Clomid for Men: Does it Work? Everything You Need to Know

Clomiphene (brand name: Clomid), is traditionally used in female fertility treatments, may also improve male infertility and boost testosterone (T) levels. It is often prescribed off-label for various uses beyond fertility enhancement. But does clomiphene really work for men, and is it the right choice for those struggling with low T or fertility issues?

Let's delve into the science behind Clomid for men, exploring how it works, its effectiveness, and the potential benefits and risks. Whether you are considering Clomid as a treatment option or simply seeking to understand its role in male health, this comprehensive guide will cover everything you need to know. 

• Clomid is FDA-approved for the treatment of female infertility caused by ovulatory issues. However, some healthcare providers may use it off-label for male infertility.  
• The drug has been shown to increase sperm concentration and motility without serious side effects. 
• The best approach to treating infertility and low T is comprehensive: get evaluated and make lifestyle changes.

Male Infertility: Is it Common?

Have you been unable to conceive with a fertile woman after at least a year of regular, unprotected sex? If so, you might be dealing with male infertility. Infertility affects about 15% of couples in the United States, with the man solely responsible in approximately 20% of those cases. It's always recommended to evaluate both partners, as the issue may not lie with just one person. In fact, male infertility may be a contributing factor in about 50% of cases.¹

What are the causes of male infertility? Some possible culprits may include:¹ 

• Genetic mutations in reproductive genes  
• Urogenital abnormalities that can be congenital (e.g., babies born with undescended testes) or acquired (e.g., injury to the testes)
• Age 
• Being overweight or obese
• Hormonal imbalances such as low T
• Medical conditions like diabetes or autoimmune disorders
• Cancer and cancer treatments such as chemotherapy or radiation
• Exposure to toxins such as pesticides, alcohol, or tobacco
• Exposure to medications or drugs such as anabolic steroids, cannabinoids, or opioids
• Infections, especially infections of the urogenital tract 
• Sexual dysfunction 

The best way to assess your reproductive health is through a semen analysis. Your healthcare provider may order this test to evaluate sperm count, shape, and movement. In some cases, the cause of male infertility remains unidentified, known as “idiopathic infertility.”¹

Signs of Male Infertility 

The main sign of infertility is difficulty conceiving with a fertile partner. However, there are other signs to look out for, especially if your T production is low:²

Trouble in the bedroom 

If you struggle with achieving and maintaining an erection (erectile dysfunction or “ED”), have low sexual desire or interest, or have issues with ejaculation, it might be a good idea to check your reproductive health. 

Weight gain

Unexplained weight gain—especially when accompanied by other symptoms—may indicate a hormonal imbalance and potential infertility.

Depression and apathy

Men with low T and impaired hormonal balance often experience mood changes, sadness, or indifference.

Hair loss or enlarged breasts 

Impaired hormone balance  can lead to other issues that deviate from a person’s norm. These may include swelling or breast tissue development (gynecomastia) or changes in hair density. 

Changes in testes

Testicles that are unusually small or firm may indicate problems with sperm production. If you notice pain, lumps, or swelling, seek medical care.

Varicocele

Enlarged veins in the scrotum, known as varicocele, can be a sign of low fertility. This condition causes the testes to overheat, which can negatively affect sperm production. 

What is Clomid? 

Clomiphene citrate, also known by the brand name Clomid, is a drug that belongs to a group of medications called selective estrogen receptor modulators (SERMs). They work by boosting the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the body.

Clomid is approved by the United States Food and Drug Administration (FDA) for the treatment of female and male infertility, as it helps to induce ovulation and sperm production (spermatogenesis). But what about using clomiphene for men with low T? Some healthcare providers may prescribe the drug off-label for the treatment of male hypogonadism (low T) and for a certain type of headache called primary short-lasting unilateral neuralgiform headache attacks.³

Clomiphene for Men: How Does it Work? 

Clomid competes with estradiol, a form of estrogen, for a place on the estrogen receptors in the body. This competition stimulates the secretion of gonadotropins (LH and FSH) from the pituitary gland in the brain. Therefore, for this drug to work, normal pituitary function is required. The extra LH and FSH  promote testosterone and sperm production in the testes.³The drug takes some time to take effect. Although the timeline is not as predictable as in women, male patients typically see an increase in sperm production after about three months of treatment with Clomid.¹ During treatment, you should regularly check in with your healthcare provider to monitor how your body responds to the drug.

Can Clomid Increase Sperm Count? 

So, does clomiphene work for male infertility? According to a recent meta-analysis, Clomid increases the concentration of total testosterone, FSH, LH, and estradiol. It has been proven to enhance sperm concentration and motility without affecting sperm morphology (shape). Moreover, it is a safe drug that rarely causes serious side effects.⁴ 

Side Effects of Clomid 

Although the drug is generally considered safe, clomiphene for men may cause side effects such as:³

• Headache
• Dizziness
• Nausea
• Liver damage
• Testicular malignancies (tumors)
• Enlarged breasts 
• Gastrointestinal symptoms 

Alternatives to Trying Clomid 

If you are struggling with infertility or just want to increase your T levels, you should know that clomiphene for men is just one potential solution. There are many reasons why your hormonal balance might be disrupted, and addressing the underlying cause is always better than merely alleviating symptoms. 

Opt Health takes a comprehensive approach to your unique health situation. After evaluating your health, our physicians will create a health optimization plan tailored to you. A heads-up: this plan includes more than just medications and will likely require changes to your lifestyle habits. Lifestyle interventions like regular exercise, good sleep, and a healthy diet can do wonders for male sexual health.

The Bottom Line

Treating male infertility and low testosterone (T) can be challenging, but there are options to consider. Clomiphene and similar drugs, although not FDA-approved for this use, have been shown to improve low T symptoms. However, quick fixes might not always be effective. It's best to fully evaluate your health and develop a personalized treatment plan. Get in touch with us. 

References

1. Leslie SW, Soon-Sutton TL, Khan MA. Male Infertility. In: StatPearls. StatPearls Publishing; 2024. Accessed August 15, 2024. http://www.ncbi.nlm.nih.gov/books/NBK562258/

2. What Is Male Infertility? Cleveland Clinic. Accessed August 15, 2024. https://my.clevelandclinic.org/health/diseases/17201-male-infertility

3. Mbi Feh MK, Patel P, Wadhwa R. Clomiphene. In: StatPearls. StatPearls Publishing; 2024. Accessed August 15, 2024. http://www.ncbi.nlm.nih.gov/books/NBK559292/

4. Huijben M, Huijsmans RLN, Lock MTWT, de Kemp VF, de Kort LMO, van Breda JHMK. Clomiphene citrate for male infertility: A systematic review and meta-analysis. Andrology. 2023;11(6):987-996. doi:10.1111/andr.13388