hCG vs Clomid: Which medication is best for men on testosterone therapy?

November 7, 2023

hCG or Clomid. What medication should I be on for TRT?

With recent regulatory changes, imposed by the FDA, Clomid is being more readily prescribed to patients on TRT.  What is Clomid? It’s the brand name for a medication called clomiphene citrate.  It is often prescribed to both men and women for similar reasons. Women are prescribed it when they have difficulty ovulating or regular menstrual cycles. It’s commonly used in treatment of infertility and works through stimulating the release of hormones which will trigger ovulation. It’s normally taken as a pill and is often part of a course of fertility treatments that help women become pregnant. it also is used and prescribed to men in some situations. For men, it’s sometimes used off label to treat conditions like low testosterone levels, which can impact fertility, and overall health and wellness. In some male patients Clomid can help increase testosterone and sperm production in their testes by stimulating both luteinizing hormone (LH) production and follicle stimulating hormone (FSH)release.

It is important to note that the use and prescription of Clomid and both men and women should be done under the care, guidance, and supervision of an experienced and licensed medical professional. It’s also important to assess the specific needs and reasons for low, testosterone treatment, and determine whether or not clomid would be an appropriate addition to any protocol. It’s not necessarily suitable for all patients, and the benefits and risks need to be carefully weighed out and considered on an individualized case by case basis.  

What is the difference between Clomid and enclomiphene?

Both clomiphene citrate, and enclomiphene are two closely related medications that are both used for similar reasons. Primarily they are used to stimulate ovulation in women with infertility, or to treat certain hormonal imbalances and low sperm production in men. The main difference between them is within their chemical composition.

1.     Clomid is a mixture of two isomers or chemical compounds that are called zuclomiphene and enclomiphene. Zuclomiphene is an estrogen, receptor antagonist while enclomiphene is the active compound that is responsible for the stimulation of ovulation. Climate contains both of the isomers, which means that there is a portion of it, which has estrogen blocking effects that are not related directly to its primary action of stimulating ovulation.
2.     Enclomiphene is different in the sense that it’s a purified form of the active enclomiphene isomer.  It contains only the specific compound responsible for the stimulation of ovulation does not have the estrogen blocking properties of zuclomiphene. This may potentially make it a more targeted, and potentially effective treatment for certain individuals that have infertility or hormone imbalances.  In men, It works by stimulating the body's own testosterone production in the testes by increasing the release of hormones like LH (luteinizing hormone) and FSH (follicle-stimulating hormone).

Enclomiphene for men?

Enclomiphene has been developed to be a more potentially selective and effective alternative to Clomid, with less side effects related to estrogen receptor antagonism. However, the choice between the two medications may depend on individual patient preferences, medical history, and the recommendations of an experienced healthcare provider.

The use of enclomiphene in men, like any prescription medication should be done under the careful guidance and supervision of a medical professional, typically an endocrinologist or urologist or physician, who specializes in hormone replacement therapy. It's important to assess the specific causes of low testosterone and determine if enclomiphene is an appropriate treatment option. As with all medications, individual health factors and potential risks and benefits need to be carefully considered on a case-by-case basis by the patient and physician.

What is better? hCG or Clomid?

For patient who needs to choose between hCG, (human chorionic gonadotropin), and Clomid, (clomiphene citrate), it’s important to address the risks and benefits, as well as the specific medical needs by the patient with their physician or healthcare provider.  Typically, it depends on the specific circumstances, as well as underlying cause of fertility issues or hormone imbalances in the patient. These two medications will serve very different purposes in fertility treatments or for men on TRT.

HCG, human chorionic gonadotropin, is a hormone that mimics the action of LH, otherwise known as luteinizing hormone.  For men, LH stimulates the testes to produce more testosterone as well as playing a crucial role in stimulating sperm production in men. LH is one of the hormones produced by the anterior pituitary gland, and it acts on the Leydig cells in the testes to trigger the production of testosterone in men. Testosterone, in turn, is essential for the development and maintenance of the male reproductive system, including the production of sperm. Men on TRT will often take hCG to combat side effects like testicular atrophy as well as to maintain fertility and natural function of the testes.

Sperm production, or spermatogenesis, is regulated by a complex feedback loop of hormones which involves not just LH but also follicle-stimulating hormone (FSH). FSH stimulates the Sertoli cells within the testes, which helps to support and nourish the developing sperm cells. In combination, both LH and FSH help maintain the delicate balance of hormone levels needed for the production of healthy sperm cells and fertility in men.

If there is a LH or FSH deficiency, it can lead to the disruption in sperm production and may even potentially result in fertility issues for men. Hormone imbalances and other factors may possibly affect this process, and in some cases, medical treatment like hormone replacement therapy may be used to treat such issues and improve sperm production. An experienced physician who understands testosterone therapy can help, or a fertility specialist may even be needed to address these issues.

The choice between hCG and Clomid will depend on the individual patient specific diagnosis, and other factors which may be contributing to fertility problems or hormone and balances. In certain cases, they may even be used in combination. It’s important to consult with your physician like a fertility specialist, endocrinologist, urologist, or HRT specialist who may be able to assess your individual situation, perform the necessary tests and make the best appropriate recommendations for your treatment based on your specific needs. Most patients seem to prefer the results of hCG for their TRT treatments however the costs and availability have made it difficult for may people to obtain. Fortunately at NovaGenix we still are able to help our patients get hCG treatment as part of their protocol when medically advisable.

If you would like to speak to a specialist, our medical director, Dr. Timothy Mackey can help. With over 20 years of experience the medical team at NovaGenix can help you address these concerns and optimize your hormones and improve your health.

Call (561) 277-8260 or visit www.NovaGenix.org


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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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