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hCG and Testosterone levels

hCG and Low Testosterone

Several weeks ago, I had the opportunity to go back to where I grew up:  Puerto Rico.  My younger brother got married in a magnificent place between the mountains and the beach.  While I was there, I had so many memories, one of which was: how good I felt when I used to live there.  I used to travel around the island during the day to explore the different beaches, mountain trails, rivers and rainforests, among other things.  At night, had the energy to be able to go partying with friends and dancing with my then girlfriend (now wife), and then wake up early in the morning the following day, ready for work without feeling exhausted.  Why?  I worked out regularly, maintained myself healthy and my testosterone levels were at their highest peak.   

Many men in their early mid-life covet to feel that way.  They struggle to maintain a healthy lifestyle, struggle to keep themselves awake during the day and have no energy to spend time with their loved ones.  They need testosterone, and most of the time… they don’t even know it.

What is hCG? 

Testosterone products help boost the levels in the human body but have several side effects which include testicular atrophy (testicles get smaller) and infertility. One of the ways testosterone can get replenished to avoid these side effects is by using hCG (human chorionic gonadotropin), and today I will take some time to help you understand how it can help boost testosterone.  

In order to understand how hCG works, we need to understand how testosterone gets naturally produced in our body. 

Everything starts out in the brain.  The hypothalamus produces a hormone called Gonadotropin-releasing hormone (GnRH) which stimulates another gland called the pituitary to produce folliculin-stimulating hormone (FSH) and luteinizing hormone (LH).   LH is the hormone and the signal that stimulates the testicles to produce testosterone.  If your body is low on testosterone,  the testicles send a signal to the pituitary asking for LH in order to produce testosterone. 


How does hCG work?

In men, hCG acts as an analog of LH, therefore stimulating the testicles to produce more testosterone. LH also stimulates production of sperm within the seminiferous tubules, which are structures inside the testicles, and therefore maintains fertility in men. HCG comes in injectable form and is usually administered 2 to 3 times a week.

Previous studies have demonstrated that hCG increased testosterone levels compared to placebo.[1]  In another study, men taking testosterone along with hCG were able to maintain adequate sperm production and testicle volume. [2]

Who will benefit from hCG?

Given it helps to maintain fertility, hCG is a good option for men with low testosterone wanting to preserve their fertility.  Moreover, men who are concerned about the size of their testicles while being on testosterone replacement therapy, benefit from taking hCG as it may prevent testicular atrophy.

Are there any side effects?

As with other forms of testosterone therapy, side effects include:

  • Gynecomastia (growth of male breasts)
  • Pain, swelling at the injection site
  • Allergic reactions (skin rashes)

Is it safe?

HCG is an FDA-approved medication that has been used to treat both men and women for decades.  In men, it serves as alternative to testosterone therapy to help boost testosterone levels while maintaining fertility.   On certain occasions, your doctor can prescribe it in conjunction with testosterone products. 


This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.  

Why Gatekeepers of Men? 

1.     Liu PY, et al. A double-blind, placebo-controlled, randomized clinical trial of recombinant human chornionic gonadotropin on muscle strength and physical function and activity in older men with partial age-related androgen deficiency. J Clin End Met. 2002;87(7): 3125-35.

2.     Hsieh TC, et al. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol 2013. Doi: 10.1016/j.juro.2012.09/043

Finding Optimal Testosterone Levels

Low Testosterone – Finding Optimal Levels

As men, we live in a very interesting time.  Our bodies are aging prematurely and become more fragile by the second.  You might wonder, why is that happening?   With social media, youtube, and TV entertainment at its highest, a sedentary lifestyle is limiting the mobility and exercise that our bodies need.  Then you add the constant assault from our environment and combine it with stress, lack of sleep and poor nutrition, and you end up with a fragile body without energy.   This premature aging, constant fatigue and lack of energy, in some instances, makes us question our own masculinity. Men’s health declines and because we are too busy running our daily lives, we don’t even pay attention to how we feel.  Ten, 15, 20 years pass by and then we realize that we not only feel old, but we ARE old. And all this time, our bodies lived in a desperate silence, longing for you to speak up, talk to someone about it, and look for help.  However,  there is hope.  That lack of sexual desire, loss of energy, constant fatigue has an explanation… Low Testosterone.  

The stone-cold hard truth is: without testosterone, a man is not a man.


What causes low T?

Although there are many organic and pathological causes for low T, one common cause that most do not account for is AGE.  Research studies have shown that once we reach 30 years old, testosterone starts decreasing by 1 to 2% in every man.  However, some men are more sensitive to those decreases than others.

How common is it?

The prevalence of low T varies depending on the research study.  However, there was a recent study that showed that up to 40% of men lived with sub-optimal T levels.  

Sub-optimal levels… what do you mean?

Testosterone levels carry a wide range of what is considered “normal levels” according to the laboratory, doctor who is evaluating you and, of course, insurance companies.   This range is, on most occasions, anywhere between 300 and about 1000.  However, imagine a 30 year-old man who used to live 5 years ago at the 700-800 range,  drop to a level of 350. How do you think he will feel?  At the same time, imagine a 65 year-old man with a level of 700…  Even though both are within a “normal level”, who do you think is at an optimal level and who is at a sub-optimal level?  The answer is a bit obvious.  When we try to box everyone within such a wide range, many men end up living in a sub-optimal level with a long list of symptoms. 

For this reason, in our office, we do not check to see if you are within the normal range.  We focus on finding what is the optimal level for you.  We help you ‘listen’ to your body. In every visit: I will ask you how is your level of energy, how are your sleeping patterns, how is your sex drive, how are your erections, etc.  This way, together, we help you reach your optimal level to live life at its fullest.

This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a urologist specialized in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.  

#GatekeepersofMen Series

Health Concerns for the Middle-Aged Male

This week I was watching a movie and a quote resonated in my head for days. Then my wife sent me a message through Instagram about a 52-year-old marathon runner leaping of joy like a teenager. The caption of the picture was the same as the quote from the movie:  “We don’t stop playing because we are old, we grow old because we stop playing.” At this time, I knew…  I had to write about this. Many men find middle-age to be the prime time of their lives.   You’ve lived, you’ve made mistakes, and you’ve learned from them.  Your mind is still agile, and your body is strong enough to enjoy the fruits of your hard work.   A man in his middle-age years can take credit for his accomplishments and find time to enjoy the beginnings of well-deserved rewards for a lifetime of taking risks and working hard. 

Then again,  the most important health concern for men over 40 is the threat of life itself.   Some start looking after themselves better, though sadly it’s often a time when other men don’t do that…     High cholesterol starts kicking in, high blood pressure, diabetes,  weight gain, fat accumulates in all the wrong places, our risks for cancer increase, and we start to struggle to maintain an erection.  

That’s why I believe the middle-age male goes through a tougher time than men in their 30s or men above 65.    Why?   Most men in their 70s and 80s, in a sense,  expect the “decline” in their bodies. However, someone who is between 40 and 65 years old feels he is in his PRIME-TIME: strength, vitality, experience, maturity and wisdom all combine so you can make the most of your life.  For some men, though, there is a problem.  Something… is just… not right. 

Your mind says it can and wants it, but your body doesn’t keep up.    And some might wonder, why is that?  Why do I feel like this?   Why am I struggling to stay awake in the middle of the day? What’s the reason for me waking up 3 or 4 times to urinate and have to strain in order to empty my bladder,  why can’t I find the energy to do things?  Why am I struggling to keep an erection and can’t satisfy my partner?  

When we talk about men’s health, we try to find ways to optimize and reinvigorate our deteriorating bodies that are in a constant attack from our environment.  In the next few weeks, I will write about the major topics that encompass men’s health in a urologic practice:  BPH, prostate cancer, low testosterone, premature ejaculation, and erectile dysfunction.  Stay tuned!

Why GateKeepers of Men?

When Cain killed his brother Abel, God asked him “where is your brother?”, for which Cain responded: “I do not know. Am I my brother’s keeper?”.  A keeper looks after someone. However, a Gatekeeper not only looks after someone, but protects them from outside insults. Well, I imagine myself in my judgement day in front of the Almighty, and the All-powerful One  asking me what I’m doing on Earth.  I will proudly say: “I see myself as a Gatekeeper of Men”. In our office, we not only provide general urology care. We have a special calling to help men.  This is why we focus on men’s health.   Therefore, I will title this series of educational posts as  #GateKeepersofMen, because in our office, we not only look out for you, we take care of you. Come visit us. Stay tuned for more.



This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a urologist specialized in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.  

Dr. Clavell presents at International Conference

Dr. Clavell takes part as one of the invited faculty for the Urology Reconstructive course at the CMU annual congress in Monterrey, Mexico. His lectures include:
1. Current concepts in the Surgical Treatment for Peyronie’s Disease.
2. Management of Climacturia in patients with Erectile Dysfunction after Prostate Cancer Treatment.


El Dr. Clavell ha tomará un rol como parte de los profesores  invitados en la sesión de Urología Reconstructiva en el congreso CMU en Monterrey, Méjico. Sus presentaciones incluyen:
1. Conceptos actuales en el Tratamiento de la Enfermedad de Peyronie. 
2. Tratamiento para Climacturia en Pacientes con Disfunción Eréctil.


Dr. Clavell joins Majic 102.1 FM


Dr. Clavell joins Funky Larry and Dr. Cornell at ‘Straight up with The Doc’ this upcoming SuperBowl Sunday on Majic 102.1 FM. 


The People’s Station will host Houston’s Experts in Prosthetic Urology who will discuss the use of prosthetic urologic devices in the treatment of Erectile Dysfunction and Male Urinary Incontinence


Tune in on Sunday, February 3, 2019 at 10am; and feel free to call and Ask the Doc any questions you have!


Prosthetic Reservoir Removal

Did you know… Dr. Clavell has published multiple peer-reviewed articles that have been featured in preeminent Journals such as Journal of Urology, Journal of Sexual Medicine and Sexual Medicine Reviews. Rest assured that he is always on the cutting edge in the latest advances in urologic technology and prosthetic surgery.

Take a look at his latest publication describing a step-by-step algorithm on prosthetic reservoir removals.…/S1743-6095(18)31281-5/fulltext