From the Guidelines
Yes, enclomiphene increases free testosterone levels in men. Enclomiphene is a selective estrogen receptor modulator (SERM) that works by blocking estrogen receptors in the hypothalamus and pituitary gland, which tricks the body into thinking estrogen levels are low. This stimulates the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which then signal the testes to produce more testosterone. Typical dosing ranges from 12.5 to 25 mg daily, with treatment courses often lasting 8-12 weeks, though some men may use it for longer periods under medical supervision. The increase in free testosterone typically occurs within 2-4 weeks of starting treatment. Enclomiphene is particularly useful for men with secondary hypogonadism or those experiencing testosterone suppression from exogenous testosterone use. Unlike testosterone replacement therapy, enclomiphene maintains fertility by preserving or increasing sperm production. Potential side effects include visual disturbances, mood changes, and rarely blood clots. Regular blood work to monitor hormone levels is essential during treatment, as noted in studies such as 1, which highlights the importance of measuring morning serum free testosterone in men with obesity and hypogonadism.
Key Points
- Enclomiphene increases free testosterone levels in men by stimulating the release of LH and FSH.
- Typical dosing ranges from 12.5 to 25 mg daily, with treatment courses lasting 8-12 weeks.
- Enclomiphene is useful for men with secondary hypogonadism or those experiencing testosterone suppression from exogenous testosterone use.
- Potential side effects include visual disturbances, mood changes, and rarely blood clots.
- Regular blood work to monitor hormone levels is essential during treatment, as emphasized in studies like 1 and 1, which discuss the efficacy and safety of testosterone treatment in men.
Considerations
- The use of enclomiphene should be individualized for each patient, taking into account their specific medical history and needs.
- As noted in 1, the efficacy and safety of testosterone treatment in men, including the use of enclomiphene, should be carefully evaluated, considering the potential benefits and risks.
- The importance of monitoring hormone levels during treatment is highlighted in studies such as 1, which discusses the efficacy and safety of testosterone treatment in men.
From the Research
Enclomiphene and Free Testosterone
- Enclomiphene citrate has been shown to increase free testosterone levels in men with secondary hypogonadism 2, 3, 4.
- The mechanism of action of enclomiphene involves the stimulation of gonadotropin-dependent testosterone secretion by the testes, which leads to an increase in endogenous testosterone production 3, 4.
- Studies have demonstrated that enclomiphene citrate can increase total testosterone levels, as well as free testosterone, while also stimulating follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production 2, 4.
Comparison with Testosterone Gel
- Enclomiphene citrate has been compared to testosterone gel in terms of its ability to increase testosterone levels and sperm counts in men with secondary hypogonadism 2.
- The study found that enclomiphene citrate was effective in increasing testosterone levels and sperm counts, while testosterone gel was less effective in raising sperm counts above 20 × 10(6) /mL 2.
Clinical Implications
- Enclomiphene citrate may offer a promising alternative to testosterone replacement therapy (TRT) for men with hypogonadism, particularly those desiring fertility preservation 5, 6.
- The use of enclomiphene citrate may help to maintain fertility in men with secondary hypogonadism, while also increasing testosterone levels and alleviating symptoms of hypogonadism 4, 5.