Doping in Power Athletes: Why hCG?

The 50-game suspension handed down yesterday to the LA Dodgers' power hitter Manny Ramirez brings another performance-enhancing drug to public attention: human chorionic gonadotropin, or hCG. Best known as the hormone assayed in urine or serum to confirm early pregnancy, hCG is used to treat infertility in women by stimulating ovulation (eg, Pregnyl; Organon). In men, the substance is also injected to treat infertility or to reverse hypogonadism; the hormone stimulates the testicular Leydig cells to produce testosterone.

But because hCG is less efficient than anabolic steroids for increasing muscle mass,* it is most likely injected by power athletes to treat androgen-induced hypogonadism, either during or after a course of anabolic steroids. The substance, consequently, is an indirect indicator of steroid abuse.

In healthy males, hCG normally occurs at low, but measurable, levels in serum or urine, and serum assays are sensitive. However, most doping surveillance tests are performed on urine, and the suitability of the assay in this context has not been defined, according to a recent report. No matter for Manny. His penalty for hCG doping was reportedly based on evidence in his medical files, not on a positive drug test, according to the NYT.

* hCG is also more expensive than anabolic steroids, but what does that matter to an MLB player.

Image of chorionic gonadotropin preparation from APP Pharmaceuticals.