Many individuals who have used anabolic steroids seek information about post cycle therapy (PCT) to restore natural testosterone production. A common question is whether Testogel, a prescription testosterone replacement therapy, can be used for this purpose. This article clarifies that Testogel is not appropriate for PCT and explains why. We examine how Testogel works, the principles of post cycle therapy, and the approved medical options available in the UK for men experiencing persistent hypogonadism following steroid use, emphasising the importance of seeking proper medical assessment and evidence-based treatment.

What Is Testogel and How Does It Work?

Testogel is a prescription-only testosterone replacement therapy (TRT) licensed in the UK for treating male hypogonadism—a condition where the testes produce insufficient testosterone. It is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and contains testosterone as a transdermal gel.

Testogel comes in different formulations with specific application instructions. Depending on the product strength, it should be applied daily to the shoulders and upper arms (all formulations) or abdomen (specific formulations only). Important safety precautions include:

• Washing hands thoroughly after application

• Allowing the gel to dry completely before dressing

• Covering application sites with clothing

• Avoiding skin contact with women (especially pregnant women) and children

• Never applying to the genital area

The active ingredient, testosterone, is absorbed through the skin into the bloodstream, where it supplements endogenous (naturally produced) testosterone. Once absorbed, testosterone binds to androgen receptors in various tissues, supporting normal male physiological functions including:

• Maintenance of muscle mass and bone density

• Regulation of libido and sexual function

• Potential effects on mood and cognitive function

• Red blood cell production

Mechanism of action: Testogel delivers exogenous testosterone to restore physiological levels in men with confirmed hypogonadism. However, it does not stimulate the body's own testosterone production. In fact, exogenous testosterone suppresses the hypothalamic-pituitary-gonadal (HPG) axis through negative feedback, reducing luteinising hormone (LH) and follicle-stimulating hormone (FSH) secretion. This further inhibits natural testosterone synthesis by the Leydig cells in the testes.

Common adverse effects include skin reactions at the application site, acne, mood changes, and potential effects on prostate health. Monitoring typically includes serum testosterone levels, haematocrit/haemoglobin, prostate-specific antigen (PSA) with digital rectal examination when indicated, and blood pressure. Liver function tests may be performed if clinically indicated. Testogel is contraindicated in men with prostate or breast cancer and should never be used without medical supervision.

Suspected side effects should be reported via the MHRA Yellow Card scheme.

Understanding Post Cycle Therapy (PCT) After Anabolic Steroids

Post cycle therapy (PCT) refers to a pharmacological strategy employed after discontinuing anabolic-androgenic steroids (AAS) to help restore the body's natural testosterone production. When individuals use supraphysiological doses of anabolic steroids—whether for bodybuilding, athletic performance, or other non-medical purposes—the HPG axis becomes suppressed, sometimes severely.

During a steroid cycle, exogenous androgens signal the hypothalamus and pituitary gland that sufficient testosterone is present, leading to:

• Reduced gonadotropin-releasing hormone (GnRH) secretion

• Decreased LH and FSH production

• Testicular atrophy and cessation of endogenous testosterone synthesis

When anabolic steroids are abruptly stopped, the body may take weeks or months to resume normal testosterone production. During this recovery period, users may experience symptoms of hypogonadism including fatigue, depression, loss of libido, muscle loss, and metabolic disturbances.

The goal of PCT is to accelerate recovery of the HPG axis by stimulating LH and FSH secretion, thereby encouraging the testes to resume testosterone production. Commonly discussed PCT agents (though not necessarily approved for this purpose) include selective oestrogen receptor modulators (SERMs) such as tamoxifen or clomifene, and human chorionic gonadotropin (hCG).

It is crucial to emphasise that anabolic steroids are Class C controlled substances in the UK under the Misuse of Drugs Act 1971. While personal possession for own use is not an offence, supply, production, and import/export without authority are illegal. The NHS and NICE do not provide guidance on PCT for non-medical steroid use, as this falls outside legitimate clinical practice, though the NHS does offer harm-reduction information for those who have used anabolic steroids.

Individuals experiencing symptoms after steroid cessation should seek medical advice from their GP for appropriate assessment, which may include evaluation for depression, suicidality, and substance misuse. GPs can provide confidential support and referral to specialist services if needed.

Can You Use Testogel as a PCT?

No, Testogel is not appropriate for post cycle therapy and should not be used for this purpose. This is a critical point that requires clear explanation, as there is considerable misinformation in non-medical communities regarding testosterone replacement products.

Testogel contains exogenous testosterone, which suppresses rather than stimulates natural testosterone production. Using Testogel after a steroid cycle would:

• Continue to suppress the HPG axis through negative feedback

• Prevent recovery of endogenous LH and FSH secretion

• Maintain testicular suppression and atrophy

• Delay or prevent the body's natural hormonal recovery

The fundamental principle of PCT is to stimulate the body's own testosterone production, not replace it with external sources. Testogel works through an entirely opposite mechanism—it provides testosterone from an external source, which the body recognises and responds to by further reducing its own production.

Clinical perspective: From a medical standpoint, using Testogel as PCT demonstrates a misunderstanding of endocrine physiology. If someone has used anabolic steroids and subsequently develops persistent hypogonadism that does not resolve naturally, this represents a medical condition requiring proper diagnosis and management by an endocrinologist. In such cases, if long-term testosterone replacement becomes necessary, it would be prescribed as treatment for hypogonadism—not as PCT.

There is no official link between Testogel and post cycle therapy in any MHRA-approved indication or NICE guidance. It is unlawful to supply or obtain prescription-only medicines without a valid prescription; using Testogel for unlicensed, non-prescribed purposes is unsafe and not recommended. Anyone considering or currently using such approaches should consult their GP immediately for appropriate medical assessment and evidence-based treatment options.

Approved PCT Options and Medical Guidance in the UK

In the UK, there are no medications specifically licensed for post cycle therapy following non-medical anabolic steroid use. However, when men develop persistent hypogonadism (whether from previous steroid use or other causes), evidence-based treatments exist within legitimate medical practice.

Medical assessment: If you have used anabolic steroids and are experiencing symptoms of low testosterone, the appropriate first step is consulting your GP. They can arrange:

• Blood tests measuring morning total testosterone (7-11 am) on two separate days

• LH, FSH, and prolactin measurements

• SHBG and calculated free testosterone if results are borderline

• Assessment of symptoms using validated questionnaires

• Evaluation for other causes of hypogonadism

Avoid testing during acute illness as this can temporarily lower testosterone levels. Referral to endocrinology is typically indicated for consistently very low testosterone, elevated prolactin, pituitary symptoms (headache/visual disturbances), testicular abnormalities, or fertility concerns.

Treatment options for confirmed hypogonadism (under specialist supervision) may include:

Selective oestrogen receptor modulators (SERMs): Medications like clomifene citrate can stimulate LH and FSH secretion in some cases of secondary hypogonadism, potentially encouraging natural testosterone recovery. These are used off-label for this indication in the UK and require specialist prescription and monitoring. Potential risks include venous thromboembolism and visual symptoms.

Human chorionic gonadotropin (hCG): This can directly stimulate testicular Leydig cells, but is typically reserved for specific clinical scenarios such as fertility preservation, and requires careful endocrine supervision.

Testosterone replacement therapy: If natural production cannot be restored, long-term TRT (including Testogel) may be appropriate, but this represents treatment for chronic hypogonadism rather than PCT. Importantly, TRT should not be initiated in men actively trying to conceive, as it can suppress sperm production.

Patient safety advice: Never purchase medications online or use them without prescription. Self-medication with hormonal agents carries serious risks including cardiovascular events, thrombosis, fertility issues, and psychological effects. If you are experiencing symptoms after steroid use, contact your GP promptly. NHS services provide confidential, non-judgmental care, and early medical intervention improves outcomes. The British Society for Sexual Medicine and Society for Endocrinology provide resources for healthcare professionals managing these complex cases within evidence-based frameworks.

Frequently Asked Questions