Testosterone versus clomiphene citrate in managing symptoms of hypogonadism in men

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I could not see clomid dosages used. This makes a big difference, as we now no too much zuclomiphene causes inverse effects. According to Dr Saya, this does not seem to happen in the low-dose patients they see, which appears to be consistent with other doctors now using lower dose clomid. Too bad enclomiphene is being held up, at least last I heard. This is an important tool for diagnosing younger men and/or boosting borderline TT levels that don’t warrant full replacement. Either way, nothing works as good as testosterone supplementation since you get a guaranteed bell curve of androgens after administration. Testosterone versus clomiphene citrate in managing symptoms of hypogonadism in men Pranav Dadhich1, Ranjith Ramasamy2, Jason Scovell1, Nathan Wilken1, Larry Lipshultz1 1 Scott Department of Urology, Baylor College of Medicine, Houston, USA 2 Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA

Introduction

Both clomiphene citrate (CC) and testosterone supplementation therapy (TST) are effective treatments for men with hypogonadism. We sought to compare changes in symptoms and treatment efficacy in hypogonadal men before and after receiving CC and TST.

Patients and Methods

52 men who received TST and 23 men who received CC for symptomatic hypogonadism were prospectively followed for change in hormone levels and symptoms after treatment. These men were also compared to eugonadal men who were not on CC or TST during the same period. Comparisons were made between baseline and posttreatment hormone levels and symptoms. Symptoms were evaluated using the androgen deficiency in aging male (ADAM) and quantitative ADAM (qADAM) questionnaires.

Results

Serum total testosterone increased from pretreatment levels in all men (P < 0.05), regardless of therapy type (TST: 281–541 ng/dL, CC: 235.5–438 ng/dL). Men taking TST reported fewer ADAM symptoms after treatment (5–2,P < 0.05). Similarly, men taking CC reported fewer ADAM symptoms after treatment (3.5–1.5,P < 0.05). Conversely, eugonadal men had similar T levels (352 vs. 364 ng/dL) and hypogonadal symptoms (1.5 vs. 1.4) before and after follow-up. When we evaluated individual symptoms, men treated with TST showed significant increases in qADAM scores in libido, erectile function, and sports performance. However, among the men who received CC, qADAM subscore for libido was lower following treatment (3.75–3.2,P = 0.04), indicating that CC could have an adverse effect on libido in hypogonadal men.

Conclusions

Both TST and CC are effective medications in treating hypogonadism; however, our study indicates that TST is more effective in raising serum testosterone levels and improving hypogonadal symptoms. CC remains a viable treatment modality for hypogonadal men but its adverse effect on libido warrant further study.