Post Cycle Therapy

If you’ve taken anabolic steroids (AAS) or related substances such as prohormones or SARMs, post-cycle therapy (PCT) is usually recommended to help your body restart its natural hormone production and reduce the risk of side-effects.

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Why PCT is often advised

Anabolic steroids or similar drugs suppress your body’s natural testosterone production.
When you stop taking them, your hormone levels can drop sharply, leading to symptoms such as:

• Low mood, anxiety or fatigue
• Reduced libido and erectile issues
• Muscle loss and weight gain
• Poor sleep or low motivation

PCT helps your body re-stimulate natural hormone release, particularly testosterone, and reduces how long those symptoms last.

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When PCT is essential

You should always consider PCT if:

• You’ve completed a steroid or SARM “cycle” of several weeks or months
• You experience symptoms of low testosterone afterwards
• You plan not to use steroids again soon and want to restore natural hormone balance

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When to seek medical advice first

You should not start PCT without professional guidance. Harley Street MD and other reputable UK hormone clinics strongly recommend:

• Seeing a doctor experienced in men’s hormone health (for example, an endocrinologist or a clinic such as Harley Street Medical Doctors)
• Having blood tests first: testosterone, LH, FSH, oestradiol, prolactin, and liver/kidney markers, to guide any treatment safely
• Receiving prescription-only medication (e.g. Clomiphene or Tamoxifen) under supervision; these are not safe to self-source or use without oversight

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The bottom line

If you’ve used anabolic steroids, post-cycle therapy is usually beneficial and often necessary, but it must be done under medical supervision. Self-medicating or skipping recovery treatment can lead to long-term hormonal suppression, fertility problems, or mood and sexual health issues.

Step One – Initial Medical Consultation

• Book an appointment with a doctor experienced in men’s hormone health, ideally someone familiar with anabolic-steroid recovery or endocrinology.
• During this consultation, the doctor will take a full medical history, including:
  • What substances were used (type, dosage, duration)
  • Any side-effects during or after the cycle
  • Symptoms such as fatigue, libido changes, or mood changes
• They’ll also discuss lifestyle factors — sleep, stress, nutrition, alcohol use, and mental health — all of which can affect hormone recovery.

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Step Two – Baseline Blood Tests

Before starting any PCT, a blood test panel is essential.

Typical tests include:

Hormones (to assess suppression and guide treatment)

• Total Testosterone
• Free Testosterone
• Luteinising Hormone (LH)
• Follicle-Stimulating Hormone (FSH)
• Oestradiol (E2)
• Sex Hormone Binding Globulin (SHBG)
• Prolactin

General health (to check for organ strain from previous steroid use)

• Full Blood Count
• Liver Function Tests
• Kidney Function (Urea, Creatinine, eGFR)

Metabolic markers (to assess cardiovascular and metabolic risk)

• Fasting Glucose
• HbA1c
• Lipid Profile

Optional (further hormone balance assessment)

• Cortisol
• DHEA-S
• Thyroid profile

Your doctor will interpret these results and decide whether your natural testosterone production is recovering or needs support.

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Step Three – PCT Plan Design

If PCT is needed, your doctor may prescribe a custom protocol such as:

• Selective Oestrogen Receptor Modulators (SERMs) — e.g. Clomiphene citrate (Clomid) or Tamoxifen (Nolvadex), to stimulate LH and FSH and restart testosterone production
• Occasionally aromatase inhibitors (AIs) — e.g. Anastrozole — to reduce oestrogen if levels rebound too high
• The protocol usually lasts 4–6 weeks, sometimes longer depending on blood results and previous cycle type
• Lifestyle guidance alongside medication: adequate sleep, nutrition, reduced alcohol, stress management, and a gradual return to exercise

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Step Four – Monitoring During Recovery

• Repeat blood tests are typically done at 4–6 weeks, and again at 8–12 weeks post-cycle
• Your doctor will track how testosterone, LH, and FSH are responding
• If recovery is slow or symptoms persist, adjustments may be made (e.g. extending the SERM course or exploring alternative support)

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Step Five – Long-Term Follow-Up

• Some men recover fully within a few months; others take longer, particularly after long or heavy steroid use
• If natural testosterone remains low beyond 3–6 months, your clinician may discuss further options such as testosterone replacement therapy (TRT), but only after careful evaluation
• Ongoing follow-up ensures stable hormone levels, fertility potential, and overall health

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Important Safety Points

• Do not self-medicate with PCT drugs bought online — they are often counterfeit or incorrectly dosed
• Medical supervision is essential — PCT drugs affect hormone and liver function, and blood tests are needed to track progress safely
• PCT does not make steroid use safe, but it can reduce harm and support recovery
• If you experience low mood, anxiety, or sexual dysfunction after stopping steroids, speak to your GP — psychological support may also help recovery

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Summary

Stage 1 – Medical consultation

• Review steroid use and symptoms
• Purpose: plan a safe pathway

Stage 2 – Baseline blood tests

• Check hormone and organ health
• Purpose: establish recovery need

Stage 3 – Personalised PCT plan

• SERMs ± AIs plus lifestyle plan
• Purpose: restart testosterone production

Stage 4 – Monitoring

• Follow-up blood tests at 4–12 weeks
• Purpose: ensure hormones recover

Stage 5 – Long-term follow-up

• Assess lasting recovery
• Purpose: maintain wellbeing and fertility

Important reminders

• These timings are general guidelines — recovery can take longer after prolonged or high-dose steroid use.
• Always use prescription medicines under medical supervision and confirm progress with blood tests.
• Lifestyle factors (sleep, nutrition, alcohol intake, stress) can speed up or slow down recovery.
• If you still feel low or have persistent symptoms after a few months, your doctor can check for ongoing suppression or discuss options like testosterone replacement therapy (TRT).

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Timeframe and Recovery Expectations

Week 0–2 (After last steroid dose)

What’s happening in the body
Synthetic hormones are still present in your system; your natural testosterone production is still “switched off.”

Typical medical actions
Wait for the substances to clear (depends on their half-life). Doctor may schedule initial blood tests.

What you might notice
You might feel flat, low energy, mild mood dip, libido changes.

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Week 2–6 (Active PCT phase)

What’s happening in the body
PCT medication (usually Clomiphene or Tamoxifen) stimulates the pituitary gland to release LH & FSH, signalling the testes to restart testosterone production.

Typical medical actions
Begin prescribed SERM protocol; monitor for side-effects. Support with good nutrition, rest, and hydration.

What you might notice
Gradual improvement in mood, energy, and libido. Some fluctuations are normal.

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Week 6–8

What’s happening in the body
Natural testosterone starts to rise; oestradiol balance begins to normalise.

Typical medical actions
Repeat blood tests to check hormone recovery (Testosterone, LH, FSH, Oestradiol). Adjust or continue therapy if needed.

What you might notice
Strength and motivation improving; mood stabilising.

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Week 8–12

What’s happening in the body
The hypothalamic–pituitary–gonadal (HPG) axis is recovering.

Typical medical actions
Doctor may taper off medication and reassess.

What you might notice
Most men feel closer to baseline, though some fatigue or minor mood swings may remain.

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3–6 months post-cycle

What’s happening in the body
Hormones stabilise naturally (in most men). Fertility, libido, and energy should return to pre-cycle levels if recovery is complete.

Typical medical actions
Long-term follow-up bloods to ensure stable hormones. If testosterone remains low, further medical review may be needed.

What you might notice
Feeling normal again; sustained energy and libido.

1. Early phase (first 1–2 weeks)

As the anabolic steroids or SARMs leave your system and before your own testosterone fully restarts, you might experience temporary “low-testosterone” symptoms, such as:

• Tiredness or low energy
• Mood swings, mild irritability, or low mood
• Decreased libido or reduced erectile function
• Poor sleep or vivid dreams
• Slight muscle loss or water weight change
• Reduced motivation in the gym

These effects are usually short-lived and tend to ease as PCT medication begins to work.

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2. During active PCT (weeks 2–6)

When medications such as Clomiphene (Clomid) or Tamoxifen (Nolvadex) are used, you might notice:

• Headache or mild nausea
• Hot flushes or flushing of the face
• Temporary visual sensitivity (rare, usually mild and short-term)
• Mood fluctuations (feeling more emotional or restless)
• Slight breast or nipple tenderness (if oestrogen briefly rises before settling)

These side-effects are usually manageable and monitored by your doctor. Always tell your clinician if symptoms are strong or persistent.

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3. Later phase (weeks 6–12 and beyond)

As your natural testosterone starts to recover, most men report:

• Gradual return of libido and sexual function
• Improved mood, energy and sleep
• Steadier weight and muscle retention
• Better concentration and motivation

However, if symptoms of low testosterone persist — for example:

• Ongoing fatigue or low mood
• Continued sexual dysfunction
• Poor gym recovery or muscle loss

Then follow-up blood tests are needed. Occasionally, some men’s natural production doesn’t fully recover, and further treatment may be required (for example, a longer PCT course or evaluation for testosterone replacement therapy).

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When to contact your doctor urgently

While most PCT symptoms are mild, seek medical advice promptly if you notice:

• Visual disturbances (e.g. flashing lights, blurred vision)
• Persistent or severe mood changes, depression, or anxiety
• Severe headache, abdominal pain, or swelling
• Painful or swollen breast tissue
• Any new or unexplained symptoms

At Harley Street MD, we advise that yes, in certain situations, PCT is strongly recommended. Some of the reasons include:

• If you have taken high doses of anabolic steroids, or for a prolonged period, the suppression of natural testosterone and hormonal imbalance may be substantial.
• If, after stopping steroid use, a person develops symptoms such as low libido, erectile dysfunction, mood changes, fatigue, or disturbed sleep. These may be signs that hormone levels need support.
• To reduce the risk of longer-term complications of hormone suppression (for example, fertility impairment, muscle loss, or mood issues).
• If you’ve used anabolic steroids or other major performance-enhancing hormones and you want your body’s natural hormone production to recover properly, then yes: PCT is strongly advised.
• It is not optional in the sense of “just skipping it and hoping everything will go back to normal quickly” — recovery can be slow, symptoms uncomfortable, muscle gains lost, and health risks increased. Harley Street MD notes recovery might take up to four months or more without PCT.

However, PCT must be done safely, under medical supervision, with proper blood tests, monitoring, and adjustment of protocol.

If you haven’t used the kind of drugs that cause significant hormone suppression, PCT as defined may not be relevant, but you should still monitor your health.

Thus, while PCT isn’t something we advocate for everyone who has ever used a steroid, in the context of significant steroid use or potential harm, Harley Street MD treats PCT as part of a harm-reduction strategy.

PCT isn’t “one size fits all”

At Harley Street MD, doctors emphasise that every individual’s hormone recovery is different.

After using anabolic steroids or other performance-enhancing drugs (PEDs), your body’s natural testosterone production is often suppressed. The degree of suppression depends on:

• The type and dose of steroids used
• The length of the cycle
• Your age, genetics, and baseline hormone levels

Without proper blood testing, you simply can’t know how suppressed your hormones are — or what your body actually needs to recover.

“Post Cycle Therapy should always be personalised, guided by laboratory tests and medical expertise.”
— Harley Street MD, London

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2. Self-treating can make things worse

Many people try to do PCT using advice from forums or YouTube, but Harley Street MD warns that this can backfire:

• Using the wrong medication or wrong dose can prolong hormone imbalance
• Some PCT drugs (such as SERMs or aromatase inhibitors) can cause side effects like vision issues, mood swings, or further hormone disruption if misused
• Over-the-counter “test boosters” often don’t contain clinically effective ingredients, or may even be contaminated

Without medical supervision, you could end up worsening symptoms like fatigue, low libido, or mood changes — and delay recovery even further.

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3. Medical monitoring is key

A proper doctor-supervised PCT at Harley Street MD includes:

• Comprehensive blood tests: testosterone, LH, FSH, oestradiol, prolactin, liver and kidney function
• A tailored treatment plan: selecting the right medication, dose, and duration for your recovery
• Follow-up monitoring: ensuring hormones are returning to healthy ranges
• Supportive advice: on sleep, nutrition, stress, and supplements that help restore balance naturally

This careful approach helps you recover faster, safely, and with fewer long-term risks.

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In summary

While it may be tempting to “DIY” your PCT to save time or money, doing it without medical supervision can be unsafe. Harley Street MD’s position is clear:

“PCT should always be carried out under the care of a GMC-registered doctor experienced in hormone management and post-steroid recovery.”

So — can you technically do it on your own?

Yes, in the same way you could technically pull your own tooth — but it’s not safe, not predictable, and not recommended. The medical approach gives you the best chance of restoring natural hormone balance and avoiding long-term health issues.

If you do not do PCT, your body may eventually restore testosterone production — but:

• It will likely take longer
• You may feel unwell in the meantime
• There’s a risk that your levels don’t fully recover

PCT doesn’t “magically boost” hormones; it simply helps kickstart your body’s natural recovery safely and more efficiently, under medical supervision.

At Harley Street MD, we suggest:

1. Blood testing to assess your hormone levels after your cycle.
2. Consultation with a GMC-registered specialist to decide whether you need PCT.
3. Avoiding self-medication — every PCT should be tailored to your results and overall health.

“With proper monitoring and support, most men can restore healthy hormone balance — but skipping PCT makes that recovery slower and less certain.”
— Harley Street MD, London

At Harley Street MD, PCT is always tailored to the individual.
The right medications, doses, and duration depend on:

• What substances were used (type of steroids, dose, duration)
• Blood test results (testosterone, LH, FSH, oestradiol, prolactin, etc.)
• Symptoms and overall health

So the medicines below are examples of what may be prescribed in a clinically supervised setting — not a self-treatment plan.

Medication examples used in supervised PCT

Selective Oestrogen Receptor Modulators (SERMs)

• Examples: Clomiphene, Tamoxifen
• Main purpose: Stimulate LH and FSH to restart natural testosterone production

Aromatase Inhibitors (AIs)

• Examples: Anastrozole, Letrozole, Exemestane
• Main purpose: Control oestrogen rebound during recovery

Human Chorionic Gonadotropin (hCG)

• Example: Human Chorionic Gonadotropin
• Main purpose: Reactivate the testes before or early in PCT

Supplements and Lifestyle Support

• Examples: Zinc, Vitamin D, nutrition optimisation
• Main purpose: Support natural hormone recovery and overall wellbeing

In short:
You should start PCT only once the external anabolic steroids or performance-enhancing drugs (PEDs) have cleared from your system — not while they’re still active.

The exact timing depends on what you’ve used, because different substances stay in your body for different lengths of time.

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Why timing matters

• If you start PCT too early — while synthetic hormones are still circulating — your body won’t respond properly to the medication.
• If you start too late — after weeks of hormone suppression — your recovery may be slower and symptoms worse.

That’s why Harley Street MD always check blood tests first and tailor the start time to your individual case.

Typical timelines (doctor-guided)
Below is a general guide based on the type of steroid used:

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Short-acting oral steroids

• Examples: Dianabol, Anavar, Winstrol, Anadrol
• Typical wait before PCT: 2–3 days after last dose
• Why: These compounds clear quickly from your system

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Short-acting injectable steroids

• Examples: Testosterone propionate, Nandrolone phenylpropionate
• Typical wait before PCT: 3–5 days
• Why: Still relatively fast-clearing injectables

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Long-acting injectable steroids

• Examples: Testosterone enanthate, Testosterone cypionate, Decanoate esters
• Typical wait before PCT: 10–14 days
• Why: These take longer to leave the body

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Mixed-ester blends

• Examples: Sustanon, Omnadren
• Typical wait before PCT: Around 3 weeks
• Why: Longest release — needs more time before PCT starts

Again, these are approximate. Harley Street MD would always confirm the correct timing with blood tests, checking when testosterone and oestradiol levels begin to fall.

At Harley Street MD, doctors always emphasise that while Post Cycle Therapy (PCT) can be very helpful in restoring hormone balance after anabolic steroid use, it’s not risk-free.
Every medication used in PCT has potential side effects, especially if taken without medical supervision.

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1. Hormonal fluctuations

When you stop steroids and start PCT, your body’s hormones are in transition.
Even with medical guidance, you may experience:

• Mood swings or irritability
• Fatigue or low motivation
• Changes in libido (can go up or down temporarily)
• Sleep disturbance

These are usually short-term, but they can be distressing if you’re not expecting them.

“Your hormones are adjusting — that’s part of recovery. We monitor and support you through it.”
— Harley Street MD, London

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2. Medication-specific side effects

A. SERMs (Clomiphene, Tamoxifen)

These are the most common PCT medicines and generally safe under supervision — but can cause:

• Headaches or visual disturbances (blurred or spotty vision)
• Nausea or abdominal discomfort
• Hot flushes
• Mood changes or irritability
• Rarely, temporary changes in liver enzymes (which is why blood tests are important)

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B. Aromatase Inhibitors (Anastrozole, Letrozole, Exemestane)

Used to control oestrogen levels — but if oestrogen is suppressed too much, you can develop:

• Joint pain or stiffness
• Low mood or anxiety
• Reduced libido
• Bone density loss if overused

This is why Harley Street MD stresses precise dosing based on blood results, not guesswork.

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C. hCG (Human Chorionic Gonadotropin)

Sometimes used to “re-activate” the testes, especially after longer steroid cycles.
Possible risks include:

• Water retention or bloating
• Acne or oily skin
• Raised oestrogen levels (if used excessively)
• Testicular discomfort or temporary enlargement

Doctors often combine hCG with an aromatase inhibitor to keep hormone levels balanced.

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3. Incomplete recovery

Without proper guidance or follow-up blood testing, testosterone levels may remain below normal even after PCT.
This can result in:

• Ongoing fatigue
• Low mood
• Sexual dysfunction

That’s why Harley Street MD re-tests hormones several weeks after completing PCT to ensure recovery is on track.

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4. Fertility changes

After steroid use, sperm count and quality can drop significantly.
PCT helps restart sperm production, but if done incorrectly — or skipped entirely — fertility may remain impaired.

In some cases, specialist monitoring and fertility-specific medications may be required.

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5. General risks if unsupervised

If PCT drugs are taken from unverified sources or without medical review, risks include:

• Contaminated or counterfeit medications
• Incorrect dosing (too weak to help, or too strong and harmful)
• Missed underlying health issues (e.g. thyroid or pituitary problems mistaken for “slow recovery”)

“We often see patients who tried to self-medicate and ended up feeling worse — not because PCT doesn’t work, but because it was done unsafely.”
— Harley Street MD, London

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Summary of risks and how they’re managed

Mood or libido changes

• Cause: Hormonal fluctuation
• Prevention/management: Regular monitoring and reassurance

Headaches or vision changes

• Cause: SERM-related side effects
• Prevention/management: Dose adjustment or medication change

Joint pain or low mood

• Cause: Over-suppression of oestrogen
• Prevention/management: Blood test–guided dosing

Water retention or gynaecomastia

• Cause: hCG-related oestrogen rise
• Prevention/management: Add low-dose aromatase inhibitor if needed

Ongoing low testosterone

• Cause: Incomplete recovery
• Prevention/management: Follow-up blood tests

Fertility issues

• Cause: Prolonged hormone suppression
• Prevention/management: Early medical intervention

Serious harm from fake medications

• Cause: Unverified products
• Prevention/management: Always use prescribed, pharmacy-issued medication

Phase: Early
Timeframe: Weeks 1–4
What to expect: Energy and libido begin to improve

Phase: Stabilisation
Timeframe: Weeks 5–8
What to expect: Hormones balancing, mood and vitality return

Phase: Recovery
Timeframe: Weeks 9–12
What to expect: Hormone levels normalise, symptoms resolve

Phase: Longer-term
Timeframe: 3–6 months
What to expect: Full recovery for heavier or longer cycles

“With proper medical support, most men start to feel better within the first month and reach stable hormone balance within 2–3 months. The key is careful monitoring and patience.”
— Harley Street MD, London