Clomiphene Citrate (Clomid)
Clomiphene Citrate (Clomid) is a medical treatment that is most often prescribed for men who have hormonal abnormalities.
Some men with low sperm counts have low levels of the crucial male hormone, testosterone. While most physicians would think to give a man testosterone replacement therapy because he has low testosterone, in some cases that may not be the correct strategy.
The same clomiphene citrate we give to women to help them ovulate regularly, we can also use in men strategically as well. Clomiphene works essentially the same way in both women and men; in women, it binds to receptors in the brain, specifically the hypothalamus and the pituitary gland to increase the production of follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones act on the ovarian follicles to induce egg development and ovulation. In men, the increase in FSH leads to an increase in sperm production, whereas the increase in LH leads to an increase in testosterone production. Currently, there is a new drug pending FDA approval called Enclomiphene, which boosts testosterone with no effect on spermatogenesis.
Clomiphene is typically given to women for 5 days early in their cycle; men need to take clomiphene every day, as sperm production occurs every day, if using clomiphene for fertility. The typical starting dose for a man using clomiphene is 25 mg (1/2 pill) per day. However, alternate dosing regimes exist for those men using clomiphene to increase testosterone levels.
Pending FDA approval, a new medication called Androxal which contains only Enclomiphene is said to be available sometime in 2017. Androxal is a nonsteroidal estrogen receptor antagonist developed for secondary hypogonadism in overweight men wishing to restore normal testicular function. The great thing about Androxal is a man can take one capsule three times a week to naturally boost their testosterone. For many men, this is sufficient to boost testosterone levels without the need for additional testosterone injections, creams or pellets.
Another drug occasionally used for men with low sperm concentrations is letrozole. This medication interferes with the natural inter-conversion of estrogen and androgen that occurs in men. This can lead to higher serum testosterone levels and, frequently, sperm counts as well. Regardless of whether a man takes clomiphene or letrozole, it typically takes between 90 and 108 days from the time that a sperm is produced in the testicles until it is eventually ejaculated. Therefore, although an increase in the sperm count may appear within the first month of treatment, you should not be discouraged if this does not happen, and you should not discontinue taking the medication unless there is no improvement by the fourth month of treatment.
Please note that before a man takes either of these medications, it is very important that he have a normal physical examination performed by a physician experienced in hormone therapy. This is critical, as sometimes a low sperm count can indicate a more serious underlying problem, such as a varicocele, an obstruction, or even testicular cancer.
What You May See With Bio-identical Hormone Replacement Therapy
Dr. Rob Kominiarek DO FACOFP is the Medical Director of ReNue Health located in Springboro, Ohio and treats male and female clients from all around the world. Dr. Rob has been specializing in Bio-identical Hormone Replacement since 2002. He can prescribe a therapy that is tailored to your unique needs.
Our focus is on the PREVENTION of the diseases associated with aging. In addition, a healthy lifestyle is important, including healthful eating and meaningful exercise. Along with strategic supplementation, bio-identical hormones are a key ingredient in your recipe for healthy aging.
ReNue Health is located conveniently in Springboro, Ohio with easy access from Dayton International Airport, Cincinnati International Airport or the adjacent Wright Brothers Private Airport (MGY) for those travelling by private aviation. Click here for directions and contact information.
Only one visit is necessary to perform a comprehensive history, interview, and education. Follow up evaluations, adjustments and balancing of hormones are done by phone or written communications and a return visit to Dr. Rob is not necessary. Ongoing testing and adjustment is mandatory and performed through a laboratory convenient to your home.
In addition to the Ohio office, Dr. Rob sees new patients in Salt Lake City, Utah. Appointments for either location can be made by calling the main office number 937.350.5527 for information.