Re: Clomiphene citrate and testosterone gel replacement therapy

[Guest guest]

There's also this study

http://www.ncbi.nlm.nih.gov/pubmed/16422830

Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism.

Shabsigh A, Kang Y, Shabsign R, M, Liberson G, Fisch H, Goluboff E.

Department of Urology, NY Presbyterian Medical Center, New York, NY, USA.

Abstract

AIM: Symptomatic late-onset hypogonadism is associated not only with a decline

in serum testosterone, but also with a rise in serum estradiol. These endocrine

changes negatively affect libido, sexual function, mood, behavior, lean body

mass, and bone density. Currently, the most common treatment is exogenous

testosterone therapy. This treatment can be associated with skin irritation,

gynecomastia, nipple tenderness, testicular atrophy, and decline in sperm

counts. In this study we investigated the efficacy of clomiphene citrate in the

treatment of hypogonadism with the objectives of raising endogenous serum

testosterone (T) and improving the testosterone/estrogen (T/E) ratio.

METHODS: Our cohort consisted of 36 Caucasian men with hypogonadism defined as

serum testosterone level less than 300 ng/dL. Each patient was treated with a

daily dose of 25 mg clomiphene citrate and followed prospectively. Analysis of

baseline and follow-up serum levels of testosterone and estradiol levels were

performed.

RESULTS: The mean age was 39 years, and the mean pretreatment testosterone and

estrogen levels were 247.6 +/- 39.8 ng/dL and 32.3 +/- 10.9, respectively. By

the first follow-up visit (4-6 weeks), the mean testosterone level rose to 610.0

+/- 178.6 ng/dL (P < 0.00001). Moreover, the T/E ratio improved from 8.7 to 14.2

(P < 0.001). There were no side effects reported by the patients.

CONCLUSIONS: Low dose clomiphene citrate is effective in elevating serum

testosterone levels and improving the testosterone/estradiol ratio in men with

hypogonadism. This therapy represents an alternative to testosterone therapy by

stimulating the endogenous androgen production pathway.

>

> This may have been discussed before but I would like the opinion of the

members of this group

>

> http://www.ncbi.nlm.nih.gov/pubmed/19694928

>

> Abstract

> INTRODUCTION: The efficacy of oral clomiphene citrate (CC) in the treatment of

male hypogonadism and male infertility (MI) with low serum testosterone and

normal gonadotropin levels has been reported.

>

> AIM: The aim of this article is to evaluate CC and testosterone gel

replacement therapy (TGRT) with regard to biochemical and clinical efficacy and

cost.

>

> MAIN OUTCOME MEASURES: The main outcome measures were change in serum

testosterone with CC and TGRT therapy, and change in the androgen deficiency in

aging male (ADAM) questionnaire scores with CC therapy.

>

> METHODS: Men receiving CC or TGRT with either Androgel 1% or Testim 1% for

hypogonadism (defined as testosterone < 300 ng/mL) or MI were included. Serum

values were collected 1-2 months after treatment initiation and semi-annually

thereafter. Retrospective data collection was performed via chart review.

Subjective follow up of patients receiving CC was performed via telephone

interview using the ADAM questionnaire.

>

> RESULTS: A hundred and four men (65 CC and 39 TGRT) were identified who began

CC (50 mg every other day) or TGRT (5 g). Average age (years) was 42(CC) vs. 57

(TGRT). Average follow up was 23 months (CC, range 8-40 months) vs. 46 months

(TGRT, range 6-149 months). Average posttreatment testosterone was 573 ng/dL in

the CC group and 553 ng/dL in the TGRT group (P value < 0.001). The monthly cost

of Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm daily) is $265, and CC (50

mg every other day) is $83. Among CC patients, the average pretreatment ADAM

score was 4.9 vs. 2.1 at follow up (P < 0.05). Average pretreatment ADAM sexual

function domain score was 0.76 vs. 0.23 at follow up (P < 0.05). There were no

adverse events reported.

>

> CONCLUSION: CC represents a treatment option for men with hypogonadism,

demonstrating biochemical and clinical efficacy with few side effects and lower

cost as compared with TGRT.

>

> Were mesaurements of E2 taken during the study - I cannot find a link to the

whole study to find out

>

[Guest guest]

I never tired Clomiphene for TRT what I know about this is what I read at Dr.

's forums it is not tested for long term use for treating low Testosterone

it has some bad sides like floaters in your eyes for one feelings of PMS like

women get. And you can't test for high levels of Estradiol on it so you can't

tell by labs if your Estraidol and some other hormones are low or high. You

need to be off Clomiphene for many weeks to get good labs.

There are a few men here on this doing a low dose per day some 3x's a week and

doing fine. Others can't take the sides.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Clomiphene citrate and testosterone gel replacement

therapy

>

> Date: Thursday, December 16, 2010, 1:20 PM

> This may have been discussed before

> but I would like the opinion of the members of this group

>

> http://www.ncbi.nlm.nih.gov/pubmed/19694928

>

> Abstract

> INTRODUCTION: The efficacy of oral clomiphene citrate (CC)

> in the treatment of male hypogonadism and male infertility

> (MI) with low serum testosterone and normal gonadotropin

> levels has been reported.

>

> AIM: The aim of this article is to evaluate CC and

> testosterone gel replacement therapy (TGRT) with regard to

> biochemical and clinical efficacy and cost.

>

> MAIN OUTCOME MEASURES: The main outcome measures were

> change in serum testosterone with CC and TGRT therapy, and

> change in the androgen deficiency in aging male (ADAM)

> questionnaire scores with CC therapy.

>

> METHODS: Men receiving CC or TGRT with either Androgel 1%

> or Testim 1% for hypogonadism (defined as testosterone <

> 300 ng/mL) or MI were included. Serum values were collected

> 1-2 months after treatment initiation and semi-annually

> thereafter. Retrospective data collection was performed via

> chart review. Subjective follow up of patients receiving CC

> was performed via telephone interview using the ADAM

> questionnaire.

>

> RESULTS: A hundred and four men (65 CC and 39 TGRT) were

> identified who began CC (50 mg every other day) or TGRT (5

> g). Average age (years) was 42(CC) vs. 57 (TGRT). Average

> follow up was 23 months (CC, range 8-40 months) vs. 46

> months (TGRT, range 6-149 months). Average posttreatment

> testosterone was 573 ng/dL in the CC group and 553 ng/dL in

> the TGRT group (P value < 0.001). The monthly cost of

> Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm daily) is

> $265, and CC (50 mg every other day) is $83. Among CC

> patients, the average pretreatment ADAM score was 4.9 vs.

> 2.1 at follow up (P < 0.05). Average pretreatment ADAM

> sexual function domain score was 0.76 vs. 0.23 at follow up

> (P < 0.05). There were no adverse events reported.

>

> CONCLUSION: CC represents a treatment option for men with

> hypogonadism, demonstrating biochemical and clinical

> efficacy with few side effects and lower cost as compared

> with TGRT.

>

> Were mesaurements of E2 taken during the study - I cannot

> find a link to the whole study to find out

>

>

>

> ------------------------------------

>

>

[Guest guest]

From the study

Average follow up was 23 months (CC, range 8-40 months)

Question - why do you need to be off Clomiphene for many weeks to get good labs?

I also posted a 2nd study

http://www.ncbi.nlm.nih.gov/pubmed/16422830

METHODS: Our cohort consisted of 36 Caucasian men with hypogonadism defined as

serum testosterone level less than 300 ng/dL. Each patient was treated with a

daily dose of 25 mg clomiphene citrate and followed prospectively. Analysis of

baseline and follow-up serum levels of testosterone and estradiol levels were

performed.

RESULTS: The mean age was 39 years, and the mean pretreatment testosterone and

estrogen levels were 247.6 +/- 39.8 ng/dL and 32.3 +/- 10.9, respectively. By

the first follow-up visit (4-6 weeks), the mean testosterone level rose to 610.0

+/- 178.6 ng/dL (P < 0.00001). Moreover, the T/E ratio improved from 8.7 to 14.2

(P < 0.001). There were no side effects reported by the patients.

The doses used were either 25mg ED or 50 mg EOD

>

> > From: cvictorg <cvgrashow@...>

> > Subject: Clomiphene citrate and testosterone gel replacement

therapy

> >

> > Date: Thursday, December 16, 2010, 1:20 PM

> > This may have been discussed before

> > but I would like the opinion of the members of this group

> >

> > http://www.ncbi.nlm.nih.gov/pubmed/19694928

> >

> > Abstract

> > INTRODUCTION: The efficacy of oral clomiphene citrate (CC)

> > in the treatment of male hypogonadism and male infertility

> > (MI) with low serum testosterone and normal gonadotropin

> > levels has been reported.

> >

> > AIM: The aim of this article is to evaluate CC and

> > testosterone gel replacement therapy (TGRT) with regard to

> > biochemical and clinical efficacy and cost.

> >

> > MAIN OUTCOME MEASURES: The main outcome measures were

> > change in serum testosterone with CC and TGRT therapy, and

> > change in the androgen deficiency in aging male (ADAM)

> > questionnaire scores with CC therapy.

> >

> > METHODS: Men receiving CC or TGRT with either Androgel 1%

> > or Testim 1% for hypogonadism (defined as testosterone <

> > 300 ng/mL) or MI were included. Serum values were collected

> > 1-2 months after treatment initiation and semi-annually

> > thereafter. Retrospective data collection was performed via

> > chart review. Subjective follow up of patients receiving CC

> > was performed via telephone interview using the ADAM

> > questionnaire.

> >

> > RESULTS: A hundred and four men (65 CC and 39 TGRT) were

> > identified who began CC (50 mg every other day) or TGRT (5

> > g). Average age (years) was 42(CC) vs. 57 (TGRT). Average

> > follow up was 23 months (CC, range 8-40 months) vs. 46

> > months (TGRT, range 6-149 months). Average posttreatment

> > testosterone was 573 ng/dL in the CC group and 553 ng/dL in

> > the TGRT group (P value < 0.001). The monthly cost of

> > Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm daily) is

> > $265, and CC (50 mg every other day) is $83. Among CC

> > patients, the average pretreatment ADAM score was 4.9 vs.

> > 2.1 at follow up (P < 0.05). Average pretreatment ADAM

> > sexual function domain score was 0.76 vs. 0.23 at follow up

> > (P < 0.05). There were no adverse events reported.

> >

> > CONCLUSION: CC represents a treatment option for men with

> > hypogonadism, demonstrating biochemical and clinical

> > efficacy with few side effects and lower cost as compared

> > with TGRT.

> >

> > Were mesaurements of E2 taken during the study - I cannot

> > find a link to the whole study to find out

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

It's in a class of drugs called Selective Estrogen Receptor Modulators (SERMs)

They selectively inhibit or stimulate estrogen-like action in various tissues.

Estrogen- Like action but not real Estrogen so doing labs your not reading ture

E's.

Co-Moderator

Phil

> From: cvictorg <cvgrashow@...>

> Subject: Re: Clomiphene citrate and testosterone gel

replacement therapy

>

> Date: Thursday, December 16, 2010, 2:18 PM

> From the study

>

> Average follow up was 23 months (CC, range 8-40 months)

>

> Question - why do you need to be off Clomiphene for many

> weeks to get good labs?

>

> I also posted a 2nd study

>

> http://www.ncbi.nlm.nih.gov/pubmed/16422830

>

> METHODS: Our cohort consisted of 36 Caucasian men with

> hypogonadism defined as serum testosterone level less than

> 300 ng/dL. Each patient was treated with a daily dose of 25

> mg clomiphene citrate and followed prospectively. Analysis

> of baseline and follow-up serum levels of testosterone and

> estradiol levels were performed.

>

> RESULTS: The mean age was 39 years, and the mean

> pretreatment testosterone and estrogen levels were 247.6 +/-

> 39.8 ng/dL and 32.3 +/- 10.9, respectively. By the first

> follow-up visit (4-6 weeks), the mean testosterone level

> rose to 610.0 +/- 178.6 ng/dL (P < 0.00001). Moreover,

> the T/E ratio improved from 8.7 to 14.2 (P < 0.001).

> There were no side effects reported by the patients.

>

> The doses used were either 25mg ED or 50 mg EOD

>

>

>

>

> >

> > > From: cvictorg <cvgrashow@...>

> > > Subject: Clomiphene citrate and

> testosterone gel replacement therapy

> > >

> > > Date: Thursday, December 16, 2010, 1:20 PM

> > > This may have been discussed before

> > > but I would like the opinion of the members of

> this group

> > >

> > > http://www.ncbi.nlm.nih.gov/pubmed/19694928

> > >

> > > Abstract

> > > INTRODUCTION: The efficacy of oral clomiphene

> citrate (CC)

> > > in the treatment of male hypogonadism and male

> infertility

> > > (MI) with low serum testosterone and normal

> gonadotropin

> > > levels has been reported.

> > >

> > > AIM: The aim of this article is to evaluate CC

> and

> > > testosterone gel replacement therapy (TGRT) with

> regard to

> > > biochemical and clinical efficacy and cost.

> > >

> > > MAIN OUTCOME MEASURES: The main outcome measures

> were

> > > change in serum testosterone with CC and TGRT

> therapy, and

> > > change in the androgen deficiency in aging male

> (ADAM)

> > > questionnaire scores with CC therapy.

> > >

> > > METHODS: Men receiving CC or TGRT with either

> Androgel 1%

> > > or Testim 1% for hypogonadism (defined as

> testosterone <

> > > 300 ng/mL) or MI were included. Serum values were

> collected

> > > 1-2 months after treatment initiation and

> semi-annually

> > > thereafter. Retrospective data collection was

> performed via

> > > chart review. Subjective follow up of patients

> receiving CC

> > > was performed via telephone interview using the

> ADAM

> > > questionnaire.

> > >

> > > RESULTS: A hundred and four men (65 CC and 39

> TGRT) were

> > > identified who began CC (50 mg every other day)

> or TGRT (5

> > > g). Average age (years) was 42(CC) vs. 57 (TGRT).

> Average

> > > follow up was 23 months (CC, range 8-40 months)

> vs. 46

> > > months (TGRT, range 6-149 months). Average

> posttreatment

> > > testosterone was 573 ng/dL in the CC group and

> 553 ng/dL in

> > > the TGRT group (P value < 0.001). The monthly

> cost of

> > > Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm

> daily) is

> > > $265, and CC (50 mg every other day) is $83.

> Among CC

> > > patients, the average pretreatment ADAM score was

> 4.9 vs.

> > > 2.1 at follow up (P < 0.05). Average

> pretreatment ADAM

> > > sexual function domain score was 0.76 vs. 0.23 at

> follow up

> > > (P < 0.05). There were no adverse events

> reported.

> > >

> > > CONCLUSION: CC represents a treatment option for

> men with

> > > hypogonadism, demonstrating biochemical and

> clinical

> > > efficacy with few side effects and lower cost as

> compared

> > > with TGRT.

> > >

> > > Were mesaurements of E2 taken during the study -

> I cannot

> > > find a link to the whole study to find out

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

If you use morning and evening wood to determine your e2 levels and adjust your

AI dosage why couldn't you do the same if you were on clomid?

> > >

> > > > From: cvictorg <cvgrashow@>

> > > > Subject: Clomiphene citrate and

> > testosterone gel replacement therapy

> > > >

> > > > Date: Thursday, December 16, 2010, 1:20 PM

> > > > This may have been discussed before

> > > > but I would like the opinion of the members of

> > this group

> > > >

> > > > http://www.ncbi.nlm.nih.gov/pubmed/19694928

> > > >

> > > > Abstract

> > > > INTRODUCTION: The efficacy of oral clomiphene

> > citrate (CC)

> > > > in the treatment of male hypogonadism and male

> > infertility

> > > > (MI) with low serum testosterone and normal

> > gonadotropin

> > > > levels has been reported.

> > > >

> > > > AIM: The aim of this article is to evaluate CC

> > and

> > > > testosterone gel replacement therapy (TGRT) with

> > regard to

> > > > biochemical and clinical efficacy and cost.

> > > >

> > > > MAIN OUTCOME MEASURES: The main outcome measures

> > were

> > > > change in serum testosterone with CC and TGRT

> > therapy, and

> > > > change in the androgen deficiency in aging male

> > (ADAM)

> > > > questionnaire scores with CC therapy.

> > > >

> > > > METHODS: Men receiving CC or TGRT with either

> > Androgel 1%

> > > > or Testim 1% for hypogonadism (defined as

> > testosterone <

> > > > 300 ng/mL) or MI were included. Serum values were

> > collected

> > > > 1-2 months after treatment initiation and

> > semi-annually

> > > > thereafter. Retrospective data collection was

> > performed via

> > > > chart review. Subjective follow up of patients

> > receiving CC

> > > > was performed via telephone interview using the

> > ADAM

> > > > questionnaire.

> > > >

> > > > RESULTS: A hundred and four men (65 CC and 39

> > TGRT) were

> > > > identified who began CC (50 mg every other day)

> > or TGRT (5

> > > > g). Average age (years) was 42(CC) vs. 57 (TGRT).

> > Average

> > > > follow up was 23 months (CC, range 8-40 months)

> > vs. 46

> > > > months (TGRT, range 6-149 months). Average

> > posttreatment

> > > > testosterone was 573 ng/dL in the CC group and

> > 553 ng/dL in

> > > > the TGRT group (P value < 0.001). The monthly

> > cost of

> > > > Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm

> > daily) is

> > > > $265, and CC (50 mg every other day) is $83.

> > Among CC

> > > > patients, the average pretreatment ADAM score was

> > 4.9 vs.

> > > > 2.1 at follow up (P < 0.05). Average

> > pretreatment ADAM

> > > > sexual function domain score was 0.76 vs. 0.23 at

> > follow up

> > > > (P < 0.05). There were no adverse events

> > reported.

> > > >

> > > > CONCLUSION: CC represents a treatment option for

> > men with

> > > > hypogonadism, demonstrating biochemical and

> > clinical

> > > > efficacy with few side effects and lower cost as

> > compared

> > > > with TGRT.

> > > >

> > > > Were mesaurements of E2 taken during the study -

> > I cannot

> > > > find a link to the whole study to find out

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > >