Benefits of Enclomiphene

Benefits of Enclomiphene

Enclomiphene is a selective estrogen receptor modulator (SERM) used to treat low testosterone (hypogonadism or “low T”) while preserving or improving fertility. Unlike traditional testosterone replacement therapy (TRT), enclomiphene stimulates the body’s natural production of testosterone. FYI, you might hear misspellings and mispronunciations that include: enclomiphene citrate, enclomifene, enclomifen, enclomephen, enclomiphen, etc. They are all referring to this same drug. The most important to note is that this is a different overall medication than clomiphene citrate, a generic of Clomid (there’s a different article on that piece).

Anyways, getting to the key benefits:

1. Stimulates Natural Testosterone Production:
• Enclomiphene enhances the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH are the precursor hormones that stimulate the testes to produce testosterone hormone.
2. Improves and Preserves Fertility:
• Traditional TRT consists of iatrogenic synthetic testosterone administration that is known to communicate in the feedback circle of sperm production. This means synthetic testosterone (especially if supratherapeutic or higher than a normal range) will communicate within the body’s endocrine system, the hypothalamic-pituitary-gonadal (HPG) axis, to say “we have enough testosterone in the body, no need to make any more of the precursors of T (LH, FSH).” The body does not know that the secondary function of LH and FSH is that it dually stimulates sperm production. So, not having LH & FSH means suppression of sperm production by the testes.  Enclomiphene, on the other hand, works more upstream – rather supporting or improving spermatogenesis, by telling the body to make more LH and FSH, making it an ideal choice for men seeking to maintain or enhance fertility.
3. Non-Invasive:
• Unlike traditional TRT (testosterone injections), enclomiphene is a standard pill medication. This avoids the need for injections, gels, or patches. Note that new oral TRT options now exist (will be discussed below).
4. Minimized Risk of Testicular Shrinkage:
• By maintaining testicular function (as discussed above), enclomiphene reduces the risk of testicular atrophy often associated with exogenous testosterone therapy. The adage “if you don’t use it, you lose it” is particularly true in human physiology. “… you shrink it” is most accurate.
5. Balances Hormones Naturally:
• Stimulates a natural hormonal balance without shutting down the HPG axis.

Choosing Between Enclomiphene and Oral TRT:

• Enclomiphene is ideal for men who want to maintain fertility, testicular size, and natural testosterone production. Some view the upstream activation of the HPG axis as unreliable and would rather have measured synthetic direct T administration to address their low T. Since enclomiphene is not considered a controlled substance by the Drug Enforcement Agency (DEA), various 3^rd party health consultants exist that potentially overprescribe this medication under less scrutiny from DEA; make sure to do your research about the clinician who is prescribing this medication to you to validate their clinical science and evidence-based guideline adherence.
• Oral TRT is great for those seeking a non-invasive, convenient solution to directly replace testosterone. Testicular size can be comanaged with combined therapy with another medication such as one from the SERM class or human chorionic gonadotropin (HCG). Note that HCG is only available as an injection. If you are only able to tolerate oral treatment protocols, oral TRT can be combined with an oral SERM such as tamoxifen or enclomiphene. That’s right, both can be used as a combination as well!

The ideal dose of enclomiphene can vary depending on the individual and the specific condition being treated. However, common guidelines suggest:

Typical Dosage for Enclomiphene:

1. Starting Dose:
• 12.5 mg daily: Often used as an initial dose to stimulate natural testosterone production while minimizing side effects.
2. Adjustments:
• Up to 50 mg daily May be prescribed if the initial dose is insufficient to achieve desired testosterone levels or if symptoms persist.
• Dosage adjustments should be guided by regular blood tests and a healthcare provider's evaluation.
3. Maintenance Dose:
• Many patients maintain 12.5 mg to 25 mg daily, depending on their response and testosterone levels.

Factors Affecting Dosage:

• Baseline Testosterone Levels: Patients with severely low testosterone may require higher doses initially.
• Fertility Goals: Lower doses may suffice for individuals focusing on maintaining or improving fertility. Especially if being used in conjunction with synthetic T.
• Side Effects: Dosage may be adjusted to minimize side effects like mood changes or headaches.

Important Considerations:

• Enclomiphene should always be taken under the guidance of a healthcare provider, who will monitor testosterone levels and overall health.
• As enclomiphene is not considered a controlled substance by DEA, many non-physician healthcare providers exist that can potentially overprescribe and misdiagnose patients to prescribe this medication.
• The hormonal implications, risks, and benefits of enclomiphene should be viewed with similar scrutiny as you would for synthetic testosterone administration and TRT.
• Avoid exceeding the prescribed dose, as it could lead to hormonal imbalances or unwanted side effects.

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