Rankings / Hormones & Endocrine
Clomiphene citrate
Hormones & Endocrine · SERM (HPG restart)
Tier C+
What this is
Alternative to TRT for men who want to preserve fertility because it increases LH/FSH instead of suppressing the HPG axis. DailyMed labels visual symptoms including blurred vision and scotomata; discontinue and evaluate if visual symptoms occur. Hohl 2025 systematic review/meta-analysis found SERM therapy increased total testosterone by about 274 ng/dL vs placebo and raised LH/FSH. The mixed-isomer drug has more clinical history than enclomiphene but also more estrogen-receptor activity outside the hypothalamus.
Mechanism
Mixed SERM containing enclomiphene (trans isomer) plus zuclomiphene (cis isomer); blocks hypothalamic estrogen feedback, increasing GnRH → LH/FSH → endogenous testosterone and spermatogenesis
Dose & route
25-50 mg every other day or daily in male off-label protocols; fertility induction protocols vary
Citations
- https://pubmed.ncbi.nlm.nih.gov/41066380/
- https://pubmed.ncbi.nlm.nih.gov/27226163/
- https://pubmed.ncbi.nlm.nih.gov/23253627/
- https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2ca373c1-4dba-4126-8616-5c533d606fe5
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.