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.
FREQUENTLY ASKED QUESTIONS
Please complete all Renue Health questionnaires, ordered laboratory and obtain any necessary old medical records before you arrive for your initial consultation. This will allow Dr. Rob and his staff time to compile your biomarkers effectively and efficiently.
You will receive an email after you make a consultation appointment that contains a link to our online patient forms. You can then download all of the intake forms, Elite Lifestyle Questionnaire and Nutritional Questionnaire. https://www.renuehealth.com/request-an-appointment/
Upon completion of your consultation, you will receive a copy of all your biomarkers, relevant data and recommendations on a flash drive. Should you need additional copies of your medical records, a $30 administrative fee will be charged for copies, handling, and postage.
We will provide you with an itemized bill that you can file with your insurance company. Patients who have out-of-network benefits may or may not be reimbursed. Our office cannot assist you with claim resolution.
You may be able to use pre-tax dollars from a Health Savings Account (HSA) or a Flexible Spending Account (FSA) to pay for your fees related to your services from this office.
Renue Health nor Dr. Rob nor any of his employees or affiliates is responsible for payment differences or amounts set by your insurance company. Payment amounts vary per insurance provider depending on your agreement with them and this office is not responsible for dictating or making you aware of the terms and agreements between your insurance company and yourself. Please contact your insurance company with any questions or concerns regarding covered amounts and deductibles.
All of our services must be paid for at the time the services are delivered.
We currently have a waiting list for consultations and many of our clients are travelling from considerable distances. We ask that if you know that you need to cancel or reschedule, please let us know as soon as possible so that we may offer your consultation time to someone on the current waiting list.
Please allow up to 72 business hours for a return call. In many instances, we may be able to get back to you sooner than that. Another way to contact the Renue Health Team is by sending us an email through our directions and contact information page.
If you are a concierge patient then you have Dr. Rob’s private cell phone number and Team numbers and can feel free to contact him or any of the team members directly.
Some of the specialty labs that we recommend involve blood, stool, urine, or saliva samples and can be done by you in your home. You will be given all lab kits and step-by-step instructions for at-home tests at the time of your consult. Once all of the final lab results are received, we will review them with you at your visit.
When we request laboratory tests, it is essential that they be performed promptly. Many tests can take up to 4 weeks to perform and for the results to be returned to us. Please do not delay in completing your tests. Some of the specialized tests may not be considered medically necessary by your insurance carrier, and therefore might not be covered.
It is your responsibility to make a follow-up appointment to review your lab results with Dr. Rob. If you are unable to return to our office to review your labs, we are available by Skype, Face time, or telephone.
Nutritional supplements are often recommended and we will help you select and find the highest quality products.
The supplements that we recommend at Renue Health are available for purchase from our office.
It is possible to have your supplements automatically shipped to your home or office for your convenience.
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While the focus of our practice is on the optimization of male performance and health we also do optimize the performance and health of women. Medical conditions we treat and testing we perform:
- Abdominal Pain
- Adrenal Fatigue
- Athletic Performance
- Autoimmune Conditions
- BioIdentical Hormone Replacement
- Bell’s Palsy
- Carotid Ultrasound with CIMT
- Cholesterol Management
- Comprehensive Intracellular Nutrient Testing
- Comprehensive Laboratory Testing
- Detoxification Programs
- DEXA Scan
- Digestive Issues
- Fitness Evaluations
- Flexibility Testing
- Food Sensitivity Testing
- Gastric Inflammation
- Gluten Sensitivities
- Healthy Aging
- Heart Attack & Stroke Prevention
- Hormone Optimization for Men & Women
- Leaky Gut
- Low Testosterone (Low T)
- Medical Body Composition Analysis (mBCA)
- Men’s Health
- Mental Focus & Clarity
- MTHFR gene mutations
- Metabolic Syndrome
- Neurocognitive Testing for Parkinson’s, Alzheimer’s, and ADD
- Nutrition Counseling & Optimization
- Natural Weight Loss
- Parasympathetic Overtraining Syndrome
- POTS Syndrome
- Strength Testing
- Sympathetic Overtraining Syndrome
- Underactive Thyroid
- VENDYS Vascular Endothelium Testing
- VO2 Max Testing
- Women’s Health