoxifen] were bunk... big disappointment :-/

That's funny, domes doc told that's not true

[powerlifterty16]

Don't be a dummy.

elaborate please?

[phaedo]

I had the SAME exact thing happen to me. On trt young, had slow growing gyno evern with low e2 numbers. Left side have the rope type thing. Had surgery and now it's back. Very frusturating. In the process of coming off TRT all together, it's been nothing but issues for me and a lot of money. Toremifene worked very well but I ended up being allergic so I had to drop it. Might be worth a shot.

Sorry to hear that man... were you on hCG?

That's funny, domes doc told that's not true

Leydig cell desensitization is actually well documented in the medical literature. I originally thought it was more hearsay by practice and experience, but indeed, clinical trials demonstrate the phenomena.

[phaedo]

Has anyone here checked their progesterone while on TRT + hCG or hCG monotherapy?

[powerlifterty16]

Sorry to hear that man... were you on hCG?



Leydig cell desensitization is actually well documented in the medical literature. I originally thought it was more hearsay by practice and experience, but indeed, clinical trials demonstrate the phenomena.

i think with hcg mono doses, leydig problems are rare. 500 iu and below should be fine.

[dreadnok89]

Sorry to hear that man... were you on hCG?



Leydig cell desensitization is actually well documented in the medical literature. I originally thought it was more hearsay by practice and experience, but indeed, clinical trials demonstrate the phenomena.

Sorry man my phone is awful. I just thought it was funny because I just read seconds before that desensitization isn't real

[dreadnok89]

The scary part is that your test would of been a lot higher if you took an air!