Clomid ( clomiphene) for Men: What Every Man Needs to Know

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Andy Peloquin

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Clomid (generic name: clomiphene citrate) is a medication commonly prescribed to treat infertility in women. It stimulates hormone production in the female body, promoting ovulation (the growth and release of a mature, viable egg to be fertilized). It's one of the most common female infertility drugs, but did you know that it can be used as a replacement for testosterone? Clomiphene is used for men who are unable to continue with testosterone replacement therapy (TRT) or who want to attempt to jumpstart their testosterone production.

When patients suffer negative side effects as a result of TRT, doctors will usually recommend that they stop taking testosterone and other androgen hormones. However, this only deals with the immediate problem (the side effects) without considering the hypogonadal state the body returns to after you cease the testosterone therapy.

One of the primary problems that affect people coming off of TRT includes Hypothalamic-Pituitary-Testicular Axis (HPTA) dysfunction. HPTA dysfunction basically means that the testosterone supplementation has prevented your body from releasing testosterone on its own. The treatment reduced Luteinizing Hormone (LH), suppressed follicle stimulating hormone (FSH) levels, and caused reduced spermatogenesis (reduction in the production of sperm).

HPTA dysfunction is a problem that affects those on TRT, but for those coming off TRT, the HPTA dysfunction can become even more pronounced. The patients may once again suffer symptoms of hypogonadism (fatigue, low libido, ED, low mood, etc), and the symptoms can last for weeks or even for months at a time. Some men use anabolic steroids to increase their muscle mass, but all that mass will be lost as a result of ceasing these agents that, like TRT, also affect the HPTA. If a specific medical protocol isn't followed to normalize HPTA, it can lead to long-term hypogonadism.

But that's where Clomid (clomiphene) comes in:

Taking Clomid (clomiphene) has proven to help increase testosterone levels in men--both normal men and those suffering from hypogonadism. In one study, Clomid helped to increase not only testosterone levels but also the levels of upstream hormones LH and FSH. Sexual function didn't improve as a result of the medication, but it did combat some of the other negative side effects of hypogonadism.

A Potential Solution

A unique protocol by Dr. Michael Sally may help with HPTA normalization and reduce the negative side effects that set in after ceasing TRT. The protocol involves the use of:

- Clomid -clomiphene (25 mg taken orally, 1 time per day)
- HCG (2,500 IU taken subcutaneously, once every two days)
- Tamoxifen (20 mg taken orally, once every day)

This protocol is divided into two intervals, with each interval focusing on a different aspect of the post-TRT recovery.

Interval 1 is designed to restore gonadal function to normal, healthy levels. Once the gonadal function is normalized, the body is ready to move on to the next phase.
Interval 2 is designed to restore the hormone production pathways in the gonads, the hypothalamus, and the pituitary gland. Basically, it's designed to jump-start the normal production of hormones in lieu of the TRT.

While this protocol has yet to be tested on a large number of patients, it has proven effective in those few cases. It helped to restore normal HPTA within 1 month, encouraging the body to produce its own hormones and getting gonadal function back on track.

Note: Several doctors use 25 mg/day instead of 50 mg/day to minimize side effects.

Proof that Clomid (clomiphene) Could Work

One study from 2013 examined the use of clomiphene for men to help restore normal hormone function among men who have had exogenous (outside) testosterone administered--via TRT.

Note: This is an off-label use for Clomid. Your doctor may hesitate to consider it as a treatment option.

The study compared the use of Clomid to the function of topical testosterone, positing?? that it could be a potential alternative to improving hormone production in the body. To analyze the effects of the Clomid, researchers measured:

- Total testosterone levels
- Estradiol levels
- Levels of FSH and LH
- Amount of sex hormone-binding globulin in the blood
- Thyroid stimulation hormone
- IGF-1
- Prolactin
- Free testosterone

At the same time, the researchers measured sperm parameters. This was to determine if the Clomid treatment had any effect on fertility, not just testosterone levels.

Six months after the 12 patients in the study stopped taking the topical testosterone and began the treatment of Clomid, the men's total testosterone levels had risen from 100-220 pg/dL to 285-810 pg/dL--a 400% increase in some cases (I do not like exclamation points) Clomid failed to increase the levels of FSH and LH (really?), but it raised the sperm counts of the men undergoing the treatment, even after six months. However, this was only the case with Clomid, rather than the topical testosterone gel treatment.

The results of this study speak for themselves: Clomid can be a viable alternative to hypogonadal men who are looking for a treatment other than topical testosterone.

The men who underwent Clomid treatment experienced a sharp rise in their sperm count and total testosterone levels. While their FSH and LH levels didn't increase, the Clomid treatment helped to restore almost-normal testosterone in the blood. The treatment helped to normalize HPTA, reducing the side effects of coming off TRT.

If you are noticing negative side effects of TRT and are looking for another safe option, it may be a good idea to consider Clomid. It provides a viable alternative to those who are trying to combat hypogonadism but are unable to continue taking exogenous testosterone. However, it is still unclear if Clomid may improve low libido in men using it as a form of TRT.

Comments from Dr. Justin Saya:

There are certainly some challenges in treating with low dose Clomid, specifically in dealing with the varying effect (estrogen antagonist/agonist) of the two isomers enclomiphene and zuclomiphene. However, as I (and Dr. Crisler) have said many times...I SEE SUCCESS in a fair number of guys with both a good objective AND subjective (symptomatic) response. This is one of my patients. Now there are certainly many guys that do NOT respond well to Clomid for various reasons (wrong dosing, mismanagement, poor estrogen control, high SHBG, lack of response from HPTA, or just simply not tolerating the medication), but there are also many that have a good and even great response.

Admittedly, the online and forum tone is overwhelmingly negative regarding for some reason, the guys that actually do well on Clomid (you know who you are...LOL) are not as vocal as the guys who've had a negative experience. I've seen the quote many times in one form or another as a matter of fact statement: "Clomid will get your T levels up, but you won't feel it...or you won't feel better". Indeed, there are guys that feel good and even great on Clomid, from my estimation anywhere from 30-50% of the guys (especially under 40yo) that I treat. It does, however, take PATIENCE and I think this is where some guys give up too quickly, possibly partly due to the negative bias that they had already formed from their "expectations" of Clomid not working for anyone. For a younger guy (or even oldest guy on Clomid is 58yo and has had a GREAT response...he doesn't want to come off!) that can or wants to stimulate his endogenous testosterone production, maintain OPTIMAL fertility, and buy himself precious years of natural production before having to rely on TRT - Clomid can be a perfect treatment for these guys!

After all, if it fails then the TRT option is always there as a backup plan."

I am trying to save many of you time in searching important information in key posts. Here is a list of good posts related to Clomid (clomiphene). This drug is used for fertility issues. Some doctors prescribe it to increase testosterone. Many patients report not feeling the same benefits with Clomid as they do with testosterone. A pharmaceutical company will seek approval of a Clomid compound in a year as a treatment for low testosterone. It will be interesting how this will end up!!

Anastrozole needs to be added to 17% of men taking Clomid

Clomid to Reset Hormonal Axis After Anabolic Steroids

Getting OFF testosterone questions

Feel awful-clomid not working

Clomid and Cialis

Clomid vs hcg

PCT post TRT....

How to Stop Testosterone Safely and Possibly Reset Your Hormonal Axis

Men with low T report similar satisfaction on Clomid as they do on testosterone replacement

Clomid (clomiphene) Increases Testosterone and Sperm Count in Men

Repros says FDA seeks more studies for clomiphene drug

clomiphene mode of action.jpg
clomiphene men.jpg

Here are some references for people to show their physicians who may need information about clomiphene.

Clomiphene studies are linked as follows:

1. Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel

Clomiphene citrate is safe and effective for long-term management of hypogonadism. - PubMed - NCBI

Outcomes of clomiphene citrate treatment in young hypogonadal men. - PubMed - NCBI

Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacy and treatment cost. - PubMed - NCBI

5. Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?

6. Hypogonadism, ADAM, and hormone replacement
Hypogonadism, ADAM, and hormone replacement
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