Clomiphene citrate and testosterone gel replacement therapy

[Guest guest]

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