Enclomiphene

Important Safety Information

• Off-label use: While enclomiphene is not FDA-approved, it has been studied for treatment of male hypogonadism and infertility. Be aware of regulatory status and source.
• Monitoring: Regularly monitor testosterone and estradiol levels, semen parameters, and ensure no contraindications (like liver disease or tumors).

Indications/Use

• Investigational use for secondary hypogonadism (hypogonadotropic hypogonadism) in men desiring fertility.
• Acts as an estrogen receptor antagonist in the hypothalamus, leading to increased GnRH, LH, and FSH secretion → endogenous testosterone production and spermatogenesis.

Contraindications

• Known hypersensitivity to enclomiphene or related compounds (e.g., clomiphene).
• Liver disease or hepatic dysfunction.
• Pituitary or hypothalamic tumors (as enclomiphene stimulates these pathways).
• Caution in those with elevated prolactin levels. Usually recommend MRI to clear prior to starting.

Side Effects

• Common: Hot flashes/night sweats (can occur with aromatization), mood swings, headache, visual disturbances (like blurred vision).
• Gastrointestinal: Nausea, abdominal discomfort.
• Reproductive: Testicular discomfort (due to increased activity), erection changes, potential for multiple pregnancies in women if used off-label (not relevant in men).
• Thromboembolic risk: Rare but possible due to estrogen receptor modulation.
• Long-term use: Limited data—caution with chronic use.
• Other: Poor sleep, edema, nipple sensitivity.