question from a user
Hi. 54 YO man. T was 170. Been on .75 Xyosted for 2 months. Now T is 420 and feeling good. But, the Testicular atrophy is killing me. Right Testicle keeps getting pulled up into my groin and it’s very uncomfortable. Testicles ache all day and painful at times. Very uncomfortable to ejaculate. Talked to my urologist (a woman w 20 years in practice) she never heard of this. Her Male partner interrupted our Telemedicine call and he corrected her. Anyhow, I asked if I could get HCG with my Xyosted to correct the problem. She said she couldn’t do that while on the TRT. Then I said what about Clomid in conjunction with the TRT. She said she can’t do both at one time. She said she’s changing my script to cancel Xyosted and prescribing only Clomid and claims that will keep my T at the same or similar levels. My question: Is she wrong? I have zero faith in her as she never heard of testicular issues with TRT. I would LOVE any suggestions. I really want to keep my levels at the 400-600 range, but with my testicles not tiny, going up into my groin, and hurting/aching. PLEASE help.
AlphaMD's Answer
Xyosted
She is wrong. TRT and hCG dual therapy is so widely used, it is currently considered standard of care in men wishing to maintain fertility and/or prevent testicular atrophy while on TRT.
It is possible to reach levels within the 400-600 range with just Clomid, which would also increase testicular size. You can also reach those levels reasonably with hCG monotherapy. That is provided you don't suffer from primary hypogonadism, in which case no amount of increased signaling from either option will help your failed testicles to naturally produce a level of 400-600 ng/dL.
Our approach for our patients in similar situations to your own would be to continue TRT and add hCG. Though you should follow-up with your doctor and discuss it further.
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