Enclomiphene - Dose / Frequency / Follow Up Labs?

[ResearchIt]

I am starting a trial of enclomiphene. 12.5mg twice a week. Sunday morning and Wednesday evening to evenly split up the dose.

The reason I am trialing enclomiphene is to see if it will raise my Free T and whether this will result in an improvement of my symptoms. I am 43, fit, healthy, never have been on TRT, no drugs, no alcohol, no porn, but about 1.5 years ago morning and spontaneous erections stopped happening with regularity, erection quality diminished a bit, and sensitivity decreased.

I have normal range Total T (usually 600-800) and all my other labs look good too, except for lower range Free T and higher range SHBG.

Do you think a dose of 12.5mg twice a week is enough to have a positive effect on my symptoms for someone with my age and background? Or do you think every other day would be better?

How long after taking enclomiphene would you wait before doing a full set of labs again? 1 week, 2 weeks, etc?

Any other tips, suggestions, or considerations given what I am trying to accomplish? Thanks!

 

[aneuman]

ResearchIt,​

I'm 59. I understand exactly where you're coming from, as I experience similar symptoms. I've been on enclomiphene 12.5mg every day sin January (6 months approx) and it started working very quickly. My T levels went from 300 to 780 in a less than month, however, sorry to say that none of the symptoms you mentioned have improved.

Enclomiphene is "Selective Estrogen Receptor Modulator", which means that it selectively blocks certain estrogen receptor inhibiting negative feedback and the pituitary/hypothalamus level, thus increasing the release of gonadotropins (LH and FSH) ergo instructing the testicles to produce more testosterone. Problem is, what other receptors does it block? What happens when these receptors are blocked? What is the effect of blocking those receptors in the Hypothalamus/Pituitary for a long time? What happens when LH and FSH are abnormally elevated for a long time? The human body has the nasty tendency to find homeostasis (balance) and we don't know what the body will do with such imbalance and and what mechanisms it will use to correct it. I'm not sure I'd recommend you going that route given your T levels are adequately healthy, but I've been where you are and I totally understand the need to do something. There may be other reasons in your case why this is happening, and you will get many suggestions in this forum, 99% of which won't work. You will be asked for blood work results and offer to lower prolactin, increase dopamine, lower estradiol, increase estradiol, bring up DHEA, stay away from DHEA, take zinc, but be careful with copper, try T-Cypionate IM, no, sub-q, progesterone creams... bottom line, be careful. Feel free to try, but understand the risks involved. Wouldn't hurt to visit and honest and knowledgeable andrologist who's not running a pill mill, if such thing exists.

The only thing I can really say was a fountain of youth in every sense was HCG. Last year I started 2000 UI/week and in 3 weeks I was like 30 years old again. Orgasm, libido, erection, nocturnal erections, desire, optimistic outlook, sense of wellbeing, confidence, fuller and more sensitive penis, and yes, big balls

Unfortunately, after that honey moon which lasted about 3 or 4 weeks, things started going downhill fast, and I ended up worse off than I started. Literally, my starting T was 492, after 3 months of HCG it was 305. I felt drained. It coincided with the FDA ban on compounded HCG and my doctor switched me to Enclomiphene.

The only changes I have observed while on enclomiphene are, 1) I'm less moody, more calmed and collected and overreact less to disagreements, more accepting and also more willing to do things around the house and exercise (although there's some evidence these effects are starting to wear off) and, 2) my nipples (not the areola) are bigger and frequently hard, there's no mass under the areola, so it may or may not be gyno.

I have blood work scheduled soon and I can update the thread if requested. I also changed doctors since my previous one, although well-known and highly regarded as a top andrologist (even in this forum) does not seem to pay much attention to symptoms or even blood work (he only ordered what I asked him to do when I asked him to do it) and seemed to have the solution before he heard what the problem was, so I'll see how it goes with the new one.

 

[JRos895]

ResearchIt,​

I'm 59. I understand exactly where you're coming from, as I experience similar symptoms. I've been on enclomiphene 12.5mg every day sin January (6 months approx) and it started working very quickly. My T levels went from 300 to 780 in a less than month, however, sorry to say that none of the symptoms you mentioned have improved.

Enclomiphene is "Selective Estrogen Receptor Modulator", which means that it selectively blocks certain estrogen receptor inhibiting negative feedback and the pituitary/hypothalamus level, thus increasing the release of gonadotropins (LH and FSH) ergo instructing the testicles to produce more testosterone. Problem is, what other receptors does it block? What happens when these receptors are blocked? What is the effect of blocking those receptors in the Hypothalamus/Pituitary for a long time? What happens when LH and FSH are abnormally elevated for a long time? The human body has the nasty tendency to find homeostasis (balance) and we don't know what the body will do with such imbalance and and what mechanisms it will use to correct it. I'm not sure I'd recommend you going that route given your T levels are adequately healthy, but I've been where you are and I totally understand the need to do something. There may be other reasons in your case why this is happening, and you will get many suggestions in this forum, 99% of which won't work. You will be asked for blood work results and offer to lower prolactin, increase dopamine, lower estradiol, increase estradiol, bring up DHEA, stay away from DHEA, take zinc, but be careful with copper, try T-Cypionate IM, no, sub-q, progesterone creams... bottom line, be careful. Feel free to try, but understand the risks involved. Wouldn't hurt to visit and honest and knowledgeable andrologist who's not running a pill mill, if such thing exists.

The only thing I can really say was a fountain of youth in every sense was HCG. Last year I started 2000 UI/week and in 3 weeks I was like 30 years old again. Orgasm, libido, erection, nocturnal erections, desire, optimistic outlook, sense of wellbeing, confidence, fuller and more sensitive penis, and yes, big balls

Unfortunately, after that honey moon which lasted about 3 or 4 weeks, things started going downhill fast, and I ended up worse off than I started. Literally, my starting T was 492, after 3 months of HCG it was 305. I felt drained. It coincided with the FDA ban on compounded HCG and my doctor switched me to Enclomiphene.

The only changes I have observed while on enclomiphene are, 1) I'm less moody, more calmed and collected and overreact less to disagreements, more accepting and also more willing to do things around the house and exercise (although there's some evidence these effects are starting to wear off) and, 2) my nipples (not the areola) are bigger and frequently hard, there's no mass under the areola, so it may or may not be gyno.

I have blood work scheduled soon and I can update the thread if requested. I also changed doctors since my previous one, although well-known and highly regarded as a top andrologist (even in this forum) does not seem to pay much attention to symptoms or even blood work (he only ordered what I asked him to do when I asked him to do it) and seemed to have the solution before he heard what the problem was, so I'll see how it goes with the new one.

Who is this andrologist you are referring to?

 

[aneuman]

Who is this andrologist you are referring to?

Out of respect, and because my experience may not apply to others, I prefer not to provide any names,

 

[ResearchIt]

I'm 59. I understand exactly where you're coming from, as I experience similar symptoms. I've been on enclomiphene 12.5mg every day sin January (6 months approx) and it started working very quickly. My T levels went from 300 to 780 in a less than month, however, sorry to say that none of the symptoms you mentioned have improved.

aneuman, thanks for your reply, very helpful. It sounds like our symptoms and goals are similar. Also, if you are "the" Alfred Neuman, I have been a long time fan lol

I am about 10 days into my enclomiphene trial. My plan is to try it for 2 or 3 months to see if it increases my Free T and helps with symptoms. If not, I will discontinue using it. It's too bad it didn't provide symptom relief for you - I read that is quite common. It hasn't really for me either, but I am only 10 days in. I am keeping my fingers crossed but expectations reserved.

I agree, my T levels and other labs are not bad at all, in fact I have levels that many people target or would hope to have, but the symptoms are real unfortunately. They are definitely not psychological. Like you, I would prefer not to take enclomiphene or anything else for that matter and I am also concerned about the other known and unknown effects it has. But also, like you said, there is that desire to do something about symptoms, albeit very carefully, so here I am

I have gotten many many labs and tests done to have a solid data set to work with. I have a few more imaging tests to go. Recently I have started talking with some specialists in this area. I want to talk with many of them to make sure I collect all the good advice and hopefully actually discover what changed in me.

While science and medicine have come a long way in the last 10 or 15 years, what I am afraid of is that specialists today still really don't know the aging mechanisms in the male body well enough to identify what actually changes that causes these symptoms and what approach to take to correct them without causing other problems. I know it's complex, but I am surprised that men in science and medicine haven't figured this out already, given how important it is to them.

The human body has the nasty tendency to find homeostasis (balance) and we don't know what the body will do with such imbalance and and what mechanisms it will use to correct it.

This is the most frustrating aspect of trying to "fix things". A few approaches I tried have helped short term, but then the body seems to not let changes I introduce have an enduring effect. Instead the body adjusts to counteract what I do so that it can maintain it's new crappy homeostasis target that it has switched to for me.

The only thing I can really say was a fountain of youth in every sense was HCG. Last year I started 2000 UI/week and in 3 weeks I was like 30 years old again. Orgasm, libido, erection, nocturnal erections, desire, optimistic outlook, sense of wellbeing, confidence, fuller and more sensitive penis, and yes, big balls

That is interesting how HCG worked so well in every area that most of us are trying to improve. Too bad it's effects are short lived.

I have blood work scheduled soon and I can update the thread if requested.

Yes, that would be great if you could include your labs here on the thread. I am going to post my before and after labs here in about 4 weeks as well as provide a symptom update and any other information that might be useful to others.

 

[aneuman]

ResearchIt​

hCG was fantastic, but short-lived. There are two alternatives I've contemplated trying to explain why: 1) the dosage was too high (2000 IU/week). That is indeed the dose that has been tried in severe hypogonadal men trying to conceive, and it has worked, but a)I was not severe hypogonadal, b) I was not trying to conceive, so maybe a smaller and more frequent dosage would have worked. Unfortunately the FDA banned compounded hCG a month after I started the treatment, and since it had stopped working, the doctor switched me to Enclomiphene. Perhaps, had it not been banned, I could have worked a dosage adjustment with the doctor. 2) The quality of compounded hCG is not consistent, or I received some low quality batches.

Enclomiphene worked like magic too, but only in the chemistry department. In two weeks my T went from 300 to 700 and in a month in was close to 800. Estradiol went from 27 to 36.

The 4 points on the chart are:
Aug '21: 492 ng/dL, My natural T before starting any treatment.
Dec '21: 309 ng/dL, Low T after hCG crash my T
Feb '22: 709 ng/dL, close to 1 month after starting Enclomiphene 12.5mg ED
Mar '22: 768 ng/dL, 1.5 month after Enclomiphene

That sounds pretty good, but the only noticeable improvement was in my mood. I became more tolerant of disagreements, less "explosive", had more willingness to do things around the house.

After 6 months I'm noticing my nipples are harder and more sensitive (I've always had very flat nipples) so I'm not sure if this has to to with an increase in E2 or a decrease in T, or both. I'm having blood work soon, so we'll see. I'm still lees moody than before, but the dark clouds are visible on the horizon, my willingness to workout is still there but much less than in March this year, so if I had to reach a conclusion, I'd say the only positive is the impact of mood, at least so far, and it's started to evade me.

There's also the FDA banning of eclomiphene. I called Empower and they are still selling it, but Nelson recently posted that it has been banned as of yesterday.

At this point I'm ready to jump onto TRT, but I'd really like to give hCG another try. Maybe using Pregnyl, or some other non-compounded version, but that'll be very expensive and most insurance won't cover it, so we're talking about close to $160 a month. It's also frequently back-ordered, so continuity of treatment could be an issue.

Totally agree with you the symptoms are not psychological at all. My Journey has been long as the symptoms started when I was your age approximately. Many doctors dismissed them, I was prescribed many psychotropic drugs, because I was "depressed", or stimulants because I had ADHD. None fixed any issues, but caused other problems. I tried every supplement available (ashwagahanda, Tribulus, Fenugreek, you name it), tried meditation, changed my diet, ate more fat, less fat, good fat, all fats, no fat, no carbs, lots of carbs, etc. Exercised, nothing helped. Then came hCG and magically ALL my problems were solved at once, so it's definitely not in my head.

So I said, What? Me worry? :-D

Thanks and good luck.

A.N

 

[ResearchIt]

Alfred,

That's interesting you also started experiencing symptoms in your early 40s. Before this happened to me I would have thought these type of problems would occur much later in life since I am really quite healthy aside from this issue. I am coming to believe these problems in men are more common than we realize.

That would be a good experiment to try HCG with a lower dose. I wonder if that would provide symptom relief without shutting down the HPTA completely, since I think it does slow down the production of LH sort of like TRT does. Too bad it's not easily available anymore. I would like to include an HCG experiment in my future testing here as well.

Even though it was short lived, it is encouraging that you had such a great experience with HCG. To me that seems to say the problem is likely chemical and not physical or related to some other traditional health concern. For example, in my case, I don't have any health condition like cardiovascular issues, venous leakage, diabetes, or any of the other "at risk" factors you see out there. Your experience with HCG seems to imply that if the chemical issue is fixed everything can come back. That is very encouraging.

I have tried literally every supplement as well. Most of them did nothing and when they helped a bit, they didn't do it long term. Tongkat Ali made a significant difference immediately for all my symptoms for about 5 days and then my body adjusted back to its new crappy normal because my symptoms came back. In my experience, the only supplements that help consistently for a few specific symptoms are Yohimbine and Maca. I don't take them all the time, but when I do sensitivity and orgasm are improved. However, these supplements don't improve my other symptoms.

I've addressed everything else too, sleep, exercise, nutrition, etc, etc. It has not fixed things.

Do you think me taking enclomiphene for 2 or 3 months is long enough to determine if it will help with symptoms? Or do you believe I need to give it longer, like 6 or 9 months? I'd rather keep it short if I could. Maybe I won't have a choice if it is banned now.

If you do get on TRT, please post how your symptoms are doing. I am not ready to start it, but am very curious if it would resolve the symptoms I have.

 

[Nelson Vergel]

Just to let you guys know.

Is enclomiphene being discontinued?

I received an email from empower saying the FDA is cracking down on enclomiphene, anyone have additional information?

www.excelmale.com

 

[aneuman]

Alfred,

That's interesting you also started experiencing symptoms in your early 40s. Before this happened to me I would have thought these type of problems would occur much later in life since I am really quite healthy aside from this issue. I am coming to believe these problems in men are more common than we realize.

That would be a good experiment to try HCG with a lower dose. I wonder if that would provide symptom relief without shutting down the HPTA completely, since I think it does slow down the production of LH sort of like TRT does. Too bad it's not easily available anymore. I would like to include an HCG experiment in my future testing here as well.

Even though it was short lived, it is encouraging that you had such a great experience with HCG. To me that seems to say the problem is likely chemical and not physical or related to some other traditional health concern. For example, in my case, I don't have any health condition like cardiovascular issues, venous leakage, diabetes, or any of the other "at risk" factors you see out there. Your experience with HCG seems to imply that if the chemical issue is fixed everything can come back. That is very encouraging.

I have tried literally every supplement as well. Most of them did nothing and when they helped a bit, they didn't do it long term. Tongkat Ali made a significant difference immediately for all my symptoms for about 5 days and then my body adjusted back to its new crappy normal because my symptoms came back. In my experience, the only supplements that help consistently for a few specific symptoms are Yohimbine and Maca. I don't take them all the time, but when I do sensitivity and orgasm are improved. However, these supplements don't improve my other symptoms.

I've addressed everything else too, sleep, exercise, nutrition, etc, etc. It has not fixed things.

Do you think me taking enclomiphene for 2 or 3 months is long enough to determine if it will help with symptoms? Or do you believe I need to give it longer, like 6 or 9 months? I'd rather keep it short if I could. Maybe I won't have a choice if it is banned now.

If you do get on TRT, please post how your symptoms are doing. I am not ready to start it, but am very curious if it would resolve the symptoms I have.

It's been a long time but I'd be interested in seeing if Enclomiphene worked for you and if not, what are you doing now.