It has long been known that clomid is very effective in males at stimulating the production of testosterone. It belongs to a category of compounds known as SERMS, or Selective Estrogen Receptor Modulators. Serms (and clomid) work by attaching selectively to certain estrogen receptors which then triggers a physiological response. The specific estrogen receptors that clomid attaches to which trigger the production of testosterone are located on the pituitary gland. This blocks estrogen from reaching these receptors. The body (more specifically the pituitary) perceives this as low estrogen levels. In an effort to increase estrogen the pituitary then produces more luteinizing hormone. This luteinizing hormone stimulates the leydig cells in the testis to produce more testosterone. That however is only half the picture with clomid. In addition clomid attaches to receptors on the hypothalamus, which causes it to produce GnRh which results in LH and FSH release. More on that later.
Clomid has long been of use in these circles as either standalone PCT or more recently alongside of tamoxifen for PCT. Clomid differs slightly from other serms in that while all serms possess estrogen agonist and antagonist activity, clomid seemingly exerts some estrogen agonist activity more so than other serms. While this may seem counterproductive, it is in fact, why many see it as the most important part of a pct regiment. Estrogen agonist activity is not bad, if it is exerted in more desirable receptor areas and this would appear to be the case with clomid.
The other interesting thing about clomid is its effect on make fertility. While most serms exert a pronounced effect on Leutenizing hormone (LH), they do not impact follicle stimulating hormone (FSH) as much. FSH has a direct effect on spermatogenesis (sperm production). Clomid does in fact seem to exert a rather pronounced effect on both LH and FSH, thus making it an effective male fertility drug.
Virtually all uses of clomid in males would be considered “off label” uses. These are known effects of the drug that have no directly been cleared by the FDA for its use in treatment. So while clomid may in fact be prescribed to males, any prescription would be considered an off label use of the drug.
The purpose of this write up is to explore the possibility of clomid as a potential trt or even test boosting option. In our circles and even in trt circles it has long been known that clomid can be very effective at increasing low testosterone levels significantly. It has also been echoed that there can be some undesired effects of the drug as well, most noted are mood swings and emotional response. It is said that clomid can make one irritable and emotional and not at ease. This has long been echoed regarding clomid but it really was word of mouth. My main concern about this is often it is used in PCT, a time of hormonal upheaval that may very well leave one this way whether clomid is used or not. Recently there have been several studies on clomid done on hypogonadal men which focused on not only testosterone levels but emotional and quality of life concerns. The results of these studies have proven more than interesting.
The first study published in 2012 by the Brazilian Journal of Endocrinology focused on males with T levels below 300ng/dl. The interesting thing is in addition to T levels alone the study focused on cholesterol profile, sexual desire and performance as well as quality of life. Again it has long been known that clomid is effective at raising T levels, the thing that is interesting to me is the study focused on 3 areas that are considered major “downfalls” if you will by many whenever the topic of clomid for trt therapy is brought up. The results were more than interesting. At a dose of 25mg/day given dily for anywhere from 3-6 months the average T levels were nearly doubled. There was no significant adverse effect on cholesterol levels. There was a reported increase in sexual desire and activity and virtually across the board an increase in quality of life. Now 25mgs it a relatively low dose of clomid, yet as is noted a very effective dose of clomid. This study goes against much of the hearsay regarding clomid for this purpose, but it is only one study. Which brings us to the next study.
The second study was conducted on young hypogonadal males, 86 in total. The average age was 25, and the T levels had to be below 310ng/dl. They were split into 2 groups ad clomid was given to one group at a dosage of 25mg EOD, the other 50mg EOD. This EOD dosing protocol is a bit unique but given clomid and most serms extended half and active lives one can see where ti would work fine. The bottom line with this study is the results were virtually the same as the first study I mentioned. T levels virtually doubled many reporting levels over 800ng/dl, no adverse effects noted on cholesterol or any other medically monitored parameters, and perhaps most importantly an improvement in the quality of life.
With the finding of these newer studies one must seriously consider the viability of clomid being a safe, effective, viable option for potential trt therapy as well as perhaps test boosting potential. I think it should be noted the dosages were conservative to say the least and it also should be mentioned that very little difference between the 25mg EOD group and the 50mg EOD was noted in the second study I referenced. I cannot help but think perhaps many of the emotional effects attributed to clomid are perhaps due to it being combined with another serm, or being dosed higher in our pct protocols.
While these studies are not the be all end all I think they point out the potential possibilities for clomids effectiveness for trt, as well as possible effectiveness as attest booster. The things that are attractive are the low dosing, the extremely high rate of effectiveness, the excellent safety profile, and the improved quality of life. It seems the medical community is coming around regarding clomid as a possible trt solution, perhaps it is time for our community to take another look at it as such and maybe even consider its uses in other applications as well.
Anyway some food for thought……
Refs:
BJU Int. 2012 Aug;110(4):573-8. doi: 10.1111/j.1464-410X.2011.10702.x. Epub 2011 Nov 1.Outcomes of clomiphene citrate treatment in young hypogonadal men.Katz DJ1, Nabulsi O, Tal R, Mulhall JP.
BJU Int. 2012 Nov;110(10):1524-8. doi: 10.1111/j.1464-410X.2012.10968.x. Epub 2012 Mar 28.
Clomiphene citrate is safe and effective for long-term management of hypogonadism.
Moskovic DJ1, Katz DJ, Akhavan A, Park K, Mulhall JP.
Int Braz J Urol. 2012 Jul-Aug;38(4):512-8.Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study. Da Ros CT1, Averbeck MA.
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Originally Posted by lovbyts
excellent read and very interesting
