How long after completing clomiphene citrate (Clomid) post‑cycle therapy should I have blood work drawn?

Timing of Blood Work After Clomiphene Post-Cycle Therapy

Blood work should be drawn 4-6 weeks after completing your last dose of clomiphene citrate to allow adequate time for hormonal normalization and accurate assessment of your endogenous testosterone production.

Rationale for Timing

The 4-6 week window is critical because:

• Clomiphene has a prolonged half-life of approximately 5-7 days, meaning it takes several weeks for the drug to be completely eliminated from your system 1
• Hormonal stabilization requires time after clomiphene discontinuation, as the hypothalamic-pituitary-gonadal axis needs to re-establish its baseline function without pharmaceutical stimulation 2
• Premature testing leads to inaccurate results because residual clomiphene effects can artificially elevate gonadotropins (LH and FSH) and testosterone, giving a false impression of recovery 3

Specific Laboratory Tests to Order

Your blood work panel should include:

• Total testosterone (morning draw, ideally between 7-10 AM for peak levels) 1
• Free testosterone or calculated free testosterone 1
• Luteinizing hormone (LH) to assess pituitary function 2, 3
• Follicle-stimulating hormone (FSH) to evaluate testicular function 2, 3
• Estradiol (E2) as clomiphene can significantly elevate estrogen levels 1, 3

Important Caveats and Pitfalls

Avoid Testing Too Early

• Testing at 1-2 weeks post-clomiphene will show artificially elevated gonadotropins and testosterone due to ongoing drug effects, not true recovery 2, 3
• This premature assessment may lead you to incorrectly believe your natural production has recovered when it hasn't 3

Estradiol Monitoring is Critical

• Clomiphene significantly increases estradiol levels, which can persist for weeks after discontinuation 1, 3
• Elevated estradiol can cause gynecomastia, mood changes, and sexual dysfunction even if testosterone appears normal 1
• If estradiol remains elevated 4-6 weeks post-treatment, you may need an aromatase inhibitor 1

Consider a Second Follow-Up Test

• If your initial 4-6 week labs show suboptimal testosterone recovery, repeat testing at 8-12 weeks is warranted 1
• Some men experience delayed recovery, and a single test may not capture the full picture of hormonal normalization 1

Use the Same Laboratory

• Different assays have varying sensitivities for testosterone and gonadotropin measurement 4
• Using the same lab ensures consistency and allows accurate comparison to your baseline pre-cycle values 4

Clinical Decision Points Based on Results

If testosterone is normal (>300 ng/dL) at 4-6 weeks:

• Your natural production has recovered adequately 1
• Continue monitoring symptoms and consider repeat testing at 3-6 months if symptoms recur 1

If testosterone remains low (<300 ng/dL) at 4-6 weeks:

• Retest at 8-12 weeks before making treatment decisions 1
• If still low at 8-12 weeks, you may require testosterone replacement therapy or extended clomiphene treatment 1

If LH/FSH ratio is abnormally elevated:

• This suggests persistent hypothalamic-pituitary dysfunction and may predict poor long-term recovery 3
• Consider endocrinology referral for specialized management 3