From the Guidelines
Enclomiphene should be dosed at 12.5 to 25 mg daily for male testosterone replacement, with the goal of achieving a total testosterone level in the middle tertile of the normal reference range, as recommended by the AUA guideline 1. The dosing of enclomiphene for male testosterone replacement is crucial to achieve optimal results while minimizing potential side effects.
- The goal of testosterone therapy, including enclomiphene, is to normalize total testosterone levels and improve symptoms or signs 1.
- The American Urological Association (AUA) recommends using the minimal dosing necessary to drive testosterone levels to the normal physiologic range of 450-600 ng/dL 1.
- Treatment with enclomiphene typically continues for 2-3 months initially, with testosterone levels monitored every 4-6 weeks to assess response.
- Regular monitoring of testosterone, estradiol, LH, and FSH levels is essential during treatment to ensure appropriate dosing and response.
- It's essential to note that enclomiphene is not FDA-approved specifically for testosterone replacement, though it is sometimes prescribed off-label for this purpose.
- Unlike testosterone replacement therapy, enclomiphene may preserve fertility since it maintains or improves sperm production.
- Potential side effects of enclomiphene include hot flashes, visual disturbances, and potential cardiovascular effects, which should be closely monitored during treatment 1.
From the Research
Testosterone Replacement Therapy
- The provided studies do not mention the specific dosing for enclophamine for male testosterone.
- However, the studies discuss various treatment options for hypogonadal men, including testosterone replacement therapy (TRT) and alternative treatments such as clomiphene citrate and human chorionic gonadotropin 2, 3, 4, 5.
- Clomiphene citrate and its derivatives, such as enclomiphene, have been shown to increase endogenous testosterone production and may be a treatment option for hypogonadal men who desire to preserve fertility 6.
Alternative Treatments
- Clomiphene citrate and tamoxifen may be a safe alternative for the treatment of functional central hypogonadism in men, but their use is off-label and data supporting their efficacy is insufficient 3.
- Gonadotropins are a good alternative to TRT when fertility is desired in the near future, but they require frequent injections 3.
- Human chorionic gonadotropin has been shown to increase endogenous testosterone production and may be a treatment option for hypogonadal men who desire to preserve fertility 5.
Testosterone Replacement Therapy Considerations
- TRT has been used for over 70 years and numerous preparations and formulations have been developed to improve pharmacokinetics and patient compliance 4.
- The aim of TRT is to improve symptoms and signs of testosterone deficiency by increasing serum testosterone levels to physiologic range 4.
- Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of late-onset hypogonadism to provide the safest and most beneficial results 4.