Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism.

[David Morris]

http://www.ncbi.nlm.nih.gov/pubmed/16422830

J Sex Med. 2005 Sep;2(5):716-21.

Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism.
Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E.

Department of Urology, NY Presbyterian Medical Center, New York, NY, USA.

Abstract
AIM: Symptomatic late-onset hypogonadism is associated not only with a
decline in serum testosterone, but also with a rise in serum
estradiol. These endocrine changes negatively affect libido, sexual
function, mood, behavior, lean body mass, and bone density. Currently,
the most common treatment is exogenous testosterone therapy. This
treatment can be associated with skin irritation, gynecomastia, nipple
tenderness, testicular atrophy, and decline in sperm counts. In this
study we investigated the efficacy of clomiphene citrate in the
treatment of hypogonadism with the objectives of raising endogenous
serum testosterone (T) and improving the testosterone/estrogen (T/E)
ratio.

METHODS: Our cohort consisted of 36 Caucasian men with hypogonadism
defined as serum testosterone level less than 300 ng/dL. Each patient
was treated with a daily dose of 25 mg clomiphene citrate and followed
prospectively. Analysis of baseline and follow-up serum levels of
testosterone and estradiol levels were performed.

RESULTS: The mean age was 39 years, and the mean pretreatment
testosterone and estrogen levels were 247.6 +/- 39.8 ng/dL and 32.3
+/- 10.9, respectively. By the first follow-up visit (4-6 weeks), the
mean testosterone level rose to 610.0 +/- 178.6 ng/dL (P < 0.00001).
Moreover, the T/E ratio improved from 8.7 to 14.2 (P < 0.001). There
were no side effects reported by the patients.

CONCLUSIONS: Low dose clomiphene citrate is effective in elevating
serum testosterone levels and improving the testosterone/estradiol
ratio in men with hypogonadism. This therapy represents an alternative
to testosterone therapy by stimulating the endogenous androgen
production pathway.