No, This Combination Will Not "Shut Down" Estrogen—It Will Likely Increase It
Taking 40mg of Nolvadex (tamoxifen) and 25mg of Clomid (clomiphene) daily will not eliminate estrogen; instead, both medications will likely cause your estrogen levels to rise significantly while blocking estrogen's effects at tissue receptors. This is a critical misunderstanding of how these selective estrogen receptor modulators (SERMs) work.
How These Medications Actually Work
Mechanism of Action
Both tamoxifen and clomiphene are selective estrogen receptor modulators (SERMs) that block estrogen receptors in certain tissues (like breast tissue and the hypothalamus) while potentially acting as estrogen agonists in other tissues 1, 2.
These medications work by blocking the negative feedback of estrogen on the hypothalamus and pituitary, which causes your body to increase LH and FSH secretion 1, 2.
The increased LH stimulates your testes to produce more testosterone, which then aromatizes to more estradiol (estrogen) 3, 4.
Expected Hormonal Changes
Testosterone levels increase significantly with clomiphene treatment, with 88% of men achieving eugonadal testosterone levels 3.
Estradiol levels rise substantially during treatment with these SERMs—this is consistently documented across multiple studies 3, 4.
One study specifically noted that "estradiol was significantly increased following clomiphene citrate treatment," with estradiol showing "a more pronounced elevation" compared to testosterone 3, 4.
Why Your Dosing Is Problematic
Excessive Dosing Concerns
The typical therapeutic dose of clomiphene for male hypogonadism is 25-50mg three times per week (not daily), or 100mg three times per week for fertility treatment 1, 5.
Your proposed 25mg daily (175mg/week) exceeds standard dosing recommendations and increases the risk of side effects without additional benefit 5, 3.
Tamoxifen for male gynecomastia is typically dosed at 20-40mg daily, so your 40mg dose is at the upper limit but within range 4.
Combining both SERMs at these doses is not evidence-based and may compound side effects including mood changes, visual disturbances, and breast tenderness 3.
Context: Post-TRT Recovery
If You're Coming Off Testosterone Replacement Therapy
The American Urological Association recommends initiating HCG at 500 IU subcutaneously 3 times weekly (1,500 IU total per week) to restore intratesticular testosterone production after long-term TRT 6.
Clomiphene can be added if HCG alone is insufficient after 2-3 months, but the typical dose is 25-50mg three times weekly, not daily 6, 1.
Approximately 67-90% of men eventually recover spermatogenesis after TRT cessation, but this can take 6-24 months 6.
The Correct Recovery Protocol
Start with HCG monotherapy at 500 IU three times weekly for 2-3 months 6.
Check testosterone, LH, and FSH levels at 2-3 months to assess testicular response 6.
If testosterone remains low after 3 months on HCG alone, consider adding FSH 75-150 IU three times weekly or clomiphene 25-50mg three times weekly 6, 1.
Combined HCG and FSH therapy provides optimal outcomes for fertility preservation 6, 7.
Critical Misconceptions to Address
Estrogen Is Not Your Enemy
You cannot and should not attempt to eliminate estrogen completely—it plays essential roles in male physiology including bone health, lipid metabolism, and sexual function 1, 2.
The goal of SERM therapy is to block estrogen's negative feedback at the hypothalamus while maintaining adequate estrogen for other physiological functions 1, 2.
What These Medications Actually Accomplish
Tamoxifen and clomiphene block estrogen receptors in specific tissues (hypothalamus, breast tissue) but do not reduce circulating estrogen levels—they increase them 3, 4.
The therapeutic benefit comes from stimulating your own testosterone production through increased gonadotropin secretion, not from lowering estrogen 1, 2.
Recommended Approach
If Your Goal Is Fertility Restoration Post-TRT
Discontinue testosterone immediately and allow 2-4 weeks washout 8.
Start HCG 500 IU subcutaneously three times weekly as first-line therapy 6, 7.
Monitor testosterone, LH, FSH at 2-3 months 6.
Add clomiphene 25-50mg three times weekly (not daily) only if HCG monotherapy is insufficient after 3 months 6, 1.
If Your Goal Is Treating Hypogonadism While Preserving Fertility
Clomiphene monotherapy at 25-50mg three times weekly is a reasonable off-label option for functional central hypogonadism 1, 3, 2.
This approach increases endogenous testosterone production while maintaining fertility potential 1, 2.
Do not combine with tamoxifen unless you have documented gynecomastia requiring treatment 4.
Common Pitfalls to Avoid
Never assume SERMs "shut down" estrogen—they block receptors while often increasing circulating estrogen levels 3, 4.
Avoid daily dosing of clomiphene when three-times-weekly dosing is equally effective with fewer side effects 1, 5, 3.
Do not combine multiple SERMs without clear indication—this increases side effect risk without proven additional benefit 1.
Excessively high doses can cause receptor desensitization, potentially reducing effectiveness 6.