From the Guidelines
Protocol for Using Clomid in Men
To raise testosterone and preserve fertility in men using Clomid, it is recommended to start with a low dose of 12.5-25mg every other day or 25mg three times a week, under the guidance of a healthcare provider 1. Clomid, also known as clomiphene citrate, should be taken for a limited duration, typically 3-6 months, to avoid potential side effects.
- Key Considerations: Men should have regular follow-up appointments to monitor testosterone levels, sperm count, and overall health.
- Off-Label Use: It is essential to note that Clomid is not FDA-approved for testosterone replacement therapy in men, and its use for this purpose is considered off-label 1.
- Benefits and Risks: Therefore, it is crucial to consult a healthcare provider to discuss the potential benefits and risks and determine the best course of treatment 1.
- Alternative Options: For men with hypogonadotropic hypogonadism (HH), treatment with exogenous gonadotropins or pulsatile GnRH may be considered 1.
- Importance of Specialist Referral: Referral to an endocrinologist or male reproductive specialist is encouraged in cases of HH or other complex fertility issues 1.
From the Research
Protocol for Using Clomid in Men
The protocol for using Clomid (Clomiphene citrate) in men to increase testosterone levels and preserve fertility involves the following:
- Clomiphene citrate is a selective estrogen receptor modulator that acts centrally to increase secretion of luteinizing hormone and follicle-stimulating hormone, thereby increasing testosterone production and serum levels 2
- The typical dosage of Clomid is 25 mg every other day, which can be titrated to 50 mg every other day to achieve the target testosterone level of 550 ± 50 ng/dL 3
- Clomid treatment has been shown to improve testosterone levels, hypogonadal symptoms, and fertility rates in men with hypogonadism 2, 4, 5
- The treatment duration can vary from several months to several years, with some studies showing efficacy and safety of Clomid treatment for up to 15 months 6 or even longer 4, 3
Efficacy and Safety of Clomid Treatment
The efficacy and safety of Clomid treatment in men with hypogonadism have been demonstrated in several studies:
- Clomid treatment has been shown to increase total testosterone levels by 2.60 (95% CI 1.82-3.38) ng/dL 5
- Clomid treatment has also been shown to improve hypogonadal symptoms, such as erectile function and bone mineral density 2
- The most common side effects of Clomid treatment are headache, dizziness, gynecomastia, and exacerbation of psychiatric illnesses, but these are generally mild and rare 2, 4, 5
- Clomid treatment has been shown to be safe and effective for long-term use, with no significant adverse events reported in several studies 4, 3
Fertility Preservation
Clomid treatment has been shown to preserve fertility in men with hypogonadism:
- Clomid treatment does not suppress the hypothalamic-pituitary-gonadal axis, preserving intratesticular testosterone production and spermatogenesis 2
- Clomid treatment has been shown to improve semen parameters and fertility rates in men with hypogonadism 2, 6
- Clomid treatment is a useful alternative to testosterone supplementation in men wishing to preserve their fertility 3