Gonadorelin

How a course is commonly described

1. 1
   Weeks 1-4Community-reported

   Clinic and compounding protocols start at 100 mcg subcutaneously two or three times a week, often on testosterone injection days, from a 2 mg vial reconstituted to 1,000 mcg/mL. Each injection is intended to produce one LH pulse; nothing is expected to be felt.

2. 2
   Weeks 4-12Community-reported

   Clinics describe judging testicular size and fullness over several weeks to months and, if shrinkage continues, moving from three injections a week to every other day or daily, or raising the dose to 250 mcg. Telehealth scripts default to 100-200 mcg twice daily from the outset.

3. 3
   Months 3-6 (pump therapy comparison)Clinical

   In men with CHH on a pump delivering 10 mcg every 90 minutes, gonadotropins rise within a week but the authors state that more than a month is needed to judge response and that gains in testosterone and testicular volume over the first 3-6 months predict later spermatogenesis. This continuous pulsing is the only schedule with fertility outcomes behind it.

4. 4
   Ongoing use and stoppingClinical

   No source describes cycling gonadorelin on TRT; it is continued for as long as testosterone is, and clinics present it as a trial that can be dropped or replaced with hCG if size is not maintained. In pump therapy for amenorrhea the monograph continues pulses through the luteal phase until pregnancy is confirmed.

5. 5
   Evidence comparisonCommunity-reported

   Every study showing that GnRH restores spermatogenesis used a pump pulsing every 60-120 minutes, and the trials showing preserved intratesticular testosterone on TRT used hCG. Twice-weekly or twice-daily gonadorelin injections sit between those two literatures with no controlled trial of their own, which several of the clinic sources above acknowledge.

• Gonadorelin's approved schedules are a single 100 mcg diagnostic dose and 5-20 mcg pulses every 90 minutes from a pump. The 100 mcg two-or-three-times-weekly and 100-200 mcg twice-daily TRT protocols are compounding and telehealth conventions with no controlled trial, and the sources that describe them say hCG has the stronger evidence for testicular size and fertility.
• The hormone has an initial plasma half-life of 2-10 minutes and a terminal half-life under 40 minutes, and the pituitary needs discrete pulses: continuous receptor occupancy desensitizes it, which is how GnRH agonists suppress testosterone in prostate cancer. Guides therefore warn against very frequent dosing while also noting that a few injections a week cannot mimic a pump.
• No FDA-approved gonadorelin product is marketed in the US; compounded gonadorelin acetate is available by prescription from 503A pharmacies, and products sold as research chemicals are unregulated. The rows above record what sources report, not recommendations.