The remedy is one of the treatments belonging to the group of non-steroidal antiestrogen. The drug stimulates ovulation in women who have infertility diagnosis, helping to conceive a child. For men, it is also used to improve insemination during intercourse.
1. What is Clomid?
Clomid (Clomiphene) is a synthesized remedy, first discovered in 1960. The pivotal prescription of the drug is the treatment of infertility disease in women by stimulating the ovulation process.
It is also used for men in the course of the therapy of oligospermia. At the end of the treatment, the content of substances returns to normal condition, reaching the levels that were before the use of anabolic steroids.
2. What Does Clomid Do?
According to the pharmacological effect of the drug, Clomiphene is a non-steroidal antiestrogen. Its action is explained by specific binding to estrogen receptors in the ovaries and pituitary gland. In small doses, it enhances the secretion of gonadotropins: prolactin, FSH, and LH.
In women, it stimulates ovulation. With a low content of estrogenic hormones in the body, it exhibits a moderate estrogenic effect. With a high estrogen content, it has an antiestrogenic effect. In large doses, it inhibits the secretion of gonadotropins. The remedy does not possess gestagen and androgenic activity.
The drug turns out to be relevant not only for those who are faced with a diagnosis of infertility but also with dysfunctional uterine bleeding, dysfunction of the ovaries, absence of the menstrual cycle, as well as other pathological diseases that provoke incorrect functioning of the ovaries and other causes of hormonal imbalance.
The drug affects the body by stimulating the secretory activity of gonadotropins. It provokes an increase in the activity of the gonads and promotes the production of hormones in the pituitary gland. Clomiphene also affects other body functions:
- Stimulates breast milk flow;
- Optimizes the process of oocyte maturation;
- Causes the formation of corpus luteum in the ovaries.
All these processes contribute to the maturation of the egg, ready for the process of conception. As a result of the use of the drug, the ovulation process is stabilized.
If the body contains a small number of endogenous estrogens, the drug increases its amount, bringing the total number to the norm necessary for effective fertilization. When estrogen levels rise, Clomiphene ingredients have a blocking effect, inhibiting their circulation. A similar property of the drug helps improve the dynamics of gonadotropins.
Clomiphene dosage studies for men have been shown to normalize testosterone levels in men with hypogonadotropic hypogonadism. It makes the insemination process in the course of sexual intercourse more effective.
2.1 What is it used for?
Clomiphene’s main mechanism lies like the medication. It is an anti-estrogenic agent. Initially, it is an effective remedy that helps women ovulate in case of secondary ovarian hypofunction, mainly due to hypothalamic-pituitary disorders.
Nowadays, it is also actively used by bodybuilders when taking anabolic steroids to eliminate the resulting side effects (aromatization).
3. How Much Testosterone Will Clomid Raise?
Conventional medicine suggests the usage of the drug to deal with symptoms of irregular cycles and issues with ovulation. The medication stimulates the release of gonadotropins by releasing certain hormones.
It restores the irregular menstrual cycles in women. Although the medication is intended for females, its effect is also manifested in men. The remedy has a strong effect on the hypothalamic-pituitary-gonadal (HPG) axis.
It stimulates the pituitary gland to release more gonadotropins, which leads to a rapid increase of follicle-stimulating and luteinizing hormones in the blood. As a result, the level of endogenous testosterone rises. Clomid acts primarily when, due to the intake of anabolic-androgenic steroids, its testosterone production is suppressed.
In most cases, it normalizes testosterone levels and spermatogenesis within 10-14 days. Therefore, it is taken as soon as you stop taking steroids. During this time, it is extremely important to restore testosterone production as quickly as possible to minimize the loss of strength and muscle mass. Even better results are achieved when Clomid is combined with CHG or when it is taken after treatment with CHG drugs.
The difference between Clomid and HCT is that Clomid has a direct effect on the hypothalamus and pituitary gland and activates the entire HPG axis, while CHG enhances the effect of the luteinizing hormone. It, in turn, stimulates testicular cells to produce more testosterone.
The result of the medication course in men is a modest improvement in testosterone levels while preserving sperm production. It is usually expected to achieve a 100% increase in T levels with the drug. In some cases, one may see up to a 200% increase.
Compared to testosterone replacement therapy, Clomid for hypogonadal men can be considered a better alternative due to the following reasons:
- Clomiphene stimulates the body’s testosterone production;
- The remedy comes in tablets and is easy to take;
- This drug is relatively cheap and affordable;
- It has a relatively low risk of side effects.
4. How to Take Clomid?
The drug dosage is prescribed according to the sex and health issues of the patient.
4.1. For Women
To stimulate ovulation, Clomiphene is prescribed 50 mg once a day before bedtime, starting from the 5th day of the menstrual cycle. It lasts for 5 days. In case of the absence of a cycle, it can be taken at any time.
In the absence of effect (for instance, ovulation does not develop within 30 days), the dose is increased to 150 mg/day. Also, the course is lengthened to 10 days. The course dose should not exceed 1 g.
The development of ovulation is determined by the presence of:
- Biphasic basal temperature;
- Average cyclical increase in LH production;
- Increase in serum progesterone during the likely middle phase of luteinization or during menstrual bleeding in women with amenorrhea.
If ovulation occurs, but there are no symptoms of pregnancy, then the same dose should be repeated at the next treatment course.
If, after alleged ovulation, menstrual bleeding did not follow, the possibility of pregnancy should be taken into account. You must exclude it before a new course of treatment.
There is another treatment option that is offered when breast cancer is diagnosed. Women who have been diagnosed with disseminated cancer, which characterizes the spread of affected cells to other organs and tissues, are prescribed a one-year course of treatment. It implies taking Clomiphene citrate for 12 months.
The dosage is 200 mg/day (4 tablets of 50 mg). At this time, it is necessary to monitor the functioning of the ovaries and regularly undergo examinations by the attending physician. If malfunctions occur in the work of the ovaries, the course is suspended and, after the resumption of functioning, treatment is continued.
4.2. For Men
Men are prescribed 50 mg 1-2 times a day for 3-4 months. Systematic monitoring of the program is required. The tablets are usually taken after meals are washed down with liquid.
The medication should not exceed 10-14 days. It is not necessary to take it longer to increase the level of endogenous testosterone. The drug should not be used for more than two weeks. Otherwise, its use as an antiestrogen disappears by itself. For this purpose, it should be applied for more than a few weeks.
5. Clomiphene Usage at the Various States
The remedy has some warnings and precautions for usage in different health conditions.
The drug is effective when the level of endogenous estrogens is sufficient. It is less effective when the level of estrogen is low. Practically, the drug turns out ineffective when the concentration of pituitary gonadotropic hormones is low.
In the course of treatment, it is necessary to constantly monitor the gynecologist, control the function of the ovaries, and vaginal examinations.
Before using the drug, be sure to visit your gynecologist. The use of Clomiphene is indicated in cases where:
- The total level of gonadotropin in the urine is below the lower limit of normal or at the normal level;
- Ovarian palpation does not show abnormalities;
- The functions of the thyroid and adrenal glands are normal.
In the absence of egg maturation, all other possible causes of infertility should be excluded or treated before medication. If ovarian enlargement or cystic transformation is found, the use of Clomiphene is not allowed until the ovaries return to normal size. In the long term, you should reduce the dose or duration of treatment.
In the course of treatment, it is necessary to constantly visit the gynecologist. You should control the function of the ovaries and do vaginal examinations. Often, during treatment, it is difficult to determine the moment of ovulation. Besides, a corpus luteum defect is often observed. Therefore, it is recommended to start prophylactic administration of progesterone after conception.
When treated with Clomiphene, the likelihood of multiple pregnancies, ectopic pregnancy, endometriosis, and the growth of existing uterine fibroids increases.
Hot flushes observed during treatment stop after the end of the Clomiphene intake. Cystic enlargement of the ovaries may also occur, especially with Stein-Leventhal syndrome. In these cases, the size of the ovaries can reach 4-8 cm. In this case, you should monitor the body temperature and stop treatment as soon as it becomes biphasic.
There are some warnings of drug use in women during pregnancy and lactation. For pregnant females, it is contraindicated. Though the lactation period has no special recommendations, you should consult your doctor.
5.2. Other Diseases
The drug has precautions for patients diagnosed with the presence of malignant and benign neoplasms. Besides, the use of medication is prohibited when the patient suffers from:
- Concomitant diseases;
- Diseases of the nervous system;
- Hepatic or renal failure;
- The tendency to form blood clots;
- The use of the drug is not recommended for people whose professional activities are associated with stress and serious psycho-emotional stress.
If a patient has hypersensitivity to the active substance or any component of the drug, it is not recommended to use it.
6. What Happens if I Overdose?
Non-compliance with the instructions of the drug leads to bad outcomes and feeling unwell. Overdose has certain symptoms that help define this state. The treatment is prescribed individually by the doctor.
Symptoms of overdose are nausea, vomiting, flushing, and blurred vision.
Consult your doctor in case of feeling unwell. Usually, the treatment is drug withdrawal. Overdose symptoms go away on their own.
7. Clomid Side Effects
Clomid has minimal toxicity and is easily tolerated by the organism. So, the likelihood of the remedy’s side effects is minimal. However, you should not exclude it. The most widespread cases are splitting and long-term headaches, nausea, abdominal pain, insomnia, and vomiting.
The development of allergic manifestations on the skin is not excluded. As a rule, negative reactions go away on their own a few days after Clomid is discontinued. No treatment for side effects is required.
7.1 The Enlarged and Tender Ovaries
The endocrine system may suffer the most during the treatment. Women experience weight gain, polyuria, and increased sweating, heavy menstruation flows.
Some women may have an enlargement of the ovaries. Sometimes, the ovaries may increase up to 4–8 cm. So, it is necessary to control the basal temperature. If a two-phase temperature curve appears, the treatment should be discontinued.
7.2. Abdominal Tenderness
The digestive system faces such health issues as a feeling of heaviness in the epigastrium, flatulence, nausea, and vomiting.
Bloating is another symptom of the drug’s side effects. It is usually accompanied by flatulence, diarrhea, and acute abdominal syndrome.
7.4. Breast Tenderness
On the part of the reproductive system and mammary glands, women suffer from breast tenderness. They experience thickening of the mammary glands.
In the course of the treatment, the patient’s nervous system is under attack. There can be occurrences of headache, dizziness, and drowsiness. Also, a patient may suffer from a slowdown in mental and motor reaction performance. There can appear increased excitability, depression, and insomnia.
8. Interactions with Other Substances
Clomiphene citrate can be used with other drugs that affect the number of gonadotropic hormones in the body. Thus, you can ensure the most effective distribution of the drug throughout the body.
The drug is gradually excreted from the woman’s body, but the period, which in medicine is commonly called the half-life, is about 5 days. At this time, the drug shows its maximum effect.
The medicine affects the egg, stimulating its release into the fallopian tubes for further fertilization. The abuse of alcoholic products during treatment or just before the beginning of the course will not only slow down the desired result but will lead to irreparable consequences.
The most acceptable option for drinking alcohol after or before the medication will be the cancellation of the therapeutic effect. In such a situation, the doctor will extend the course. The active substance of the drug will accumulate in the body. This can lead to disruption of the activity of the ovaries.
Usually, patients try to avoid alcohol during pregnancy planning. Products containing alcohol can harm the process of conceiving a child in healthy people. The compatibility of the drug ingredients and alcohol in such a situation is completely useless. Doctors recommend excluding the use of alcohol while taking the medication.
Alcohol intoxication has a hazardous effect on the entire body. Treatment can be prescribed only after the elimination of all the consequences and signs of poisoning. The interaction of the medication and alcohol adversely affects health even when pregnancy has already occurred.
8.2. Other Drugs
The use of Clomiphene citrate in combination with other drugs is possible. The remedy is compatible with drugs belonging to gonadotropic hormones. These are the cases when diagnosing neoplasms in the mammary glands and early detection of cancer.