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What is enclomiphene therapy and how does it work as a fertility-boosting alternative to Testosterone Replacement Therapy (TRT)?

Enclomiphene is an estrogen receptor antagonist, with fertility-boosting properties, that is utilized as an alternative testosterone replacement therapy (TRT) in men with secondary hypogonadism. Enclomiphene binds to and blocks estrogen receptors in the anterior pituitary gland, resulting in a hormonal cascade and release of gonaotropins (LH and FSH) to increase levels of testosterone naturally produced by Leydig cells in the testes. An increase in naturally produced testosterone stimulated by enclomiphene can improve sperm production, libido, erection strength, testicle volume (ball size), and ejaculate volume (load size).

Enclomiphene comes in capsule form and is taken as an oral medication for the duration of desired effects. Meaning, it can be taken short-term to enhance fertility, or for longer periods as an alternative to testosterone replacement therapy (TRT). When properly utilized, enclomiphene monotherapy can be an effective option for men with low testosterone levels (secondary hypogonadism) or who have difficulty producing sperm. Enclomiphene is generally considered a safe medication with a low risk profile, when used properly, but it can cause side effects like nausea, upset stomach/acid reflux, hot flashes, and headache. If you are considering whether you could benefit from enclomiphene therapy, it is important to speak to your physician or a Valhalla Vitality clinician about you specific needs.

Who can benefit from enclomiphene and who should avoid it altogether?

Enclomiphene is an effective medication for treating low testosterone levels in men with secondary hypogonadism who need to preserve or enhance fertility.  This means that enclomiphene could be a viable option for men with low testosterone that want to have children and preserve fertility. Testosterone is the major hormone responsible for the development of male characteristics, such as increased muscle mass, penis size and growth, broad shoulders, strength, bone density, and body hair. Testosterone is a driver of healthy sexual function, erection strength and quality, libido, and virility/fertility.

Enclomiphene monotherapy can elevate testosterone levels by 1.3-2.7x and help to provide symptom relief in men with low testosterone levels caused by secondary hypogonadism. Enclomiphene monotherapy is most effective in men younger than 40 years old as it can easily increase testosterone levels to the high end of healthy levels with intact/healthy testicular function. Enclomiphene therapy is not recommended for men with primary hypogonadism, or men who have high levels of circulating gonadotropins (Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)) with concurrent low testosterone. Enclomiphene monotherapy is also not recommended to be the primary choice of treatment for low testosterone for men that do not require to preserve fertility, as testosterone injections are the most reliable way to alleviate symptomatic low T.

Enclomiphene side effects are typically mild, but the most common side effects are headaches, nausea, and bloating, although more concerning side effects, such as visual disturbances are possible. Enclomiphene therapy is an effective treatment for men with secondary hypogonadism (who have low testosterone levels and who have difficulty producing sperm). Men who are not good candidates for enclomiphene therapy should speak with their doctor or a Valhalla Vitality clinician about other options for treating symptoms of low testosterone, enhancing libido, sexual function, and fertility.

How effective is enclomiphene therapy compared to traditional TRT methods like testosterone injections or gels/creams?

Enclomiphene therapy is a treatment option for men with low testosterone levels. It works by binding to and blocking the action of estrogen receptors in the body and brain, which increases testosterone production. Studies have demonstrated that enclomiphene therapy can be as effective as traditional testosterone replacement therapies (TRT), such as testosterone injections or gels/creams at increasing testosterone levels in men with secondary hypogonadism.

In one study, enclomiphene was shown to increase testosterone levels by an average of 100% (2x) after three months of treatment. Enclomiphene is also very effective at preserving and increasing fertility compared to testosterone replacement therapy (TRT), which can lower sperm count and quality, and cause testicular atrophy (ball shrinkage). Overall, enclomiphene therapy is a safe and effective treatment option for men with symptoms of low testosterone levels that should be considered by men of all ages.

What are the potential side effects of enclomiphene therapy and how can they be minimized or avoided altogether?

Enclomiphene is a drug used to treat men with low testosterone levels. While it is generally safe and effective, there are some potential side effects that men should be aware of. The most common side effect is nausea and bloating, which can occur in up to 15% of men taking enclomiphene. Nausea and/or bloating associated with enclomiphene treatment can often be relieved by taking each dose with a meal. Other potential side effects include weight gain (lean mass), headaches, and the potential for visual disturbances. Most side effects are mild and disappear with time, but in the rare instance that a visual disturbance occurs enclomiphene therapy should be discontinued immediately. To minimize the risk of side effects, men should advocate undergoing treatment at the lowest effective dose.

Men who experience bothersome side effects or lack of symptom reduction may also want to consider switching to a different testosterone replacement therapy (typically injections). Enclomiphene is a safe and effective treatment for low testosterone levels, but like all drugs, it does have some potential risks and side effects. By understanding these risks and taking steps to minimize them, men can make sure that they get the most benefit from enclomiphene therapy.

How much does enclomiphene therapy cost on average, and what kind of insurance coverage is available for those seeking treatment?

Enclomiphene therapy is a relatively new treatment for low testosterone, and as such, it can be quite expensive. The average cost of enclomiphene therapy is around $200 per month plus the cost of labs (bloodwork) and clinician fees as insurance coverage is often limited. However, there are a few ways to offset the cost of treatment, such as subscribing to a therapy option that ships bi-monthly. With a bi-monthly prescription shipment option, enclomiphene therapy treatment cost with Valhalla Vitality is reduced to $98.95 (50% of the cost). Enclomiphene therapy is an effective treatment for low testosterone, and with a little planning, it can be affordable for many men.

Are there any other alternatives to TRT that may be more suitable for certain individuals based on their unique situations and needs?

Testosterone replacement therapy (TRT) is a hotly debated topic among doctors and patient groups. Some men feel that TRT is a life-saving treatment that has helped them gain back their energy and libido, while others worry about the (speculated) long-term risks associated with testosterone supplementation. There are some alternatives to testosterone replacement therapy (TRT) that may be more suitable for certain individuals based on their unique situations and needs.

Enclomiphene, for example, is a non-hormonal drug that is effective in treating low testosterone levels. It works by stimulating the production of testosterone in the testes, and it has the amazing benefit of increasing fertility rather than reducing fertility like testosterone itself. Enclomiphene may be a better option for men who are concerned about the potential risks of TRT, or who have not had success with traditional testosterone supplementation.

Enclomiphene therapy is a new male fertility treatment option that offers many potential benefits over traditional TRT methods like testosterone injections or gels/creams. It is safe, effective, and has very few side effects. Also, enclomiphene therapy is an affordable option in comparison to TRT programs, making it a great choice for men who are looking for an affordable way to improve their fertility.

Consult Valhalla Vitality for a personalized diagnosis and treatment.

Please call us to learn more about our services or schedule an appointment today.

Works Cited


      1. Ko EY, Siddiqi K, Brannigan RE, Sabanegh ES Jr. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol. 2012;187:973–978.

      1. Katz DJ, Nabulsi O, Tal R, Mulhall JP. Outcomes of clomiphene citrate treatment in young hypogonadal men. BJU Int. 2012;110(4):573-578.

      1. Ramasamy R, Scovell JM, Kovac JR, et al. Testosterone supplementation versus clomiphene citrate for hypogonadism: an age-matched comparison of satisfaction and efficacy. J Urol. 2014;192-(3):875-870.

      1. Ribeiro RS, Abucham J. Clomiphene fails to revert hypogonadism in most male patients with conventionally treated nonfunctioning pituitary adenomas. Arq Bras Endocrinol Metabol. 2011;55(4):266-271.

    1. Wexler, Tamara L. Enclomiphene Citrate Improves Hormone Levels While Preserving Sperm Production in Men With Secondary Hypogonadism. Fertil Steril. Mar 2014. 102(3): 720-727.
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