Best Post Cycle Therapy (PCT): 100% T Recovery Within 45 Days

Post cycle therapy (PCT) is the phase when a bodybuilder utilizes medication(s) to restore endogenous (natural) testosterone production.

Anabolic steroids impair HPT (hypothalamic–pituitary–testicular) axis function, as the body detects excessively high serum testosterone levels.

Consequently, the body signals to cease testosterone production in a bid to keep homeostasis, by inhibiting GnRH (Gonadotropin-releasing hormone).

This decreases the release of LH (luteinizing hormone) and FSH (follicle-stimulating hormone) — two hormones crucial for testosterone synthesis.

Thus, when a bodybuilder comes off steroids and exogenous testosterone is removed, natural testosterone often becomes shut down.

This can result in various psychological and physiological side effects. The most common we see are:

• Decreased well-being
• Low libido
• Erectile dysfunction
• Catabolism (muscle loss)
• Decreased sperm count
• Testicular atrophy

The severity of the above effects depends on the anabolic steroids used, the dosages and the length of a cycle.

We find that low testosterone can persist for several weeks or months post-cycle, increasing the likelihood of addiction, due to strong withdrawal symptoms lingering.

The aim of a PCT is to dramatically shorten this process, thus accelerating the recovery of natural testosterone production. Bodybuilders at our clinic typically utilize any or all of the following medications:

• Clomid (clomiphene)
• Nolvadex (tamoxifen)
• HCG (human chorionic gonadotropin)

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Best PCT Protocol

Dr. Michael Scally is one of the leading medical experts in hormone therapy, having specialist knowledge in regard to ASIH (anabolic steroid-induced hypogonadism).

After treating hundreds of patients, Dr. Scally developed a PCT protocol that was used in a clinical report to treat 19 healthy men. All of these men had extremely suppressed testosterone levels, as a result of using Testosterone and Deca Durabolin for 12 weeks.

The following protocol successfully treated 100% of the male subjects, bringing their serum testosterone back to normal levels (within 45 days). This is quite a feat, considering it is common for bodybuilders to experience low testosterone for up to 4 months, following a steroid cycle.

• hCG – 2000IU administered every other day for 20 days
• Tamoxifen (nolvadex) – 2 x 20mg for 45 days
• Clomiphene (clomid) – 2 x 50mg for 30 days

The above post cycle therapy plan should be viewed as aggressive. Thus, if potent AAS are used, it is necessary and very effective in our experience.

However, if milder steroids are used (such as Anavar, Primobolan or Turinabol), testosterone levels may only be moderately suppressed (rather than completely shut down).

In this case, all three of these PCT medications taken simultaneously may not be necessary; as we have seen one or two of these drugs produce great results.

The timing of a PCT is crucial in regards to its effectiveness. If began too early, we often see it being ineffective, due to exogenous testosterone still being present in the body. If started too late, the body will have already entered a catabolic state, with withdrawal symptoms already occurring.

The timing of a PCT should be tailored to the half-life of the steroid(s) taken. If users are taking multiple AAS simultaneously, then a PCT should begin after the last compound clears out of the body i.e. the slowest.

Here is a guide so users know when to start their PCT:

Clomid

Clomid is a SERM (selective estrogen receptor modulator), often prescribed to women as a fertility drug, acting as an ovulatory stimulant.

Clomid increases the secretion of gonadotropins (LH and FSH), via the inhibition of estrogen in various tissues, leading to an increase in endogenous testosterone.

Despite blocking estrogenic effects in many parts of the body, our tests have shown Clomid to increase estrogen activity in the liver, causing a positive shift in cholesterol levels. This is particularly useful in regulating blood lipids and easing cardiovascular strain in our patients post-cycle.

Clomid Side Effects

Our patients have reported of visual changes occurring on Clomid, when they have taken it in high doses.

This includes flashes or blurring; however, these are often temporary and subside within a few days/weeks post-cycle.

It is unknown what causes such alterations in vision. In very rare cases, such side effects have the potential to be irreversible, but we are yet to see this happen. If such changes start to occur, users should discontinue Clomid supplementation immediately and visit an ophthalmologist for urgent examination.

More common side effects of Clomid, in our experience, include:

• Flushes
• Abdominal discomfort
• Nausea
• Headaches
• Liver stress
• Impaired eyesight

Nolvadex

Nolvadex (tamoxifen citrate) is a SERM, commonly prescribed to women with breast cancer, and is regarded as one of the main reasons why the mortality rate for breast-cancer sufferers has significantly dropped in the last decade.

Nolvadex was first synthesized in 1962 and initially prescribed to treat female infertility.

However, it was later observed to have anti-mitogenic effects, reducing the stimulation of breast tissue — beneficial for slowing the growth of breast cancer.

Nolvadex also exhibited cancer-killing properties, due to the blocking of protein kinase C (PKC) via oxidative stress mechanisms (1).

Bodybuilders who see us commonly use Nolvadex to prevent the onset of gynecomastia (accumulation of breast tissue).

As a PCT, Nolvadex works in the same way as Clomid, stimulating LH and FSH production, via the inhibition of estrogen’s negative effects in the hypothalamus (and thus restoring the HPTA axis).

Nolvadex Side Effects

• Skin rash
• Hot flashes
• Decreased white blood cell count
• Visual disturbances
• Blood clots (deep vein thrombosis)
• Liver stress

Uterine sarcoma and endometrial cancer have been linked with Nolvadex use; however, the risk is very low, being approximately 1 in 500 cases (2). Such side effects are also correlated with long-term use (more than 2 years). This is not something we have seen in our clinic as of yet.

HCG

HCG (human chorionic gonadotropin) is a hormone produced by women in high quantities in the early stages of pregnancy, facilitating an increase in progesterone, helping to nurture the developing fetus and its surrounding environment (preventing miscarriage).

We have found that hCG taken post-cycle elevates luteinizing hormone (LH) levels, stimulating the Leydig cells to produce more endogenous testosterone.

HCG has not only been used in the treatment of male hypogonadism but also obesity. It was previously believed that hCG may have a stimulating effect on T3 levels; however, we have not seen this in our testing.

However, we have found hCG to have appetite suppressant effects, meaning people can eat very low-calorie diets, without feeling excessive hunger.

In 1957, hCG became the most prescribed medication for weight loss, due to this powerful (yet indirect) effect on satiety.

Thus, hCG may be particularly beneficial after a cutting cycle to minimize any potential weight gain following steroids.

We have found HCG to be the most effective post-cycle therapy medication for treating testicular atrophy (shrinkage), due to its spermatogenesis-inducing effects.

PCT for Women

Post-cycle therapy is often deemed unnecessary for women, which may stem from them having smaller quantities of endogenous testosterone.

As with men, women’s endogenous testosterone production will also shut down, due to the body detecting an excess of this male hormone.

In our experience, testosterone remains a crucial hormone in females; greatly affecting their libido, well-being, energy and muscle mass.

We see that when testosterone declines, estrogen also drops significantly, due to less aromatization (conversion of testosterone into estrogen).

Dave Crossland also has anecdotal evidence of female steroid users experiencing: very low estrogen levels, low mood, diminished libido and depression post-cycle (3).

Nolvadex has been used as a PCT among women, in a dose range of 5-15mg for up to 4 weeks. Many of our female patients are reporting this to have a positive effect on their mood and consequently have accelerated their hormonal recovery.

However, we find that a few women still experience 3+ month delays before their menstrual cycles return.

HCG is not an optimal PCT medication for women, with it potentially causing virilization and enlargement of the ovaries. Clomid may also not be optimal due to ovarian hypersensitivity.

The medical treatment for women deficient in androgens is DHEA (dehydroepiandrosterone), which is one of the most critical hormones in females — being a key precursor of androgen and estrogen synthesis (4).

One study found that 50mg/day of DHEA ‘significantly increased’ libido in women over 70 years old when taken for 1 year (5).

Another study found that a 6-week cycle of DHEA improved sexual function in women, including arousal, orgasm quality and libido (6). They also found that depression symptoms decreased by 50%, significantly improving mood.

These women took 90mg/day of DHEA for the first 3 weeks, followed by 450mg/day of DHEA for the remaining 3 weeks.

Other research (Morales et al. 1994) has shown that 50mg/day of DHEA when administered for 3 months, improves well-being in women by 82% (7). They also reported: greater relaxation, improved sleep, less stress and higher energy levels.

Thus, an effective post-cycle therapy for women in our experience is:

• 50mg/day of DHEA for 12 weeks.

FAQs

Is a PCT essential?

A post-cycle therapy is not essential, as natural testosterone levels will eventually recover.

However, a better question may be: ‘Is a PCT optimal?‘. The answer to this is yes, as not only will users retain more of their gains from a cycle, but they will also improve their mental and sexual health.

A PCT may be deemed less essential when taking mild AAS, such as Anavar, as we only see moderate declines in endogenous testosterone.

Research correlates with our findings, showing a moderate reduction of 45% when taking 20-40mg/day for 12 weeks (8).

How Do I Know If I Need a PCT?

The most accurate way to know if you need a PCT is to get your testosterone levels checked.

However, if you have reasons for not wanting to see a doctor, you can often tell from the following signs:

• Depression
• Low libido
• Testicular atrophy (shrinkage)

Where Do Bodybuilders Buy PCT Medications?

Bodybuilders will either make an appointment with a doctor and hope they will be prescribed necessary PCT medications, or they will purchase them on the black market (in the same way they buy anabolic steroids).

The second method involves asking around and finding a source where you can pay with cash, or by making a payment online (which is riskier if entering your card details).

How Much Do PCT Medications Cost?

A reliable supplier of anabolic steroids has provided us with the UK market price for PCT drugs. We have done a rough conversion into dollars for our American readers. 

• Clomid 50 (50mg) tablets – £35 / $49
• Tamoxifen (Nolvadex) 50 (20mg) tablets – £35 / $49
• HCG 11,000iu –  £54 / $75

Do SARMS Require a PCT?

Selective androgen receptor modulators (SARMs) are suppressive, in our experience, thus a PCT is necessary. However, the severity of the decline in testosterone will determine the PCT protocol and how aggressive it should be.

As with steroids, we see certain SARMs causing greater declines in endogenous testosterone than others.

However, as a general rule if users take one SARM, stick to a low to moderate dosage and cycle it for 8 weeks or less — only a moderate decline in testosterone is likely to occur.

In this case, 3 weeks of Nolvadex will be sufficient in bringing endogenous testosterone levels back to normal, with 30mg/day taken for week 1, 20mg/day for week 2 and 10mg/day for week 3.

If slightly higher dosages are taken or/and lengthier cycles are utilized, Nolvadex can be taken for 4 weeks, starting on 40mg for week 1, then decreasing the dosage by 10mg each week for the remaining 3 weeks.

For a high-dosed SARM cycle, a 4-week Nolvadex PCT may be necessary, being: 40mg/day during weeks 1 and 2, then 20mg/day during week 3 and 4.

We have seen some individuals take risks with SARMs i.e. stacking several compounds together, such as combining Ostarine, RAD-40 and LGD-4033 in excessively long cycles, lasting 12-16 weeks. In this case, we find that a more drastic PCT protocol is needed, being Dr. Michael Scally’s combination of:

• hCG – 2000IU administered every other day for 20 days
• Tamoxifen (nolvadex) – 2 x 20mg for 45 days
• Clomiphene (clomid) – 2 x 50mg for 30 days

Note: Some people mistake certain compounds as SARMs, such as Cardarine and MK-677. These are not SARMs, and thus do not require a PCT, with Cardarine being a Peroxisome Proliferator Activator Receptor (PPAR-delta) and MK-677 a growth hormone secretagogue. Both of these products are not suppressive in our experience.

How Much Muscle Will a PCT Help Keep?

We have seen effective PCTs help retain up to 80% of lean muscle gains from a cycle.

Mild compounds, such as Anavar or Primobolan, may enable users to retain high amounts of muscle tissue. This is because our tests show less dramatic peaks in exogenous testosterone levels on-cycle (and thus less endogenous shutdown).

Note: It is normal to lose some weight when coming off steroids, particularly when utilizing wet, bulking compounds; with users losing some intracellular and extracellular fluid (that previously accumulated due to high estrogen levels). This should not be confused with losing muscle weight.

PCT Diet & Supplementation

A person’s diet can also help to increase testosterone and anabolism post-cycle.

Our consultant, Dr. George Touliatos, has found eating a diet rich in meat and egg yolks to be an effective protocol, with cholesterol being a steroid hormone that synthesizes testosterone. Research has also found a link between higher HDL levels and high testosterone in males (9).

Dr. Touliatos also states that ZMA, D-aspartic acid, Tribulus Terrestris, maca and vitamin D3 supplements can help to maximize natural testosterone production.

PCT Pros and Cons

Pros:

• Increases testosterone production (10,11)
• Improves well-being
• Enhances energy
• Helps to retain lean muscle
• Increases testicular size
• Increases libido and erection quality
• Improves fertility (12)
• Affordable

Cons:

• More expense (on top of steroids)
• Some medications come with side effects (in sensitive users)

Co Authors :

Dr. Thomas O'Connor MD, PA

For TRT enquiries, please contact Dr. O’Connor via the Anabolic Doc App.

Over the last 20 years, Dr. O’Connor has successfully treated thousands of men who have taken anabolic steroids, SARMs and other PEDs (giving him first-hand experience of their effects). Board certified MD since 2005.

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