Clomid for Men

Low Testosterone is something that affects millions of men worldwide. Clomid seems like a good treatment, but is it that good? Let's look at Clomid for Men.

The use of testosterone has become popular in recent years as more and more men strive to increase their testosterone levels. When “manopause” was first introduced to the public on the cover of Time in 2014, it noted testosterone’s success as an industry, worth $2 billion dollars.

All of this meant that men’s health is now more than ever in the public eye and that the world is aware of the problem in declining testosterone levels.

With the advancements in medical science, treatments for men with low testosterone now exist. These treatments give hope that our biology will not determine our destiny.

Whatever the reason for this awareness in testosterone is, knowing the is available and the alternatives available are important for both patient and provider.

In this post, we are going to focus on the use of clomid as an alternative form of testosterone replacement therapy and how it can be used as a form of hormone therapy in men.

Key Takeaways

  • Clomiphene citrate treatment has been shown to be effective in helping improve both testosterone levels and sperm parameters.
  • Clomid is a safe alternative to testosterone replacement therapy with mild side effects.
  • The function of Clomid is that it acts on the brain by tricking it.

Testosterone Replacement Therapy: A Potential Alternative

According to Food and Drug Administration (FDA), testosterone replacement therapy (TRT) is the only approved treatment for men with hypogonadism or medical condition associated with a deficiency in testosterone levels.

But, as with every other medication, there are certain side effects that should be brought up before use. In the case of testosterone replacement therapy, a possible side effect is infertility. This is where Clomid comes in as an alternative for testosterone therapy.

What is Clomid?

Clomiphene citrate, or better known as Clomid, is a selective estrogen receptor modulator (SERM). This simply means that it binds to the estrogen receptors and changes their activity.

This medication is often used to treat female infertility by inducing ovulation. However, for men, this drug is prescribed off-label for men who may want alternatives to testosterone replacement therapy and for those who need to improve sperm production.

Since the FDA has not approved Clomid as a treatment for low testosterone, it is considered “off-label.” Yet, multiple clinical studies have shown Clomid to be an effective treatment for improving male fertility by improving sperm concentration and boosting testosterone production.[1]

How does Clomid work?

In the body, we have many hormones that are constantly being produced and travel around in the body thanks to our blood. When levels are unbalanced, it is our brain that is responsible for sending the green light to produce more or signal red to stop.

Before we dive into how Clomid works, let us look at how testosterone is produced.

The Testosterone Production Cycle

In order for men to produce testosterone, the body needs LH (luteinizing hormone).

LH is a hormone produced in the the pituitary gland, a part of the brain attached to the hypothalamus. It is this hormone that signals the testicles to produce testosterone. So, when there is a lot of LH, more testosterone is produced and vice versa.

Clomid for Men
Figure 3: HPG Axis for both males and females

Once testosterone is produced, a small amount of this testosterone is converted to estrogen.

This is normal.

Estrogen then acts as a stop signal for LH. This is most commonly referred to as negative feedback, where one hormone influences production of another hormone. Here, it is testosterone that is influenced.

So, if for some reason there is some signaling issue happening in the brain, it might register the incorrect levels of testosterone and stop production of LH all together. And, as we just learned, without LH, we can’t produce testosterone.

Clomid works by shutting down estrogen’s communication with the pituitary gland, forcing it to produce more LH and continue making testosterone.

Clomid Treatment for Men

For men that want to begin their testosterone journey with a more “natural” alternative to treat low testosterone, clomiphene citrate may be a good choice.

Clomid is most commonly taken as a pill by mouth and the dosage range varies depending on the patient.

Exactly how much Clomid should be taken to raise testosterone levels to a healthy amount is fully dependent on the dosage taken. Currently, there has not been an established optimal dose, but the range is anywhere from 12 mg to 400 mg. It is up to your doctor to determine the appropriate dosage.

One study by the Division of Urology at Southern Illinois University found that a good recommended dose for most men to start at is 25 mg every 3 days with a gradual increase as needed. [2]

To see an improvement in testosterone levels and semen parameters, most studies agree that Clomid should be taken for a minimum of three months. A study that looked at both testosterone, LH, and included semen parameters found that men responded well on 100 mg of Clomid after 3 months.[3]

Responses of serum LH, and testosterone to 100-mg alternate-day Clomid therapy in 11 responders (n=20)
Figure 4: Studies have shown that Clomid can lead to an increase in LH and FSH levels

Although clomiphene citrate is not a steroid, it is still a prescription medication. This means it should only be used under the care of health professional that specializes in male hormone health, such as those found at a TRT clinic.

What are the side effects of Clomid for Men?

While Clomid is generally considered to be safe, as with almost every drug, there are some side effects.

Some of the most commonly reported side effects are mild and include:

  • headache
  • diarrhea
  • visual disturbances
  • tenderness of the pectoral muscle
  • severe mental complications

It’s important that you be informed of the potential side effects before starting any medication and discuss with your doctor if you have any concerns.

Is Clomid Right for You?

There are two things to bear in mind.

For one, just because Clomid is not approved as a treatment for men with low testosterone does not mean that it is not effective. There are a number of studies that strongly show how effectiveness of Clomids potential to improve testosterone levels, even for men diagnosed with hypogonadism.[4]

Second, Clomid is great, even for long-term treatment. Studies have shown that taking clomid for up to 15 months is safe and effective at helping improve testosterone levels, improve male factor infertility, and maintain testosterone levels up for as long as 3 years.[5]

However, clomid has has not been well studied in men over the age of 60. But the studies so far have shown that men may not respond very well.

If you are interested in using Clomid, the best way to do so would be through an HRT clinic such as Evolve Telemed.

The Bottom Line

While clomiphene citrate can be a good alternative to testosterone replacement therapy, it is not for everyone. This is assuming the cause of the initial problem is not brain signaling to the testis.

The evidence for clomid treatment is pretty strong for young men as well as middle-aged men. However, if you are a man over the age of 60, the evidence is not so clear.

If you think that Clomid might be the right testosterone therapy for you, contact your local TRT clinic to obtain some professional medical advice.

How long will it take for Testosterone to Increase on Clomid?

Studies have shown that it takes approximately 3 months to see improvement in both testosterone and sperm count levels.

Does Erectile dysfunction improve on Clomid?

While some studies do show that it can improve erectile dysfunction and overall sexual function, there has not been significant data to suggest it is an effective treatment option for ED. [6]

Moradi M, Moradi A, Alemi M, Ahmadnia H, Abdi H, Ahmadi A, Bazargan-Hejazi S. Safety and efficacy of clomiphene citrate and L-carnitine in idiopathic male infertility: a comparative study. Urol J. 2010 Summer;7(3):188-93. PMID: 20845296.

Current medical management of endocrine-related male infertility Ring Joshua D, Lwin Aye A, Köhler Tobias S Year : 2016, Volume: 18, Issue Number:  3, Page: 357-363

Ross LS, Kandel GL, Prinz LM, Auletta F. Clomiphene treatment of the idiopathic hypofertile male: high-dose, alternate-day therapy. Fertil Steril. 1980 Jun;33(6):618-23. doi: 10.1016/s0015-0282(16)44775-8. PMID: 6769716.

Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E. Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism. J Sex Med. 2005 Sep;2(5):716-21. doi: 10.1111/j.1743-6109.2005.00075.x. PMID: 16422830.

Ramasamy R, Scovell JM, Kovac JR, Lipshultz LI. Testosterone supplementation versus clomiphene citrate for hypogonadism: an age matched comparison of satisfaction and efficacy. J Urol. 2014 Sep;192(3):875-9. doi: 10.1016/j.juro.2014.03.089. Epub 2014 Mar 21. PMID: 24657837.

Guay AT, Jacobson J, Perez JB, Hodge MB, Velasquez E. Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit? Int J Impot Res. 2003 Jun;15(3):156-65. doi: 10.1038/sj.ijir.3900981. PMID: 12904801.

Jimmy Diaz M.S.

Hi I'm Jimmy. I was born and raised in sunny Los Angeles, California and love everything about the west coast lifestyle - the beach, the mountains, and the desert. Like many California natives, I can be a bit of a lot of things. Completed my undergraduate studies in Chemistry from University of California, San Diego and pursued a masters in Reproductive Clinical Science from Eastern Virginia Medical School. I primarily work as a clinical scientist and am also a baby maker (through IVF). I'm also a freelancer, ghostwriter, former D1 athlete, and enjoy everything I do.

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