CLOMID FOR LOW TESTOSTERONE

WHY IS MY DOCTOR PRESCRIBING ME CLOMID FOR LOW TESTOSTERONE?

NovaGenix May 25^th, 2022

We all know that the testosterone levels in men begin to decrease slowly over time. When men reach their mid-20's a shift begins to take place and hormone levels in men on average will start to decline between 1 and 2% annually. There are many other possible causes of Low T in men. Factors such as genetics, age, medications and other medical factors like diabetes, obesity or cancer are all examples of things that could cause a disruption to the endocrine system causing male andropause.For men over 50 years old with low testosterone levels, there are many well documented benefits to raising T levels to within optimal ranges. Being able to fight the symptoms of low testosterone can include improving libido, fatigue, mood, ED/PE issues, Weight gain, muscle loss, improved sleep and more. There are various protocols to offer individual patients regarding their hormone replacement therapy. Testosterone supplementation can be done in many forms including compounded cream/gels, patches, pellets and most prescribed are injections. Typically compounded testosterone cypionate from a licensed US pharmacy is prescribed however other forms of testosterone are available. The physician in the patient will determine which type of testosterone delivery is best suited as well as the dose and frequency.

How can you increase testosterone?It is important to speak with an experienced physician who can help test for low testosterone and thus accurately diagnose and potentially treat. An experienced TRT physician will be nuanced in helping a patient reach an optimal hormone balance which addresses both blood test results for hormone levels, as well as the signs and symptoms of hypogonadism.For selected men with secondary hypogonadism, a clinician may consider a medication that stimulates endogenous testosterone production. This requires evaluation of symptoms, repeat morning testosterone measurements, LH/FSH and fertility goals. Both clomiphene citrate (clomid) and enclomiphene are popular medications for TRT protocols. Since the recent regulatory changes regarding hCG, enclomiphene/clomid have become popular to replace human chorionic gonadotropin. Clomiphene citrate contains enclomiphene and zuclomiphene, while enclomiphene is the isolated trans-isomer. They are not interchangeable medications; their composition, regulatory status and evidence differ. Low dosing of enclomiphene is effective in raising serum testosterone levels and helping balance the testosterone/estrogen ratio in males who have hypogonadism.Clomid stimulates the androgen production pathway which is why it can be an effective medication for TRT. Clomiphene citrate (Clomid) is FDA-approved for ovulatory dysfunction in women who desire pregnancy. Its use for low testosterone or infertility in men is off-label. Enclomiphene is not an FDA-approved standalone drug in the United States. A clinician should explain the status, evidence, risks and monitoring for any medication considered. Clomiphene is not a routine safeguard against the adverse effects of exogenous testosterone and should not be added to TRT automatically.

How to know if you have low testosterone?The hypothalamic pituitary testicular axis, or HPTA is a cycle that detects hormone levels in the blood and then regulates them by releasing other hormones from the hypothalamus and pituitary to stimulate testosterone production. Adding clomiphene or hCG to TRT does not guarantee preservation of sperm production, fertility or testicular size. Exogenous testosterone can suppress LH, FSH and spermatogenesis.Clomid works by blocking estrogen at both the hypothalamus and pituitary. Estrogen disrupts the releasing of luteinizing hormone, or LH which stimulates the testes to produce testosterone. Some testosterone gets converted into estradiol and by blocking estrogen at the hypothalamus and pituitary, the pituitary continues to produce LH which continues to stimulate sperm and testosterone production in the testes.

Testosterone Replacement Therapy with clomid

Clomiphene should not be assumed to be a necessary adjunct to testosterone replacement therapy protocols. For some patients it's even used as a mono-therapy. It may be considered off-label for selected men with secondary hypogonadism or infertility, but benefits and adverse effects vary. The AUA/ASRM guideline advises against exogenous testosterone therapy in men interested in current or future fertility, and the Endocrine Society recommends against starting testosterone when near-term fertility is planned. Evidence for adding medications to testosterone to preserve spermatogenesis is too limited to recommend that strategy as a reliable fertility-preservation approach. It is also taken as a pill or capsule making it more convenient than subcutaneous injections.Most patients will begin to see the benefits of Clomid after a few weeks of taking the medication. Many factors can determine the effectiveness of a TRT protocol such as original testosterone levels, genetics, age, lifestyle choices, other medication etc. Neither clomiphene nor hCG is universally the best choice; they act differently and should be selected according to the diagnosis and treatment goal. Many clinics are prescribing Gonadorelin for TRT, an injectable medication, however that medication is not convenient for a typical TRT patient as it would require multiple daily injections to do what hCG or Clomid can.Prescription decisions require individualized evaluation. Men seeking pregnancy should discuss semen analysis and reproductive-urology evaluation rather than relying on serum testosterone alone. If you would like to learn more about how we can help test, diagnose and treat you for low testosterone and discuss options regarding TRT with clomid, or hCG, please feel free to fill out our new patient intake form and we will be able to schedule a physician consultation with you. Call or text us at (561) 277-8260 or email us at info@novagenix.org to schedule an appointment of find out more information.

Frequently asked questions

"How long does it take for Clomid to increase testosterone?"

It varies for every patient but typically it will take a few weeks before serum testosterone levels are elevated.

"Does Clomid increase testosterone?"

It can increase testosterone in selected responsive men. Sperm production and fertility are not guaranteed and require separate evaluation.

"How much will clomid raise testosterone?"

It will be different for every patient so it's important to have blood work pre and post starting clomid to see how much of an increase in testosterone production each individual will have. For patients looking to maintain testicular function and optimize their testosterone levels, clomid may be a great option.

"How often do I take clomid?"

There is no single dosing schedule appropriate for every man. Follow the prescribing clinician's individualized instructions and monitoring plan; do not adjust prescription treatment from an online article.

609 North Hepburn Ave Suite 106, Jupiter, Florida 33458web: www.NovaGenix.org Phone: 561-277-8260 email: info@novagenix.org

Sources for these corrections

• FDA Clomid prescribing information: approved indication
• AUA/ASRM Male Infertility Guideline, amended 2024
• Endocrine Society testosterone guideline

Educational information only. Medication selection and fertility care require individualized clinical evaluation.

Compare the options and plan your evaluation

Read our hCG vs. Clomid comparison and TRT and fertility guide to understand the different treatment goals. To discuss your own history and laboratory results, request a consultation.