Library / Peptides / Hormone Optimization / HMG

Strong evidence · Grade A

HMG

HMG (Human Menopausal Gonadotropin)

Score

82 / 100

Class

Hormone Optimization

Brand

Menopur

Status

Strong Evidence

TL;DR

Human menopausal gonadotropin (HMG) is a purified preparation containing both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity, originally derived from the urine of postmenopausal women. It is FDA-approved for the treatment of infertility in both women (ovarian stimulation) and men (spermatogenesis induction).

Part 01 · How it works

Mechanism.

If HCG is like one key that turns on testosterone production in the testes, HMG is like a master keyring with two keys — one (FSH) that tells the sperm factory to start production, and another (LH) that powers the testosterone furnace. Together, they restart the full reproductive system.

Mechanism · technical

HMG provides both FSH and LH activity. FSH acts on granulosa cells in the ovary to stimulate follicular development, or on Sertoli cells in the testes to support spermatogenesis. The LH component acts on theca cells in the ovary to produce androgens (which are converted to estrogen by granulosa cells) or on Leydig cells in the testes to produce testosterone. The combination of both gonadotropins more closely mimics the body's natural signaling compared to FSH-only preparations.

Part 02 · Dosing & administration

How it's taken.

Values below describe how HMG has been administered in published trials and labeling. Provided for educational purposes only — this is not medical advice and not instructions for self-administration. Consult your healthcare provider before making any health decision.

Standard dose

75-150 IU for male fertility; 75-450 IU for ovarian stimulation

Intramuscular or Subcutaneous injection · Daily or per fertility protocol

Duration

Per fertility protocol (typically days to weeks per cycle)

FDA-approved (Menopur). Contains equal FSH and LH activity. Used under close medical supervision for fertility. Ovarian hyperstimulation syndrome (OHSS) is a serious risk in women.

Need help with reconstitution?

Use the free peptide calculator for dilution, unit conversion, and injection volume.

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Part 03 · Safety

Side effects, rare serious events, who shouldn't.

Reported side effects

In women: ovarian hyperstimulation syndrome (OHSS), multiple pregnancies, ovarian torsion, injection site reactions, bloating, mood changes, and headache. In men: gynecomastia, acne, and injection site reactions. Rare: thromboembolic events, allergic reactions.

Absolute · do not use

Hormone-sensitive cancers

Pregnancy (except under specific fertility protocols)

Known hypersensitivity to HMG, urinary-derived gonadotropins, or any component

Undiagnosed uterine bleeding

Ovarian cysts or enlargement not due to PCOS

Primary ovarian failure or primary testicular failure

Adrenal or thyroid dysfunction (must be corrected first)

Interactions

Clomiphene citrate

Often used in combination for fertility but increases risk of ovarian hyperstimulation syndrome (OHSS)

Moderate

GnRH agonists/antagonists

Used together in controlled ovarian stimulation protocols; requires careful timing and monitoring

Moderate

Anticoagulants

OHSS risk includes thromboembolic events; anticoagulation management may need adjustment

Moderate

Labs to monitor

Estradiol (E2)

Baseline and during stimulation cycles

HMG contains FSH and LH activity — stimulates estrogen production

Total and Free Testosterone

Baseline and per protocol

LH component stimulates testosterone

FSH and LH

Baseline

Baseline gonadotropin levels and response monitoring

Semen Analysis

Baseline and at 3-6 months

If used for male fertility

Pelvic Ultrasound

Per fertility protocol

Monitor follicular development in women (if applicable)

CMP (Comprehensive Metabolic Panel)

Baseline

General metabolic safety

Part 04 · Evidence

How strong is the evidence?

Scores derived from rating, indexed studies, regulatory status, and catalogued safety data for this peptide. Curated per-peptide scoring replaces this when available.

Grade B

Grade B. Evidence is strongest where indications match regulatory approval — pair with a clinician when applying beyond label.

Clinical efficacy

Rating reflects consistent peer-reviewed evidence in its indication.

Study quality

2 indexed studies in our dataset. Designs vary — see Research log for per-study grades.

Regulatory clarity

FDA-approved for at least one indication.

Safety profile

Based on 7 documented contraindications, 3 interactions, 6 lab checkpoints.

Long-term data

Years of post-approval surveillance available.

Part 05 · Research log

Every study we cite.

Each study with its published finding and a plain-language note on limitations or funding.

2011

HMG versus recombinant FSH for ovarian stimulation

HMG and rFSH showed comparable efficacy for IVF outcomes; HMG may have slight benefit in live birth rates

Cochrane meta-analysis; high-quality evidence

PMID 21975736 ↗

2013

Gonadotropin therapy for male infertility

HMG combined with HCG restored spermatogenesis in most hypogonadotropic men

Well-established clinical practice; multiple supporting studies

Part 06 · Cost & access

Where you can get it.

Regulatory status

HMG is FDA-approved for the treatment of infertility. Menopur (menotropins) is the primary branded product available in the United States. It requires a prescription and is typically administered under the supervision of a reproductive endocrinologist.

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Part 07 · Your appointment

Questions to bring.

Is HMG or recombinant FSH more appropriate for my fertility treatment?

What monitoring (ultrasound, estradiol levels) is needed during HMG treatment?

What is my risk of ovarian hyperstimulation syndrome with HMG?

How does HMG compare to HCG for male fertility purposes?

What is the expected timeline for spermatogenesis recovery with HMG?

Are there risks of multiple pregnancies with HMG-based protocols?