HMG (human menopausal gonadotropin)

HMG (human menopausal gonadotropin) is a gonadotropin preparation that provides follicle-stimulating hormone (FSH)– and luteinizing hormone (LH)–like activity. It has long-standing use in regulated reproductive and endocrine medicine.

In some catalogs and informal materials, HMG is also discussed in broader hormone-related or performance-oriented contexts, which may diverge from evidence-based fertility indications and local regulations.

HMG contains gonadotropin activity that can:

• Stimulate ovarian follicular development through FSH-like actions
• Support ovulation and sex-steroid production via LH-like actions
• Influence testicular function and spermatogenesis in certain male endocrine contexts

The net effects depend on baseline endocrine status, concomitant therapies, and the carefully structured protocols used in reproductive medicine.

In regulated care, HMG may be used in specific fertility and endocrine indications, such as controlled ovarian stimulation under specialist supervision. Precise indications, eligibility criteria, and labeling vary by product and jurisdiction.

Outside such settings, discussion of HMG in performance or non-fertility contexts should be approached cautiously. Use that diverges from evidence-based protocols can carry additional legal, ethical, and safety considerations.

This section has to open with a qualification. "hMG" and "menotropins" do not appear anywhere in the text or index of the 2026 WADA Prohibited List. That is not the same as being permitted, and understanding why matters more here than on any of the individually named peptides.

The listing works at the level of the hormone, not the product. Sub-section S2.2.1, headed "Testosterone-stimulating peptides in males," names four things: "chorionic gonadotrophin (CG)," "luteinizing hormone (LH)," GnRH and its agonist analogues, and kisspeptin and its agonist analogues. Human menopausal gonadotropin is not a novel molecule — it is a urinary preparation defined by the gonadotropin activities it delivers. The FDA-approved label for one such product states that "each vial of MENOPUR contains 75 International Units of follicle-stimulating hormone (FSH) activity and 75 International Units of luteinizing hormone (LH) activity," and, separately and explicitly, that "Human Chorionic Gonadotropin (hCG) is detected in MENOPUR" (MENOPUR prescribing information, DailyMed). Two of the four things S2.2.1 names are therefore in the vial by the manufacturer's own account. A male athlete administering hMG is administering LH activity and hCG, both prohibited by name.

What is not covered. Follicle-stimulating hormone is not named anywhere in S2.2 or elsewhere on the 2026 List, and this reference has not found a basis for treating FSH activity on its own as prohibited. The prohibition here rests on the LH and CG content, not on the FSH content — which is also why the restriction is scoped to males. As with the rest of S2.2.1, hMG's coverage follows the heading "in males"; it does not apply on this basis to female athletes.

The detection question, answered carefully. This reference found no published doping-control method, controlled administration study, or reference-range paper specific to hMG or menotropins in athletes. Anyone claiming a specific detection window for hMG is going beyond the published literature.

The absence of a published detection method has not prevented enforcement. In the highest-profile case involving this substance, the Court of Arbitration for Sport in May 2025 dismissed Colombian cyclist Miguel Ángel López's appeal and upheld a four-year suspension (25 July 2023 – 24 July 2027) for the use and possession of menotropin around the 2022 Giro d'Italia (International Testing Agency). The case was built on evidence gathered in a criminal investigation rather than on an adverse analytical finding, which is the practical point for readers: a substance can be unlisted by brand name and lack a published assay, and a violation can still be established through possession, records, and testimony. What can be said is narrower and still consequential: the analyte WADA laboratories actually measure in male urine for this category is intact hCG, against a numeric decision limit — historically "> 5 IU/L" (Kuuranne et al., Drug Test Anal 2013), with more recent reference-interval work in 570 male urine samples recommending "a threshold of 1.0 IU/L for intact hCG" (Butch et al., Drug Test Anal 2018). Since the product label confirms hCG is present in hMG, that routine test is looking for a substance the preparation contains. The magnitude and duration of any resulting urinary hCG elevation after hMG administration has not, as far as this reference can establish, been characterised in published athlete data — so it should be treated as an uncharacterised risk rather than a quantified one. See hCG for how that threshold test works.

Because hMG has genuine approved fertility and endocrine indications, a clinically indicated use in a male athlete runs through the therapeutic use exemption process, applied for in advance through the relevant anti-doping organization. Athletes in any doubt about a specific product should ask their anti-doping organization directly rather than reasoning from the absence of a product name on the List — the List is written in hormones, not brand names.

Reported risks and side effects can include ovarian hyperstimulation syndrome (OHSS), multiple pregnancy in fertility contexts, local injection-site reactions, and hormone-related symptoms such as bloating, mood changes, or breast tenderness.

Because outcomes depend heavily on patient selection, monitoring, and protocol design, decisions belong with clinicians experienced in reproductive or endocrine medicine.

HMG (Menotropin) contains both FSH and LH activity (1:1 ratio) and is used to stimulate follicle development or spermatogenesis.

This information is based on standard fertility clinic protocols.

Menotropin products are supplied as lyophilized vials reconstituted with a provided diluent and standardized by biological activity in international units rather than by mass, because the preparation is a mixture of glycoprotein isoforms whose potency cannot be read off a weight. Highly purified formulations such as Menopur are urine-derived and carry both FSH and LH activity; recombinant alternatives supply FSH alone, and produce a measurably different serum profile of FSH, androgens, and estradiol (PMID 30264288).

HMG is a component of a sequence rather than a standalone treatment. It drives follicular growth over the stimulation phase, and a separate LH-like agent — usually hCG — supplies the terminal surge that matures and releases the eggs. The Menopur label permits co-administration with a urinary FSH product and specifies that only the total dose is counted, which reflects the same activity-based accounting. In male gonadotropin deficiency the pairing runs the other way, with an FSH source added to hCG; pooled data across 41 studies found the combination outperformed hCG alone on every sperm threshold measured (PMID 39445789).

HMG has been studied in a range of fertility and endocrine indications, with outcomes that include ovulation rates, pregnancy rates, and endocrine marker changes. Over time, protocols and product choices have evolved alongside newer agents and refinement of assisted reproductive technologies.

Interpretation of HMG data requires close attention to study design, populations, and comparators. High-level summaries like this are not a substitute for specialized fertility guidelines or primary research.

For deeper dives on this peptide, see:

• HMG (human menopausal gonadotropin) benefits and areas of interest
• HMG (human menopausal gonadotropin) side effects and safety context
• HMG (human menopausal gonadotropin) dosing concepts (educational)
• HMG (human menopausal gonadotropin) research and evidence overview

Is HMG an approved medicine? Yes. Menopur (menotropins for injection) carries an FDA-approved indication for development of multiple follicles and pregnancy in ovulatory women as part of an assisted reproductive technology cycle, with an initial U.S. approval date of 1975 (DailyMed).

What makes HMG different from recombinant FSH? It carries LH activity as well as FSH activity, which changes the endocrine profile it produces. In practice the comparison is more nuanced than "more hormones is better": Menopur matched recombinant FSH on pregnancy rates in IVF/ICSI despite yielding fewer oocytes, improved some aspects of embryo quality in IVF but not ICSI, and was associated with a less pronounced follicular response and a lower risk of ovarian overstimulation (PMID 30264288).

Why does the label list so many warnings? Because the drug's therapeutic effect and its hazards sit on the same axis. Menopur carries nine numbered warnings — abnormal ovarian enlargement, OHSS, pulmonary and vascular complications, ovarian torsion, multi-fetal gestation and birth, congenital malformation, ectopic pregnancy, spontaneous abortion, and ovarian neoplasms — and OHSS also appears among the reactions occurring in 2% or more of ART cycles. It is Pregnancy Category X.

Is HMG used in men? Off-label, yes — as the FSH arm alongside hCG in gonadotropin deficiency. Across 41 studies and 1,673 men, combined hCG/FSH beat hCG monotherapy on mean sperm output and every concentration threshold, despite similar effects on testosterone and testicular volume (PMID 39445789).

Why is there no simple "HMG dose"? The label defines a starting dose plus adjustment rules — a minimum interval before changing, a maximum step size, and a daily ceiling — because the actual dose is titrated against ultrasound follicle counts and serum estradiol. See the dosing page.