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A large proportion of naturally occurring HMG consists of copurified urinary proteins inactive at the FSH receptor, with a lesser proportion containing a blend of FSH, LH, and hCG.40 Therefore, similar to hCG, refinements have led to production of highly purified urinary HMG, and more recently recombinant FSH (rFSH), to achieve higher specificity for the FSH receptor. Initially extracted from the urine of pregnant females, naturally occurring hCG has demonstrated efficacy at restoring spermatogenesis.38 Newer, recombinant hCG has emerged and is considered equivalent to urinary sources pharmacologically although further study is warranted to confirm its equivalency to urinary forms in restoring spermatogenesis.39 Similarly, FSH has traditionally been derived from the urine of postmenopausal women in the form of human menopausal gonadotropin (HMG). Certainly, men with a prior, multiple year history of TRT or AAS use may not expect the same rate of recovery.
When discontinuing a long-acting injectable ester, such as cypionate or enanthate, therapy to stop TRT is usually initiated roughly five days after the last injection, as the hormone levels start to fall. This includes the stimulation of LH production in the pituitary or stimulation of the testicular cells to produce testosterone. This results in the body slowing down or stopping its own production of testosterone. At Great Lakes Testosterone, we specialize in safe, medically guided hormone therapy that’s built to support your body for the long haul. When you begin testosterone therapy, your body starts receiving testosterone from an external source. When testosterone levels are adequate, your brain dials down production of GnRH, LH, and FSH.
With the right phased protocol, most motivated men can break free from dependency, restore natural levels, preserve fertility, and feel prime again without lifelong injections. Testosterone Replacement Therapy (TRT) helps treat low Testosterone, or hypogonadism, in men. But it can help you avoid avoid hormone withdrawal symptoms for a more comfortable transition. We have protocols to assist patients in restarting their HPTA axis. If you want to discontinue TRT safely with limited side effects, Defy Medical can help. This is called primary hypogonadism and results from the testicles’ inability to respond to LH (or HCG) stimulation.
Understanding the bistable nature of the HPO axis has significant implications for developing novel therapeutic approaches to restore normal reproductive function. By preventing menses, the body initiates infertility so that a pregnancy does not occur and cause another source of energy demand. Even upon return to normal diet or physical activity, the body may take months to years for menses to return to normal, almost as if the body hysterically remembers the previous state of energy deficiency. The hyperandrogenism creates a self-perpetuating cycle, in which the increased GnRH pulse frequency promotes LH secretion over FSH, resulting in a high LH/FSH ratio. For instance, in polycystic ovary syndrome (PCOS), alterations in the GnRH pulse generator and abnormal androgen feedback may lead to a persistent high-LH state. Disruptions in the bistable nature of the HPO axis have been implicated in various reproductive disorders. The corpus luteum's lifespan is influenced by LH pulse frequency and amplitude, gonadotropin levels, and luteotropic factors like prolactin, oxytocin, and prostaglandins.
Following the use of exogenous anabolic steroids, the majority of users will experience what has been dubbed a "hormonal crash" or "post cycle crash", which is a bodily environment in which key hormones essential to the retention of the newly created muscle mass has been suppressed or shut down. It is important to remember humans are the only species to hide their fertile period, but this effect is a difference in the effect of the hormones rather than a difference in the HPG axis. Depending on which hormone and receptor are unable to bind different effects occur but all alter the HPG axis.citation needed

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