How is Clomid used to treat male infertility?
Clomiphene Citrate (Clomid) is a fertility medication that is used primarily in women to help with egg release and reproductive hormone release. As an off-label usage of clomiphene, it can be used to treat male infertility.
Clomiphene works by binding to estrogen receptors (locations where signals are received) in the pituitary gland (master hormone gland). The pituitary gland is in charge of releasing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are responsible for many reproductive responses including testosterone and sperm production in men. Estrogen attaches to the receptors on the pituitary gland and tells the pituitary to stop producing the hormones that provide the signal to release these reproductive hormones. Since clomiphene blocks estrogen from getting to the pituitary, it allows more LH and FSH to be released. In men, this allows for more sperm and testosterone production. In women, this allows for ovulation and egg maturation.
Men with fertility problems usually suffer from a low sperm count and low testosterone levels. One would expect to reverse this problem by supplementing with testosterone. This does the opposite and in fact, lowers sperm count. Testosterone is metabolized into estrogen in the body. More testosterone production leads to more estrogen production, which attaches to the pituitary gland. This then tells the body to stop LH release, which then lowers testosterone production as well as sperm production.
Clomiphene is taken once daily for men with low sperm count. It is usually monitored with blood work a couple weeks later to determine how the testosterone and hormone levels are responding to treatment.
Clomiphene may cause an increase in energy, sex drive, and muscle mass in response to testosterone level increase. Sometimes aggression, anxiety, and restlessness may occur.