What is male hypogonadism?

Male hypogonadism is a condition defined by testosterone deficiency along with associated symptoms or signs, impaired sperm production, or both. Symptoms span three areas: sexual (decreased libido, erectile dysfunction, reduced morning erections), somatic (increased body fat, reduced muscle mass and energy), and psychological (depressed mood, mood instability, poor concentration, sleep disturbance).

What is hCG and how does it treat male hypogonadism?

hCG stands for Human Chorionic Gonadotropin. It treats male hypogonadism by mimicking LH (luteinizing hormone), which stimulates the testes (specifically Leydig cells) to produce testosterone naturally from within the body, rather than replacing testosterone from an external source.

What is the advantage of hCG therapy over testosterone replacement therapy?

The key advantage of hCG monotherapy is that it preserves fertility. Standard testosterone replacement therapy can reduce sperm production and weaken sperm strength, which is a concern for men who wish to have children. hCG stimulates the body's own testosterone production without suppressing fertility.

Does hCG therapy affect FSH, LH, estradiol, red blood cells, or PSA levels?

No. hCG monotherapy does not interfere with FSH, LH, or estradiol levels, and does not affect serum red blood cell concentration or PSA levels. This makes it a favorable option compared to exogenous testosterone in men where these parameters are a concern.

How long does hCG therapy take to show results?

Clinical improvement from hCG monotherapy is generally expected after 6 months of regular use. Patients should commit to consistent treatment and follow-up with their andrologist to monitor response.

How often do I need to inject hCG for hypogonadism treatment?

hCG injections are required twice a week, which is more frequent than exogenous testosterone replacement therapy (which ranges from every 2 weeks to every 3 months depending on the formula). This higher injection frequency is the main drawback of hCG monotherapy.

hCG Monotherapy for Male Hypogonadism

Last updated: May 18, 2026

Soarawee Weerasopone, Urologist

Bangkok hospital Headquarter, Bangkok

Samitivej Sriracha hospital, Chonburi

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Now a day, younger gentlemen come to see me with a hypogonadism symptom issue. Today we will discuss the new alternative way to treat this kind of disease by using hCG monotherapy with evidence-based medicine. We will pay attention in the late-onset hypogonadism which related with aging process only and here is the definition.

Hypogonadism is a state of testosterone deficiency including associated symptoms or signs, deficiency of sperm production, or both. The hypogonadism symptoms are shown below.

Symptoms of Hypogonadism

Sexual aspect – Decrease libido, erectile dysfunction, decrease morning erection frequency, decrease sexual performance.
Somatic aspect – Increase visceral fat or obesity, decrease lean body mass, decrease muscle strength, feeling loss of energy or fatigue.
Psychological aspect – Depressed mood, unstable mood, inability to concentrate, sleep disturbance.

Loss libido is one sign of Hypogonadism

Normally, when patients experience in those kinds of symptoms, we will have a protocol to confirm the medical diagnosis and then will consider about the testosterone replacement therapy. By the way, the testosterone replacement therapy itself has a concern of the cons on reducing fertility performance by weakening sperm strength. This why hCG or Human Chorionic Gonadotropin monotherapy was introduced and has lots of supported literatures.

Characteristic of hCG

Full name	Human Chorionic Gonadotropin
Mechanism of action	Mimic LH or luteinizing hormone which stimulate intrinsic testosterone production from testis (Leydig cell)
FSH, LH and estradiol interference	No
Serum red cell concentration and PSA interference	No
Preserve fertility	Yes
How long should we prospect clinical improvement?	6 months of regular use
Injection interval time	2 times a week

From the table above, you can notice that the cons of hCG therapy seem to be much frequent injection interval when compared with exogenous testosterone replacement therapy.

Good thing is the gentlemen who are currently using testosterone replacement therapy can safely switch to hCG monotherapy without any complication. Any questions, please talk to your trusted andrologist, or you can leave me the message.

You can visit my official homepage here.

Frequently Asked Questions

Q1: What is hCG and how does it work in male hypogonadism?

hCG (Human Chorionic Gonadotropin) is a hormone that mimics LH (luteinizing hormone), stimulating the Leydig cells in the testes to produce testosterone naturally. Unlike conventional testosterone replacement therapy, hCG works by stimulating the body’s own testosterone production rather than replacing it from an external source.

Q2: Who is the best candidate for hCG monotherapy?

hCG monotherapy is particularly suitable for younger men with hypogonadism who wish to preserve their fertility. Since conventional testosterone replacement therapy suppresses sperm production, hCG offers an alternative that treats testosterone deficiency while maintaining fertility potential. Your urologist will assess your hormone profile and fertility goals before recommending this option.

Q3: What is the difference between hCG monotherapy and testosterone replacement therapy?

Testosterone replacement therapy (TRT) delivers exogenous testosterone directly into the body, which can suppress natural testosterone and sperm production. hCG monotherapy stimulates the testes to produce testosterone internally, preserving fertility. hCG requires injection twice a week, whereas TRT injections range from every 2 weeks to every 12 weeks depending on the formula.

Q4: How long does it take to see results from hCG monotherapy?

Clinical improvement from hCG monotherapy is typically expected after approximately 6 months of regular treatment. Symptoms such as low energy, reduced libido, and mood changes should gradually improve as testosterone levels normalize. Regular follow-up with blood tests is essential to monitor progress and adjust the treatment plan.

Q5: Can I switch from testosterone replacement therapy to hCG monotherapy?

Yes. Men who are currently on testosterone replacement therapy can safely transition to hCG monotherapy without major complications. However, this switch should always be done under the supervision of a qualified urologist or andrologist, with appropriate monitoring of hormone levels throughout the transition period.

If you are experiencing symptoms of hypogonadism and would like a comprehensive evaluation, Dr. Soarawee Weerasopone offers specialist consultations in men’s health and testosterone therapy at Bangkok Hospital Headquarters. Book a Consultation.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.

Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).

Dr. Soarawee Weerasopone

Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.