Understanding Enclomiphene
Enclomiphene citrate is a key treatment in men's health, focusing on targeted hormonal therapy. As a selective estrogen receptor modulator (SERM), enclomiphene is the isolated trans-isomer of clomiphene, specifically developed for addressing symptoms of male hypogonadism [1].
Unlike clomiphene, enclomiphene offers more refined and targeted therapy with flexible dosing options to accommodate individual healthcare needs. It specifically blocks estrogen receptors without mixed agonist/antagonist effects, leading to more targeted increases in luteinizing hormone (LH) and follicle stimulating hormone (FSH) [2].
Trans-isomer of clomiphene
Selective Estrogen Receptor Modulator
- Targeted Hormone Regulation: Specifically blocks estrogen receptors without mixed effects, leading to more targeted increases in LH and FSH while boosting testosterone levels [1][2].
- Fertility Preservation: Could be considered first-line therapy in hypogonadal men who wish to maintain their sperm count and fertility.
- Reduced Side Effects: Minimizes potential unwanted effects such as mood changes and gynecomastia compared to similar therapies [2].
- Rapid Adjustments: Best for those needing minimal estrogen impact and rapid adjustments in testosterone levels.
- Minimal Estrogen Interference: Acts solely as an estrogen receptor antagonist, beneficial for those sensitive to estrogen-related side effects.
Enclomiphene works by specifically blocking estrogen receptors in the hypothalamus and pituitary gland, which removes the negative feedback loop that normally suppresses testosterone production. This targeted action leads to increased production of LH and FSH, which in turn stimulates the testes to produce more testosterone naturally.
Unlike testosterone replacement therapy, enclomiphene maintains the body's natural hormone production pathways while addressing the underlying issue of low testosterone. This approach helps preserve fertility and maintains the natural rhythm of hormone production.
| Characteristic | Clomiphene Citrate | Enclomiphene Citrate |
|---|---|---|
| Type of Isomer | 38% zuclomiphene, 62% enclomiphene | 100% enclomiphene |
| Receptor Interaction | Estrogen receptor agonist & antagonist | Estrogen receptor antagonist |
| Testosterone Impact | Substantial increase, potentially beneficial for fertility | More targeted, robust increase, excellent potential for fertility |
| Estradiol Impact | Increase in estradiol | Minimal increase in estradiol |
| FSH and LH Effects | Increases FSH and LH | More pronounced increase in LH with less effect on FSH |
| Half-life | ~5 days | ~10 hours |
| Common Side Effects | Mood swings, gynecomastia, visual disturbances, bloating | Fewer mood swings, minimal gynecomastia, fewer visual disturbances |
| Risk of Tachyphylaxis | Higher | Lower |
| Custom Dosing Options | Capsules, troches | Capsules, flex-dose tablets, troches |
Strive Pharmacy Flex-Dose Options
Enclomiphene 12.5 mg flex-dose tablet: Allows for precise dosing at 3.125 mg, 6.25 mg, 9.375 mg, or 12.5 mg
Enclomiphene 25 mg flex-dose tablet: Allows for precise dosing at 6.25 mg, 12.5 mg, 18.75 mg, or 25 mg
Typical Dosage: Ranges from 6.25 mg to 25 mg, taken every other day or daily, based on individual needs
- Customizable Dosing: Flex-dose tablets are the preferred option for precision dosing and gradual adjustments
- Optimized Patient Outcomes: Designed to support gradual dose adjustments to achieve optimal therapeutic effect
- Convenience & Flexibility: Flex-dose tablets allow for easier dosing modifications compared to capsules
- Alternative Options: Capsule option also available upon request
- Primary Hypogonadism: Enclomiphene will not be effective in raising testosterone levels in patients with primary hypogonadism who already have high LH levels.
- Estrogen Sensitivity: Acts solely as an estrogen receptor antagonist, making it beneficial for those sensitive to estrogen-related side effects.
- Monitoring Required: Regular monitoring of hormone levels and clinical response is recommended during treatment.
- Individual Response: Response to therapy can vary among patients, requiring personalized dosing adjustments.
- Wiehle R, Cunningham GR, Pitteloud N, Wike J, Hsu K, Fontenot GK, Rosner M, Dwyer A, Podolski J. Testosterone Restoration by Enclomiphene Citrate in Men with Secondary Hypogonadism: Pharmacodynamics and Pharmacokinetics. BJU Int. 2013 Jul 12;112(8):1188–200.
- Saffati G, Kassab J, Rendon DO, Hinojosa-Gonzalez DE, Kronstedt S, Lipshultz LI, et al. ENCLOMIPHENE VS. CLOMIPHENE: SAFETY AND TESTOSTERONE LEVELS IN HYPOGONADAL MEN. Journal of Urology. 2024 May 1;211(5S):e762.
Last Updated: 12/15/2025 | Professional Healthcare Education