Following a period – or ‘cycle’ – of anabolic steroid use, there is often a necessary period of recovery treatment involving other medication, called Post Cycle Therapy.
This medication usually comprises prescription strength drugs, and the purpose of them is to counteract various negative side effects of the steroid run.
For many users the organization and correct implementation of proper PCT leaves them overwhelmed. This often means it is carried out incorrectly, or not done at all.
As you can imagine, it is not an aspect of steroid use that should be neglected.
Note: The need for PCT is NOT applicable to women, nor is the need for supplemental testosterone.
The Main Reason For Post Cycle Therapy
The use of exogenous anabolic steroids causes the body to reduce its own natural (endogenous) production of testosterone.
When natural testosterone is low, several unpleasant health issues can arise. In fact, testosterone is vital for healthy function.
During a cycle of steroids, most people use exogenous testosterone to help prevent these health problems. This does not, however, provide a long-term solution.
Eventually, endogenous production must be allowed to recover, otherwise it may never be able to fully.
This is where PCT becomes important: to encourage the natural recovery of endogenous testosterone levels to prevent a state of low testosterone.
Note that no matter which steroid is used – from the least suppressive to the most – they all will do enough to require some level of PCT.
The level of testosterone suppression varies from one anabolic steroid to another. Some have the power to virtually shut it down in one shot (e.g. Deca Durabolin / Nandrolone) while others have less of an impact (e.g. Anavar / Oxandrolone).
The use of exogenous testosterone will mitigate many of the other symptoms of the suppressive effect, but there is one in specific which will remain.
Depending on the level of suppression, the testicles will shrink accordingly. This is known as testicular atrophy, and every serious steroid user simply must accept this as par for the course.
A group of chemicals known as Selective Estrogen Receptor Modulators (SERMs) have been used to treat breast cancer in women.
When used on men certain SERMs increase the production of LH and FSH. As such, there are two of note which are generally included in any Post Cycle Therapy plan.
Tamoxifen (traded under Nolvadex) and Clomiphene (also Clomifene, traded under Clomid) have been shown to increase FSH and LH in reliable scientific studies. The huge, openly shared knowledge base of the steroid using community also supports them extensively.
Some men use Human Chorionic Gonadotropin (HCG) during the steroid cycle. HCG imitates the behaviour of LH and so can maintain a certain amount of endogenous testosterone production. It also prevents testicular atrophy (see above) to some degree.
In theory HCG used ‘on cycle’ may ease the full endogenous testosterone recovery.
HCG is also used post-cycle sometimes. It is important to note that it does not actually increase LH; it simply acts like LH. So, even though it may stimulate the production of natural testosterone it is still only used as an aid – or bridge – to real recovery.
Stahl F, Schnorr D, Rohde W, Poppe I, Geier T, Dörner G. – Effects of tamoxifen on the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), 17 beta-oestradiol (E2), total and free testosterone (T) and total and free dihydrotestosterone (DHT) in blood of patients with benign prostatic hyperplasia – Exp Clin Endocrinol. 1983 Jul;82(1):21-8 [http://www.ncbi.nlm.nih.gov/pubmed/6193975]
Guay AT(1), Jacobson J, Perez JB, Hodge MB, Velasquez E. – Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit? – Int J Impot Res. 2003 Jun;15(3):156 65 [http://www.ncbi.nlm.nih.gov/pubmed/12904801]
Dosage and Blood Work
Though other reference sites will explain a Post Cycle Therapy plan in more detail with respect to dosages, we are hesitant to do this because too many factors – including genetics – come in to play.
Getting regular blood tests will be of huge benefit to anybody running steroids or PCT. It is the only real way to know what is happening. Reading the blood analyses, interpreting them and adjusting meds accordingly is another thing altogether.
A doctor is the obvious person to consult; they will suggest dosages and timescales.
Given the stance on steroids that many countries have, don’t expect a doctor to be anything but reticent to enable their use. Private medical institutions are usually more obliging.
The best advice we can give is to know your plan in full before commencing any steroid cycle. Trying to adapt as you go will probably end in a lesson a lot of people are only too sad to have the experience to preach.
Side Effects and Other Risks
Yes, Post Cycle Therapy medications have side effects. You may think they exist purely to combat side effects but the truth is that any medication has its drawbacks.
We haven’t covered Aromatase Inhibitors (AIs) in this article because they are not a long cycle PCT option. They are stronger than SERMs and come with worse side effects, the main one being the negative effect on cholesterol profiles. They are worth mentioning in this context if only to answer the question: “why haven’t AIs been mentioned?”
Finally, it is necessary to highlight that PCT does not necessarily fix testosterone production every time for everyone.
The use of anabolic steroids comes with the risk of permanently damaging your Hypothalamic Pituitary Gonadal Axis (HPGA). That is to say there is a chance your natural testosterone production will never fully return to previous levels.
Indeed some people need to undergo Testosterone Replacement Therapy (TRT) for the rest of their lives.
This is a possibility that all anabolic steroid users must accept.