Treatment of male hypogonadism with clomiphene citrate: Review article

Clomiphene citrate (CC) is a selective estrogen receptor modulator and estrogen antagonist originally developed in 1956 and introduced into clinical medicine in 1967 for the treatment of female infertility [1]. CC has also been explored for off-label use for male infertility and male hypogonadal symptoms [1]. This article will review the medical literature on CC and its contribution to the treatment of male hypogonadism. A comprehensive review of the literature pertaining to CC through April 2022 was performed through PubMed. We looked at variety of questionnaires for hypogonadal men and our goal was to define the role of Clomiphene Citrate in treatment of male secondary hypogonadism with structurally intact hypothalamic- hypophyseal axis (HT-HP), but physiologically changed and compare it with the currently FDA approved treatment with Testosterone in different forms. We included 30- articles relevant to CC. CC can increase the Testosterone as much as Testosterone gel in hypogonadal patient with the similar improvement of the hypogonadal symptoms while preserving fertility and sperm production in males with secondary/tertiary hypogonadism and structurally intact HT-HP axis [2,3]. Also, the safety of CC was discussed in our article and it was compared to Testosterone safety as well, while treating men with secondary/tertiary hypogonadism with CC and structurally intact hypothalamic- hypophyseal axis, but physiologically changed. CC is regarded as an effective therapy for specific patients who suffer from male factor infertility and complain of hypogonadal symptoms. More studies are needed to further validate CC's efficacy for male infertility and hypogonadism [1].