TRT vs. HRT – What’s the Difference?

TRT stands for Testosterone Replacement Therapy. HRT stands for Hormone Replacement Therapy. To some people (and healthcare providers) there is no difference. For myself and many others, it makes sense to separate them as:

• TRT referring to testosterone mono-therapy; and

• HRT meaning multiple or general hormone replacement.

Of course, testosterone is a hormone, so it’s not ‘wrong’ to call it HRT. One could argue that TRT replaces hormones downstream of testosterone as well such as the commonly monitored estradiol (E2) and dihydrotestosterone (DHT).  

But again, it makes sense to separate these two into different forms of therapy, and going forward that’s how I will use the terms above. While a large fraction of the men on TRT feel well and don’t supplement other hormone medications, a growing fraction of men are using Human Chorionic Gonadotropin (hCG) together with testosterone (e.g. HRT). So what is hCG and why would men add it to their protocol? HCG is a luteinizing hormone (LH) mimic. By mimicking LH, hCG activates LH receptors in the brain and testicles. This counteracts the suppression of natural LH release in the pituitary gland as a result of exogenous testosterone already available within the body. There are several good arguments why men should take hCG with testosterone: