Enclomiphene Citrate

Promote systemic and intratesticular endogenous testosterone in hypogonadal men. ^1-3

• Potential improvement in muscle mass and strength ¹
• Potential improvement in libido and energy levels ²
• Supports mood and cognition ²
• Potentially fewer unwanted estrogenic effects such as mood changes, gynecomastia, and fluid gain ²
• Support preservation of sperm count and fertility in men with fertility aspirations ³
• May avoid the potential for testicular atrophy. ^1,3

Potential Side Effects

• Decreased libido ²
• Decreased energy levels ²
• Headache ⁴
• Estrogenic side effects such as gynecomastia, bloating or mood swings (less incidence compared to clomiphene) ^{2, 3}

Enclomiphene is a selective estrogen receptor modulator (SERM). It is the isomer of clomiphene primarily responsible for desired pharmacological effects, whereas zuclomiphene is the isomer associated with unwanted effects. Enclomiphene antagonizes estrogen in the hypothalamic-pituitary-gonadal axis to induce Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). LH stimulates the Leydig cells to produce testosterone. Intratesticular testosterone supports spermatogenesis and also confers broader systemic testosterone pharmacology. FSH acts on the Sertoli cells of the testes, and in concert with LH, modulates sperm health. FSH is instrumental in the functionality of spermatogenesis, sperm maturation, and sperm quality.^1,2

IMPORTANT INFORMATION ABOUT COMPOUNDED MEDICATIONS

This medication has been compounded (custom-prepared) by a pharmacy. Compounded medications are specially prepared for individual patient needs based on a valid prescription from a prescribing healthcare practitioner and, as such, are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy. Compounded drugs are intended for patients whose prescriber has determined their medical needs are not met by an available FDA-approved drug. These statements have not been evaluated by the FDA.

This compounded preparation:

• Has not been approved by the FDA
• Has not undergone FDA review for safety, effectiveness, or quality
• Is prepared specifically for you based on your prescriber's order
• Individual outcomes may vary

Dosing is determined by the prescribing provider based on patient-specific factors. Always follow your healthcare provider's instructions. Compounded medications are not subject to FDA approval and lack the same safety and efficacy data as FDA-approved commercial medications. This medication should be prescribed and monitored by a licensed healthcare professional familiar with the condition being addressed and the specific applications of the medication.

DISCLAIMER:
Compounded medications are specially prepared for individual patient needs based on a valid prescription and, as such, are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy. These statements have not been evaluated by the FDA.

This information is for educational and informational purposes only. It is not medical advice or a health, diagnosis, or a treatment recommendation. Always consult your healthcare provider before starting any new medication to determine whether it is appropriate for your individual circumstances. Contact your healthcare provider with any questions regarding a medical condition.

1. Wiehle R, Cunningham GR, Pitteloud N, Wike J, Hsu K, Fontenot GK, Rosner M, Dwyer A, Podolski J. Testosterone Restoration by Enclomiphene Citrate in Men with Secondary Hypogonadism: Pharmacodynamics and Pharmacokinetics. BJU Int. 2013 Jul 12;112(8):1188–200. doi: 10.1111/ bju.12363. Epub ahead of print. PMID: 23875626; PMCID: PMC4155868.
2. Saffati G, Kassab J, Rendon DO, Hinojosa-Gonzalez DE, Kronstedt S, Lipshultz LI, Khera M. Safety and efficacy of enclomiphene and clomiphene for hypogonadal men. Translational Andrology and Urology. 2024 Sep 30;13(9):1984-90.
3. Thomas J, Suarez Arbelaez MC, Narasimman M, et al. Efficacy of Clomiphene Citrate Versus Enclomiphene Citrate for Male Infertility Treatment: A Retrospective Study. Cureus. 2023;15(7):e41476. Published 2023 Jul 6. doi:10.7759/cureus.41476
4. Hohl A, Chavez MP, Pasqualotto E, Ferreira ROM, Sande-Lee SV, Ronsoni MF. Clomiphene or enclomiphene citrate for the treatment of male hypogonadism: a systematic review and meta-analysis of randomized controlled trials. Arch Endocrinol Metab. 2025;69(5):e250093. Published 2025 Oct 9. doi:10.20945/2359-4292-2025-0093
5. Fontenot GK, Wiehle RD, Podolski JS. Differential effects of isomers of clomiphene citrate on reproductive tissues in male mice. BJU Int. 2016;117(2):344-350. doi:10.1111/bju.13244
6. Mauvais-Jarvis, Franck, and Sarah H. Lindsey. "Metabolic benefits afforded by estradiol and testosterone in both sexes: clinical considerations." The Journal of Clinical Investigation 134.17 (2024).
7. Finkelstein, Joel S., et al. "Gonadal steroids and body composition, strength, and sexual function in men." New England Journal of Medicine 369.11 (2013): 1011-1022.

Q. I am already on enclomiphene to promote testosterone while maintaining fertility. Can I use it with any other meds that will support fertility goals even further?

A. Yes. Low dose gonadorelin or hCG are often used in men on exogenous testosterone to support the maintenance of fertility potential. But keep in mind that gonadorelin and hCG can also be used in men on enclomiphene to further augment fertility.

Q. I want to get the most out of enclomiphene. Will I get a stronger effect using it on all 7 days of a week?

A. Enclomiphene may exert potential benefits if cycled 5 days out of 7 (or every other day). Enclomiphene opposes estrogen receptors in the hypothalamus to induce a cascade of downstream effects. However, whenever a biological signal is present for prolonged periods, it may potentially down-regulate the receptors it acts upon. Cycling the enclomiphene is a best-practice to ensure the medication does not weaken over time.

Q. I understand enclomiphene is frequently used in men with fertility aspirations in place of testosterone replacement. Are there other clinical reasons someone might choose enclomiphene?

A. Testosterone replacement can be administered within physiologic ranges; however, some patients remain cautious about direct hormonal replacement. Testosterone replacement may be associated with changes in clinical markers such as hematocrit, prostate-specific antigen (PSA), and serum lipid levels, which is why routine monitoring is typically recommended.

Enclomiphene works by helping stimulate the body’s endogenous production of testosterone rather than providing exogenous hormone. In clinical studies, enclomiphene has generally maintained testosterone levels within physiologic ranges and has shown minimal impact on certain serum biomarkers. By supporting endogenous testosterone production within normal ranges, enclomiphene may help limit the likelihood of potential side effects sometimes associated with supraphysiologic testosterone levels, such as acne or hirsutism.⁴

Q. You also offer a Test Booster that appears comparable to enclomiphene. How do these options differ, and which one might be most appropriate for my situation?

A. The SERM used in Test Booster is clomiphene, which is a racemic mixture of both enclomiphene and zuclomiphene. Whereas enclomiphene exerts desirable effects, zuclomiphene is responsible for estrogenic side effects. As such, enclomiphene exhibits a favorable adverse effect profile.^2,3 Furthermore, when zuclomiphene was administered in isolation, it adversely affected testicular histology such as Leydig cells, seminal vesicles and epididymis.⁵ This is echoed in the finding that enclomiphene not only induces a robust gonadotropin release, but is also associated with a potential improvement in total motile sperm cell counts.³ The choice of whether to use Test Booster or enclomiphene would also factor in patient preference decided by the healthcare provider.

Q. Other than tracking sex steroid hormones and related biomarkers such as SHBG, is it necessary to monitor any other labs with enclomiphene?

A. As enclomiphene supports endogenous testosterone production rather than introducing exogenous testosterone, changes in serum PSA, lipid levels, and hematocrit may depend on individual patient risk factors. Monitoring decisions should be guided by the patient’s overall clinical context.

Q. My estrogen labs have risen in addition to my testosterone on this med. Should I be concerned?

A. A modest increase in estrogens along with testosterone is nothing to be concerned about. As part of normal physiology, your body will covert some testosterone to estrogen. Enclomiphene generally helps induce the fewest estrogenic side effects amongst SERMs. It is a misconception that estrogen and testosterone necessarily antagonize each other. When testosterone and estrogen increase in tandem, it may amplify an array of anabolic and libido effects. By itself, estrogen has a weak anabolic effect. But it does play a role in muscle regulation, sensitizing it to exercise stimuli and testosterone’s actions. The increase in estrogen may also help support cardiovascular wellness and nervous system balance along with bone mineral density support and healthy body composition contribute to balanced mood and cognitive wellness.^6,7