By what mechanism? That's not how it works. LH and FSH are suppressed when you're on TRT, but they stabilize after cessation. The question is, why would someone with clinical hypogonadism cease TRT?
> That's not how it works. LH and FSH are suppressed when you're on TRT, but they stabilize after cessation.
The testes atrophy over time when LH and FSH are suppressed. Even if LH and FSH return (which isn’t guaranteed) the testes need to be able to respond to those hormonal signals, but atrophied testes do not respond the same.
For someone with true intractable hypogonadism this hardly matters because they weren’t capable anyway. Many people prescribed TRT today don’t actually have intractable hypogonadism, though.
Body builders have some tricks to try to reverse this, but it’s not perfectly effective and even body builders know to cycle their steroids to avoid having prolonged periods of suppressed HPG axis activity. I was involved with weightlifting in my younger years but never dabbled with steroids or TRT. Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs.
Men on TRT for years will have considerable testicular atrophy that is not totally reversible.
> The question is, why would someone with clinical hypogonadism cease TRT?
TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT.
Can you share your longitudinal anecdata? I am considering going back on AAS for the QoL benefits, but would like to create a better mental model of long-term ramifications for testicular health.
It's my understanding that 40, it simply is expected that your hormones levels will be much lower (and that is not necessarily a bad thing). However my mind is failing to grasp what long-term damage TRT can do to the HPTA when not using an obscene amount of gear and on HCG.
Trying to figure out the mechanism. Perhaps receptor desensitization and epigenetic compensatory changes?
> Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs.
Then your sample is either very limited or very weird, because I test my testosterone, and my friends who did multiple cycles in the past (10–15+ years ago, and not huge competition level doses) are also within the normal range.
> TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT.
That's hugely problematic if true. They should be investigated and if found of wrongdoing, have their medical licenses revoked.
It’s true. You can even go on Reddit and find anecdotes and guides about which clinics to call and what to say to get prescribed with minimal hassle.
Some of the clinics were even prescribing anabolic steroids intended for terminal cancer patients.
If you want to read about something even crazier, look up the services that were started during COVID to be prescription mills for Adderall or Xanax. The relaxed COVID prescribing rules allowed telehealth providers to give schedule II prescriptions to new patients remotely, so services were created to advertise on TikTok and give prescriptions for a monthly fee. The FDA cracked down on these, though.
There’s even a famous story of a whistleblower who worked at one of these clinics and got reprimanded for not prescribing Adderall enough. There was a leaked memo where they pushed providers to prescribe Adderall over other options because their data showed the highest customer retention rate that way.
Argh. It’s so strange to be ridiculed and have your ideas devalued just because you know how to use punctuation marks. I have 20 year old blog posts with hundreds of comments accusing me of using AI. I understand people being suspicious, but it’s beyond annoying when it becomes an entire personality online, as it has for many persons.
How about we go back to valuing ideas, regardless of their origins, if they deliver insight, value, or joy? I don’t care if someone writes something good or if the idea was stolen from something they read, or if a machine made it for them, unless the value proposition is their personal capacity for original prose.
AI gotchaism is becoming as least as tiring as the droll, tone deaf creations of LLMs.
I hope you are not writing this in reference to my question, because this does not in any way capture the feelings or thoughts I had while asking. Just some mild curiosity living in a strange new world.
In case this is not obvious: I am aware that you could just not answer honestly. If I thought this was a critical issue and that you were likely to be dishonest about it, I would not have asked to begin with.
I think I read things into your comment you did not intend, and for that I apologize. I confess I have been pretty sensitized from the barrage of accusations I recieve—mostly from em dashes and using “ai words” whatever that means lol. It wouldn’t be so bad if AI wrote better prose, but I really hope that my own writing doesn’t come off with that singularly droll countenance that AI tends to present.
No, it's quite real and has been reported on in the press. It's straightforward to get prescribed hormones for even the flimsiest of reasons [0]:
> This patient expressed no gender dysphoria, but he got hormones, too. I asked the doctor what protocol he was following, but I never got a straight answer.
I dunno. It seems straightforwardly analogous to the fake medical marijuana clinics you see in places where recreational use isn't legal, or the countless online pharmacies with doctors on retainer to prescribe Ozempic and Viagra. It's not how I would design the medical system if I were in charge, but these aren't addictive substances like opioids.
