HMG
Also known as: Human Menopausal Gonadotropin, Menotropins, Menopur, Pergonal, Repronex
Lower numbers = closer to natural. Higher numbers = more enhanced.
Why this rating?
HMG (Human Menopausal Gonadotropin) is a prescription gonadotropin (FSH+LH activity) used to restore testicular function and fertility, not to build muscle beyond natural potential. Per the PubMed case study cited (Menon, Fertil Steril 2003), HCG+HMG therapy reversed steroid-induced azoospermia over 3 months of treatment, restoring semen parameters to normal - a recovery/restoration effect, not an enhancement one. Rated 2, in line with this project's other ancillary/axis-support compounds (gonadorelin, clomiphene, anastrozole) that stimulate or protect the natural hormonal axis rather than driving muscle growth directly. It is not rated 1 because, like HCG, it does directly stimulate testosterone production via LH activity rather than merely blocking/modulating estrogen.
Overview
A urinary-derived medication containing both FSH and LH activity (typically 1:1 ratio, 75 IU each per vial). Unlike HCG which only mimics LH, HMG provides FSH activity that directly supports spermatogenesis through Sertoli cells. Often combined with HCG for comprehensive fertility restoration after AAS use. Clinical case studies show successful reversal of steroid-induced azoospermia even after 1+ year of infertility.
Important Warnings
- •Requires prescription - must be obtained through legitimate medical channels
- •More expensive than HCG ($40-316+ per vial)
- •Monitor estrogen levels - gynecomastia risk from testosterone aromatization
- •FDA label caps ART (ovarian stimulation) dosing at 450 IU/day for no more than 20 days - typical male protocols (75-150 IU a few times weekly) stay well below this, but it is the label's hard ceiling
- •Off-label use for PCT/bodybuilding is not FDA-approved
- •Should be used under medical supervision with hormone monitoring
- •Complete spermatogenesis takes 6-12 weeks
- •Antibody development possible with prolonged use
Purpose & Use Cases
Fertility Restoration After AAS
Provides both FSH (for Sertoli cells) and LH (for Leydig cells). Clinical case: HCG 10,000 IU 2x/week + HMG 75 IU daily restored normal semen parameters in 3 months after steroid-induced azoospermia.
Comprehensive PCT
More complete than HCG alone for fertility recovery, since it adds direct FSH/Sertoli-cell support that HCG cannot provide on its own.
Spermatogenesis Support
FSH directly supports Sertoli cell function and sperm development. HCG alone does not directly support spermatogenesis.
Testicular Volume Recovery
Clinical studies show marked continuous testicular volume increase in 12/13 patients receiving HMG/HCG therapy.
Benefits
- Contains BOTH FSH and LH activity (unlike HCG which is LH-only)
- FSH directly supports spermatogenesis through Sertoli cells
- HMG + HCG combination adds FSH-driven spermatogenesis support that HCG alone cannot provide
- Documented reversal of steroid-induced azoospermia in a published clinical case study
- Not federally scheduled; HCG has carried state-level controlled-substance status in some states (e.g., California, historically) though this varies and has been changing
- Marked testicular volume increase reported in clinical case series
- FSH activity has a long enough half-life (~11-17 hours) to allow 2-3x/week dosing
- Some meta-analyses (e.g. Cochrane) show a modestly higher live birth rate with urinary hMG vs. recombinant FSH in IVF, though the overall evidence is mixed
Good to Know
It brings the FSH that HCG lacks
HMG (menotropins) contains BOTH LH and FSH activity. HCG only mimics LH: it drives testosterone and intratesticular testosterone but does nothing directly for sperm. FSH is what actually stimulates the Sertoli cells that produce sperm. That is why HMG + HCG (not HCG alone) is the go-to for restoring fertility and reversing spermatogenesis after AAS-induced azoospermia.
It acts at the testes, not the pituitary
Like HCG, HMG is a downstream gonadotropin: it delivers LH/FSH activity straight to the testes, so it works whether or not your pituitary has recovered. This is the opposite of SERMs, gonadorelin and kisspeptin, which all need a functional upstream axis to do anything.
It raises estrogen via testosterone
By pushing intratesticular and serum testosterone up, HMG increases aromatization to estradiol, so gyno/high-E2 is the main side effect to watch. Manage with an AI or SERM if it develops, guided by bloodwork.
Expensive, prescription, urine-derived
HMG is purified from the urine of postmenopausal women and costs more than HCG. It is used mainly for fertility restoration, typically alongside HCG (for robust LH/testosterone) and often a SERM, as part of a complete axis-recovery protocol.
Dosage Guidelines
| Experience Level | Dosage Range |
|---|---|
| Beginner | 150 – 225 IU/week |
| Intermediate | 225 – 450 IU/week |
| Advanced | 450 – 525 IU/week |
Standard vial: 75 IU FSH + 75 IU LH activity. Typical protocol: 75-150 IU per injection, 2-3x weekly, combined with HCG. Clinical case study (Menon 2003): HMG 75 IU daily + HCG 10,000 IU 2x/week for 3 months reversed steroid-induced azoospermia. The FDA label's "do not exceed 450 IU/day for more than 20 days" ceiling is from the female ovarian-stimulation (ART) dosing section, not the male protocol - typical male dosing (75-150 IU a few times weekly) sits well under it. Treatment courses for fertility restoration are typically run at least 3-4 months (~12-16 weeks) given the ~64-72 day spermatogenesis cycle plus epididymal transit.
The 11-13 hour figure is the steady-state, multiple-dose FSH elimination half-life (Menopur FDA labeling); single-dose terminal half-life has been reported considerably longer (~54-59 hours per Repronex labeling). The LH-activity component is not well characterized for menotropins specifically (native LH has a very short ~20-minute half-life, though depot IM/SC absorption may prolong the apparent curve).
Side Effects
Gynecomastia
commonAs testosterone rises from LH stimulation, excess can aromatize to estrogen. Common concern with gonadotropin therapy.
Monitor estrogen levels. Consider AI (anastrozole) or SERM (tamoxifen) if gyno develops.
Headache
commonCommon side effect reported in clinical use.
Usually transient.
Injection Site Reactions
commonRedness, pain at injection site.
Rotate injection sites.
Mood Changes
uncommonDepression, emotional lability, irritability from hormonal fluctuations.
Monitor mood. Usually transient.
Edema
uncommonFluid retention.
Usually mild.
Antibody Development
rareAntibodies against gonadotropins can develop, potentially reducing effectiveness.
Monitor therapy response.
General Mitigation Strategies
Primary concern is gynecomastia from increased testosterone aromatization. Monitor estrogen levels and consider AI (anastrozole) or SERM if needed. HMG is generally well-tolerated. Long half-life (especially FSH component) means effects persist after discontinuation.
Post Cycle Therapy (PCT)
HMG IS a PCT/fertility-restoration compound - but like HCG, it supplies exogenous FSH+LH activity directly to the testes rather than stimulating the pituitary's own gonadotropin release, so it does not by itself restart upstream HPT-axis signaling. Often combined with HCG (redundant/robust LH support) and SERMs (which DO drive endogenous pituitary LH/FSH) for a comprehensive PCT that restarts the full axis, not just the testes.
How It Works
HMG works through dual receptor activation: FSH binds to FSHR on Sertoli cells, stimulating androgen-binding protein production and supporting spermatogenesis. LH binds to LHCGR on Leydig cells, stimulating testosterone production to intratesticular concentrations ~100x higher than peripheral levels. This testosterone then works synergistically with FSH via androgen receptors on Sertoli cells. FSH activity predominates - this is why HMG is often combined with HCG for optimal LH/testosterone support.
Fundamentals
Reference on the practices relevant to HMG: how they are done and where they go wrong. Not a recommendation to use it.
Common Stacks
- HMG 75-150 IU 2-3x/week + HCG 1000-2500 IU 2-3x/week - optimal fertility restoration
- HMG + HCG + SERM (Nolvadex/Clomid) - comprehensive PCT
- HMG for FSH support, HCG for LH/testosterone support
- Consider recombinant FSH (75 IU EOD) if semen parameters dont improve with HMG
Legal Status
Prescription medication, not a controlled substance (unlike HCG in some states). FDA-approved for fertility treatment.
Legal status varies by country and changes over time. This is a general summary, not legal advice.
WADA Status
HMG (menotropins) contains LH and FSH activity; CG, LH and their releasing factors (gonadotrophins) are prohibited in males under S2.2 (both in- and out-of-competition).