Estradiol Cypionate
Long-acting estradiol injection for menopause and perimenopause symptoms and for gender-affirming hormone therapy, given every one to two weeks. Prescribed and dosed by a licensed physician.
Injection
from $139/mo
Injected under the skin · Twice a week
Men's healthFertilityTestosterone support
Human chorionic gonadotropin (hCG), a commercial pharmaceutical, supports testicular function in men on testosterone therapy by mimicking LH. Subcutaneous injection, 500 IU twice weekly; keeps sperm and testicular size intact while on external testosterone.
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
(ach-CEE-jee)
hCG (human chorionic gonadotropin) is a hormone made by pregnancy tissue and produced commercially as a pharmaceutical. It mimics LH (luteinizing hormone), telling the testes to make testosterone and sperm. When you take external testosterone, your pituitary stops signaling the testes, so they shrink and stop producing sperm. hCG replaces that signal, keeping the testes active. It is given as a subcutaneous injection, typically 500 IU twice weekly (0.25 mL of a 10,000 IU vial reconstituted with sterile water). The vial must be refrigerated after mixing and discarded after 60 days.
500 IU
twice weekly: the typical hCG dose used to maintain testicular function and sperm production on testosterone therapy
hCG is off-label when used with testosterone; it is an FDA-approved drug but used for a different indication. Your physician decides if it fits your goals.
Men on testosterone who want to preserve fertility, or men raising testosterone without replacing it.
It acts directly on the testicles like LH does. It has the most evidence for fertility on testosterone.
The vial is mixed before use and kept in the refrigerator. It raises estrogen too, so that is watched.
the shrinkage of TRT is prevented
or stay much higher than on testosterone alone
natural conception remains possible
recovery from TRT is faster and more complete
Day 1
A US-licensed physician reviews your testosterone plan, fertility goals, labs, and starts you on hCG (usually 500 IU twice weekly). The kit includes vials, sterile water, syringes and alcohol pads.
1Week 1
Subcutaneous injection twice weekly. You mix the 10,000 IU vial with 5 mL sterile water (making 500 IU per 0.25 mL), inject into the thigh or abdomen, and refrigerate the vial.
2Month 1–2
hCG keeps LH signaling alive. Men on TRT report the testes staying fuller and maintaining their size. Your physician may check labs (testosterone, LH, FSH, semen parameters if fertility is the goal).
3Month 3
Follow-up labs confirm testicular function is maintained. Your physician reviews testosterone levels, any side effects, and adjusts if needed.
4Beyond
hCG runs alongside your testosterone plan as long as you want to preserve testicular function and fertility. Your physician reviews progress every 3–6 months.
5Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
A sample week
Twice a week
hCG preserves testicular volume and sperm production in men on exogenous testosterone, well-established in the andrology literature and widely used in TRT protocols for men concerned with fertility.
Men using hCG alongside testosterone report maintained testicular size and sperm counts that would otherwise drop to near-zero, and the option to recover quickly if therapy is stopped.
Learn morehCG is generally well tolerated. The most common side effects are mild injection-site reactions (redness, itching, small lump) and, as testosterone rises, acne, mood swings or fluid retention. Rarely, hCG can overstimulate the testes (ovarian hyperstimulation syndrome does not occur in men, but testicular enlargement or pain can). hCG is not prescribed in men with prostate cancer, breast cancer, or a pituitary tumor. Tell your physician if you have a history of blood clots, heart disease, or uncontrolled high blood pressure. Seek care immediately for testicular pain, severe acne, chest pain, leg swelling, or mood changes that interfere with daily life. Tell your physician about every medication and any fertility or hormone treatment.

1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.

2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.

3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.

hCG educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Injected under the skin, twice a week. The starting prescription is 0.25 mL (500 IU) each time. Your physician sets your own dose and it is printed on your label.
1 vial at the starting strength, shipped to your door from a licensed US pharmacy.
External testosterone suppresses your pituitary's signal to the testes, so they stop making sperm and shrink to about half their size. hCG mimics the signal the pituitary should be sending, keeping the testes active. Men on TRT who want to preserve fertility, maintain testicular size, or have the option to stop therapy later choose hCG.
The 10,000 IU vial comes with sterile water. Add 5 mL water to the vial to make 2,000 IU/mL. Draw 0.25 mL (500 IU) into an insulin syringe and inject subcutaneously into the thigh or abdomen twice weekly. Refrigerate the vial after mixing; discard after 60 days. Your physician shows you; most men master it in one or two injections.
No. hCG stimulates the testes to make testosterone, but only if the pituitary is working normally. Men with truly low LH and FSH (central hypogonadism) may not respond. hCG is added TO testosterone therapy, not as a replacement.
Stopping TRT is often easier if you've been on hCG, because your testes never fully shut down. The pituitary's own signals can recover in weeks to months instead of the 6–12 months typical after TRT alone.
Tell your physician about every medication. hCG is generally compatible with most drugs, but certain treatments (GnRH agonists, antiandrogens) interfere. Also tell your physician about any other hormone or fertility treatments.
Long-acting estradiol injection for menopause and perimenopause symptoms and for gender-affirming hormone therapy, given every one to two weeks. Prescribed and dosed by a licensed physician.
Injection
from $139/mo
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Injection
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7-Keto DHEA, a metabolite of DHEA that does not convert to testosterone or estrogen. Supports energy and metabolism without hormonal side effects.
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A low-dose aromatase inhibitor for men on testosterone therapy whose blood work shows high estradiol, easing breast tenderness and water retention. Slow-release capsule, prescribed and dosed by a licensed physician.
Capsule
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression.
J Clin Endocrinol Metab, 2005Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy.
J Urol, 2013hCGfrom $249/mo