Is Your Provider Ignoring hCG? 5 Questions Every TRT Patient Should Ask

Testosterone Replacement Therapy (TRT) has changed countless lives—but if your provider isn’t discussing human chorionic gonadotropin (hCG) as part of your protocol, it might be time to ask why.

At AlphaMD, we believe in giving patients not just prescriptions—but knowledge and agency. Many providers skip over hCG, yet for some men, it plays a critical role in long-term success and overall health while on TRT.

Here’s what you need to know—and five smart questions to bring to your next appointment.

First, What Is hCG and Why Does It Matter?

hCG is a hormone that mimics luteinizing hormone (LH)—the chemical messenger that tells your testes to produce testosterone and sperm. When you're on TRT, your body often stops producing LH naturally, which can lead to testicular shrinkage, fertility issues, and a drop in intratesticular testosterone levels.

Adding hCG to your protocol can help maintain testicular function, natural testosterone production, and fertility.

But not every patient needs it. That’s why it’s important to ask the right questions.

1. “Will TRT affect my fertility, and if so, how do we manage that?”

TRT is not a birth control method, but it can drastically reduce or eliminate sperm production if unmanaged. If you’re planning to start or expand your family now or in the future, your provider should be having a serious conversation about hCG as a fertility-preserving tool.

👉 Why it matters: hCG helps maintain sperm production and testicular size in men on TRT who want to remain fertile.

2. “Do I need hCG to maintain testicular size and function?”

Some men experience testicular atrophy on TRT. It’s not just cosmetic—smaller testes can indicate suppressed function. While this doesn’t bother every patient, for others it’s a deal-breaker.

👉 Why it matters: If this matters to you, hCG can help keep the testes active and preserve their function.

3. “How will my protocol support natural hormone balance beyond testosterone?”

TRT affects more than just testosterone—it impacts estrogen, DHEA, LH, FSH, and more. hCG can help keep your endocrine system more balanced by preserving some of the body’s natural hormone pathways.

👉 Why it matters: Over-suppressing your natural hormone function can lead to long-term side effects. hCG provides a bridge between natural production and optimized therapy.

4. “How will we monitor and adjust my protocol over time?”

Even if you don’t start with hCG, you might need it later. If your provider isn’t open to that conversation—or doesn’t monitor fertility markers or testicular function—they may be using a one-size-fits-all approach.

👉 Why it matters: Good care is personalized and proactive, not cookie-cutter.

5. “What’s your philosophy on long-term hormonal health?”

This is the big one. Is your provider optimizing for quick symptom relief, or thinking long-term? If the answer is the former, hCG may be seen as optional or unnecessary. But if the goal is sustainable health and hormonal harmony, it should at least be on the table.

👉 Why it matters: You deserve a provider who looks at the full picture—not just T levels.

Final Thoughts: It’s Your Body—Ask Questions.

Too many men on TRT are left in the dark about hCG. Not every patient needs it, but every patient deserves to understand it.

If your provider dismisses your concerns, doesn’t explain your options, or avoids this topic altogether—it may be time to seek care from someone who values shared decision-making and transparent guidance.

💬 Have you talked to your provider about hCG? Did they recommend it—or leave it out? Share your experience in the comments or on our latest Instagram post. Let’s empower each other.

🔗 Learn more about how AlphaMD supports patient-centered TRT, including protocols that include hCG when appropriate: AlphaMD.org