Clomid and Testosterone
Sometimes the best offense is a good defense. This applies to the world of hormones at times as well. For example, the most obvious way to solve low testosterone, or hypogonadism, is to add testosterone, right? Well, there's another way: add a SERM such as Clomid (clomiphene citrate)
instead. In other words, lower estrogen and you'll naturally get more
testosterone due to the body's feedback mechanisms.
What is a SERM? It means that it will in some tissues act as an estrogen and in others
block estrogen. However, the bottom line is that in males it generally works its
hormonal magic by blocking or inhibiting estrogen at the hypothalamus which, in turn,
stimulates GnRH and, further downstream, LH (leutinizing hormone) in the pituitary. Males can see their low testosterone levels double or more,
especially if you have secondary hypogonadism.
Some decent research and years of clinical practice have born this out. For
example, one study put 36 men with average total testosterone of 248 ng/dl on 25
mg/day of Clomid and after 4-6 weeks the men's average testosterone was a hefty
610 ng/dl.  This is a nice boost indeed, especially for what is considered a
relatively low dose of Clomid. The authors also point out that the
all-important testosterone to estrogen ratio was raised from 8.7 to 14.2.
We have had a couple of Peak Testosterone Forum member who were enthusiastic
Clomid users. Look at what this guy wrote:
"Yep, seems like i 'passed' the Clomid challenge. February i had a reading of
total T at 270 ng/dl. Today's results, after 5 1/2 weeks on Clomid: 627 ng/dl!!
Wow, so that was really good news..." 
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Clomid also has certain advantages over standard testosterone therapy. HRT
requires shots or topicals that require time and potential risks. It's nice just to take a simple pill, as is the case with Clomid. And the good news is that Clomid seems to generally raise testosterone in the younger men who try it, which is still more evidence that the great majority of men have tertiary hypogonadism. Also, it is worth pointing out that a significant percentage of men have what I would call an "HRT-like" experience from Clomid, i.e. it improves libido and erectile strength and they feel better as well.
However, many have th opposite experience where their testosterone increases but they get no increase in libido. We have had men shoot up into the 800's or higher on Clomid and yet have absolutely no increase in sexual desire. This shows just how Clomid can negatively impact the male brain due to its sometimes estrogenic qualities. And there is simply no way to know if you will be one of the lucky or unlucky ones.
So how safe is this convenient Clomid? In the short term, Clomid seems
safe and that is one reason that some doctors are increasingly prescribing it
for hypogonadism. Clomid has been taken for years by males as a fertility
treatment due to its FSH-stimulating powers. So it has a reasonable track record
considering that it has been out for awhile.
One other crowd that has used Clomid for an extended period of time are steroid
users and certain athletes. Steroid men will use Clomid to get their testosterone back, a common issue with steroid abuse. It is commonly used upon completion of a steroid cycle
to "jump start" testosterone. Often testosterone will collapse after
steroid use and Clomid is the only thing that will bring back testosterone and
estrogen within normal physiological ranges. This was documented when one
study discussed Clomid's effective use to do just this with a "steroid abuser".
The bottom line is that Clomid has been used extensively by several off label and
even non-legal users and all have found it to be reasonably well-tolerated with
low side effects for short term use. NOTE: Clomid does not always work. If you are primary hypogonadal, for example, Clomid will do nothing for you. And the same is true if you have pituitary damage..
CAUTION: Many men now want to use Clomid long term. Talk to your
doctor, but I think this is unwise for a variety of reasons that I go into
detail about in
my link on Your Risks with Long Term Clomid Usage.
Below I give a quick summary, though, of the issues involved:
1) Vision. A surprisingly common side effect of Clomid is blurred vision.
Is this drug doing some kind of subtle long term damage within the eye that we
do not understand yet? We just don't know. However, cases of
spontaneous retinal thrombosis (clotting), spasms and detachment have been
reported. . Is this really safe to use long term for men? That’s a good question. Some pretty smart doctors believe it is safe long term if it is used a) low dose and b) no side effects are experienced. I certainly do not have a crystal ball myself however. This is such a potentially major long term issue that I have
created a page called
Clomid and the Risk to Your Long Term Vision on the
2) Moodiness and Estrogen. Clomid is actually estrogenic in some cases and
moodiness and mood swings are fairly commonly reported. The bottom line is
that Clomid's effects are poorly understood and likely vary from individual to
3) Thyroid. Some of Clomid's common side effects match up quite well with
those encountered during various thyroid issues. This has some wondering
if Clomid does subtely affect thyroid function in some way.
4) Nausea or Headache. These are fairly common side effects with Clomid. Again, one can't help but ask what it is doing long term.
5) Peripheral Neuropathy and Paresthesia. One commonly reported side
effect of clomid are the symptoms of nerve damage, such as tingling, numbness,
burning, itsching, etc. This usually discontinues several months after
stopping the drug, but one can't help but wonder how much damage has been done.
6) Clomid. Clomid raises SHBG enough to where it could be an issue for some men.
As SHBG rises, the percentage of free testosterone can fall. Ideally, you want this range to
be 1.5-2.5 percent of total testosterone. See this link on High SHBG
for more information.
1) J Sex Med, 2005 Sep, 2(5):716-21, "Clomiphene citrate effects on
testosterone/estrogen ratio in male hypogonadism"
2) Fertility and Sterility, Jan 2003, 79(1):203-205, "Use of clomiphene citrate
to reverse premature andropause secondary to steroid abuse"