Clomid for 2nd hypogonad with low E2

[Quantium]

Hi!

I have both low T and thus low E2. Both somewhat lower than most ranges. This is caused by my low LH.

I keep reading about how some doctors want to try clomid on 2nd hypogonadal males. However, something doesn’t add up for me....

Clomid works by blocking the hypothalamus’ estrogen receptors, which will make gnrh production ramp up because the body believes it is low on esttrogen as a sub-effect of having low T.

My question is: Why would this help if I’m already low on estrogen?? My receptors should already be emptyish and my gnrh production should already be stimulated!

Where am i wrong here?

In advance, thanks!

 

[BryanW]

Your understanding of Clomid is not correct; Clomiphene can act as both an estrogen agonist, and an antagonist.

source

"[FONT=&quot]Clomiphene citrate works as an estrogen antagonist at the level of the pituitary gland and thus stimulates the release of LH and FSH, which in turn drives both the steroidogenic and spermatogenic functions of the testes."[/FONT]

 

[Quantium]

Your understanding of Clomid is not correct; Clomiphene can act as both an estrogen agonist, and an antagonist.

source

"Clomiphene citrate works as an estrogen antagonist at the level of the pituitary gland and thus stimulates the release of LH and FSH, which in turn drives both the steroidogenic and spermatogenic functions of the testes."

Thanks for the answer!

I know that, though.. I don't see where I am wrong. Could you elaborate?

 

[Vince Carter]

By stimulating the testes thru Clomid > LH/FSH production you end up with Estrogen problems because of this, the Aromatase in the testes. The few Clomid guys we do have are typically failures because, 1, they're dosed to high...50/D or even 25/D is too much, and 2, consequently the Estrogen goes way up and out of control. Its the direct stim of the testes that causes this, you get both T, and E.

 

[BryanW]

For each estrogen receptor an antagonist occupies, that is one less receptor for an estrogen to activate. The net effect is to make your estrogen level appear lower than it actually is, thereby stimulating more LH.

 

[BryanW]

By the way, I've been on 15 mg of Clomid every day for around 11 months. My total testosterone went from 400 to 700 ng/dl, and improvement in strength and sexual function was very pronounced.

 

[Quantium]

For each estrogen receptor an antagonist occupies, that is one less receptor for an estrogen to activate. The net effect is to make your estrogen level appear lower than it actually is, thereby stimulating more LH.

I know this.. My theory was that for someone who already HAS low estrogen, said receptors wouldn't be filled anyway! Filling the receptors with clomid should theoretically do nothing if there wasn't any estrogen to fill the receptors to begin with..

Thanks for your testimonial, btw!

 

[Quantium]

By stimulating the testes thru Clomid > LH/FSH production you end up with Estrogen problems because of this, the Aromatase in the testes. The few Clomid guys we do have are typically failures because, 1, they're dosed to high...50/D or even 25/D is too much, and 2, consequently the Estrogen goes way up and out of control. Its the direct stim of the testes that causes this, you get both T, and E.

Thanks, I am generally not attracted to using clomid, because of the several side effects. I'd rather take hcg or trt, to be honest.. But I need to know what to say if my endocrinologist says she wants to try clomid.

 

[BryanW]

I know this.. My theory was that for someone who already HAS low estrogen, said receptors wouldn't be filled anyway! Filling the receptors with clomid should theoretically do nothing if there wasn't any estrogen to fill the receptors to begin with..

I think that theory only holds if a person had zero estrogen to begin with.

 

[Quantium]

I think that theory only holds if a person had zero estrogen to begin with.

Sure.
That said, if the cause of my low LH is caused by filled estrogen receptors, even with low estrogen, it would have to mean that my hypothalamus is somehow SUPER sensitive to filled estrogen receptors.. Which seems odd..

 

[BryanW]

Thanks, I am generally not attracted to using clomid, because of the several side effects. I'd rather take hcg or trt, to be honest.. But I need to know what to say if my endocrinologist says she wants to try clomid.

I'd tell her that you only agree to try if she starts you out at a very low dose (something like 12.5 mg ED, or 25 mg EOD), and you reserve the right to stop at any time if you don't feel any better (or feel worse).

For what it's worth, in my case I wanted to try the easy road of taking a pill before committing to a lifetime of injections.

 

[madman]

Hi!

I have both low T and thus low E2. Both somewhat lower than most ranges. This is caused by my low LH.

I keep reading about how some doctors want to try clomid on 2nd hypogonadal males. However, something doesn't add up for me....

Clomid works by blocking the hypothalamus' estrogen receptors, which will make gnrh production ramp up because the body believes it is low on esttrogen as a sub-effect of having low T.

My question is: Why would this help if I'm already low on estrogen?? My receptors should already be emptyish and my gnrh production should already be stimulated!

Where am i wrong here?

In advance, thanks!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155868/

 

[Vince]

I know this.. My theory was that for someone who already HAS low estrogen, said receptors wouldn't be filled anyway! Filling the receptors with clomid should theoretically do nothing if there wasn't any estrogen to fill the receptors to begin with..

Thanks for your testimonial, btw!

I had very low estradiol levels before starting trt, for me it was probably a gift. I've never had to be concerned or worried about having high estradiol levels which has made my TRT experience that much better.

 

[lowe2sucks]

https://www.excelmale.com/forum/showthread.php?14562-Is-it-normal-to-feel-this-on-clomid

Took 25mg each day for the first 4 days but then decided to drop it to 12.5mg per day.

I currently feel like I'm run down, it's a feeling similar to when you crash your E2 with too much of an AI but not quite as extreme of a feeling.
Achy bones/joints would be a similar description.

Just wondering if this is a normal side effect?

 

[Kirk001]

By the way, I've been on 15 mg of Clomid every day for around 11 months. My total testosterone went from 400 to 700 ng/dl, and improvement in strength and sexual function was very pronounced.

Nice. Never heard of that dosing, do you get your meds through a compounding pharmacy? Any estradiol issues or other side effects?

 

[BryanW]

Nice. Never heard of that dosing, do you get your meds through a compounding pharmacy? Any estradiol issues or other side effects?

Yes I get my script from a compounding pharmacy. I'm a patient with Defy; not sure why Dr. Calkins went with 15 mg instead of 12.5. Maybe because of my weight (210#)?

My E2 has increased as my testosterone has gone up, but the number seems reasonable and I haven't noticed any E2 related side effects. Granted I started from a very low E2 level since I'm a low SHBG guy.

Before I started Clomid, I specifically requested that they not compound an AI into the Clomid; I wanted to give my hormones some time to equilibrate before determining if I need/want to start an AI.

 

[Quantium]

Yes I get my script from a compounding pharmacy. I'm a patient with Defy; not sure why Dr. Calkins went with 15 mg instead of 12.5. Maybe because of my weight (210#)?

My E2 has increased as my testosterone has gone up, but the number seems reasonable and I haven't noticed any E2 related side effects. Granted I started from a very low E2 level since I'm a low SHBG guy.

Before I started Clomid, I specifically requested that they not compound an AI into the Clomid; I wanted to give my hormones some time to equilibrate before determining if I need/want to start an AI.

"...very low E2 level since I'm a low SHBG guy."

Are E2 and SHBG levels correlated?

 

[BryanW]

"...very low E2 level since I'm a low SHBG guy."

Are E2 and SHBG levels correlated?

I have no idea. I could be completely wrong, so here is my very simple thought process; low SHBG results in higher clearance rate of testosterone, which limits the available pool from which E2 can aromatize. And any E2 that is aromatized would have a similarly high clearance rate.

 

[Vince]

Having low estradiol levels does that mean you're a low shbg guy. I've always had low estradiol levels but never low shbg.