Macimorelin

Leuprolide (brand name Lupron) is a synthetic GnRH agonist, a modified peptide far more potent than natural GnRH, and it is FDA-approved for advanced prostate cancer, endometriosis, uterine fibroids, and central precocious puberty. The clever part is counterintuitive: it works by overstimulating the GnRH system so hard that the pituitary shuts down sex hormone production. It is a real, long-established prescription drug (first US approval 1985), not a research peptide, and it carries meaningful side effects from the low-hormone state it creates.

Octreotide is a synthetic eight-amino-acid mimic of the natural hormone somatostatin, the body's main 'off switch' for hormone secretion. It shuts down excess growth hormone, so it is a frontline FDA-approved drug for acromegaly, and it also tames the flushing and diarrhea of hormone-secreting carcinoid and other neuroendocrine tumors. This is real, approved medicine with decades of clinical data behind it, sold as Sandostatin (injectable, since 1988), Sandostatin LAR (monthly depot), and Mycapssa (oral capsule, approved 2020).

Lanreotide (development code BIM-23014) is an eight-amino-acid somatostatin analog, a close cousin of octreotide, given as a long-acting deep-injection gel (Somatuline Depot/Autogel) usually once a month. The FDA approved it for acromegaly in 2007, for gastroenteropancreatic neuroendocrine tumors in 2014, and for carcinoid syndrome in 2017. Generic versions now exist alongside Ipsen's Somatuline Depot. It is established prescription medicine, not an experimental compound.

Pegvisomant (brand name Somavert) flips the usual acromegaly strategy on its head: instead of telling the tumor to make less growth hormone, it blocks growth hormone's receptor on target tissues directly. It is a PEGylated, genetically modified version of human growth hormone that acts as a receptor antagonist, FDA-approved in 2003 for acromegaly patients who do not respond well to surgery or other drugs. It is the single most effective option for normalizing IGF-1, which is why it is a key second-line therapy.

HMG (human menopausal gonadotropin, sold as menotropins under the brand Menopur) is a purified hormone mix extracted from the urine of postmenopausal women. Each standard vial carries 75 IU of FSH activity and 75 IU of LH activity, with most of the LH activity coming from hCG. It is an FDA-approved fertility drug used to stimulate egg development in IVF, and it is also used, mostly off-label in the US, together with hCG to kick-start sperm production in men whose pituitary does not make enough FSH and LH. This one has decades of real clinical use behind it.

Triptorelin is a synthetic analog of gonadotropin-releasing hormone (GnRH) with a D-tryptophan swapped in at position 6, which makes it far more potent and longer-lasting than the natural hormone. As a long-acting depot it is FDA-approved to shut down testosterone in advanced prostate cancer (Trelstar) and to pause early puberty in children (Triptodur), and in Europe it is sold as Decapeptyl, including a short-acting 0.1 mg form used in IVF. In men's health circles it is known for something else: a single small dose used to 'restart' testosterone after steroid use. That idea rests on very little published evidence.