Does Enclomiphene Increase Testosterone?

Key Takeaways:

• Enclomiphene stimulates your body’s own testosterone production, and research finds it can help restore levels to the normal range within 2 to 6 weeks. Other forms of testosterone therapy use synthetic versions of the hormone.

• Unlike testosterone replacement therapy, enclomiphene boosts luteinizing hormone and follicle-stimulating hormone—key points for preserving fertility in men. The difference means enclomiphene supports sperm production instead of suppressing it.

• Early studies show enclomiphene effectively increases testosterone and is generally well-tolerated, but long-term safety and efficacy data are still lacking.
  

Enclomiphene citrate can increase testosterone without compromising your fertility, making it a promising option for many men dealing with low levels of the hormone.

In this article, we’ll cover everything you need to know about how enclomiphene can increase natural testosterone production, to what magnitude, and how long it takes to work. We’ll also break down why enclomiphene might be a preferable intervention compared to testosterone replacement therapy (TRT), particularly for some men who want to preserve their fertility.

One small study measured the effects of daily enclomiphene supplementation in men with secondary hypogonadism — a type of low testosterone caused by insufficient signaling between the brain and the testes. Ultimately, enclomiphene raised their total testosterone into the normal range within about 2 to 6 weeks.

Testosterone restoration is one of the key benefits of enclomiphene. It’s also a key differentiator that sets it apart from testosterone replacement therapy, which replaces testosterone with a synthetic version of the hormone.

Testosterone restoration may be preferable to testosterone replacement for a few reasons. For one, testosterone replacement shuts down your body’s natural hormone production by suppressing luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This, in turn, affects spermatogenesis (sperm production), making testosterone replacement a risky choice for men planning to have kids.

Testosterone restoration, on the other hand, increases LH and FSH levels, which support your body’s natural production of testosterone and sperm, making enclomiphene a fertility-safe treatment option.

In addition to lowering sperm count, testosterone replacement is also linked to side effects like testicular shrinkage, male breast growth (gynecomastia), hair loss, enlarged prostate, and worsening of sleep apnea. These effects are not guaranteed, but they highlight the importance of careful monitoring by a healthcare professional.

By contrast, current studies suggest enclomiphene is less likely to cause these issues, though long-term safety data are still limited.

Enclomiphene citrate is a selective estrogen receptor modulator (SERM), just like clomiphene citrate (Clomid^®). Enclomiphene acts on the hypothalamic-pituitary-gonadal axis, which is like an air traffic control tower for the body, guiding signals from the brain to the testes.

A key differentiator between Enclomiphene and TRT is that the former works by promoting your body’s natural testosterone production, while the latter supplements the hormone with a synthetic version.

Here’s a quick breakdown of how enclomiphene works:

1. Enclomiphene binds to estrogen receptors in the brain. By binding to estrogen receptors in the hypothalamus region of the brain, enclomiphene reduces estrogen’s negative feedback on the hypothalamic-pituitary-gonadal axis. This stimulates the release of gonadotropin-releasing hormone (GnRH).

2. GnRH signals the pituitary gland to release gonadotropins. The release of GnRH prompts the pituitary gland to secrete luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

3. LH and FSH stimulate testosterone and sperm production. Increased LH and FSH levels trigger the testes' Leydig cells to make more testosterone and the Sertoli cells to produce more sperm.

In short, enclomiphene tricks your body into creating more testosterone by activating the signals between the brain and the testes, all without compromising your fertility.

In a small study of 44 men prescribed either oral enclomiphene citrate or topical testosterone, both treatments raised testosterone into the normal range within 2 to 4 weeks. Enclomiphene also restored LH and FSH, while TRT suppressed those hormones.

Some other notable study findings:

• Enclomiphene produces more consistent results. Enclomiphene generally increases testosterone across different dose groups, with higher doses tending to produce slightly greater rises. For example, studies comparing 12.5-milligram (mg) and 25-mg doses conclude that the 25-mg dose may lead to higher total testosterone, but increases are variable and remain within the normal physiologic range. This gradual, controlled rise may help to avoid the high-end spikes sometimes seen with exogenous testosterone therapy.

• Enclomiphene treatment mimics the natural daily rhythm of testosterone release. Enclomiphene may partially restore the natural circadian rhythm of testosterone (morning peak, midday dip, evening rise), though further research is needed to confirm this effect.

• Enclomiphene has a “legacy effect.” After study participants stopped enclomiphene treatment, testosterone, FSH, and LH levels remained elevated for at least 1 week, while TRT users saw a rapid decline in their T levels after discontinuing.

Ultimately, both enclomiphene and TRT are effective in normalizing testosterone levels in men with low T, but enclomiphene may do so in a way that preserves fertility, provides steadier hormone levels, and carries a legacy effect that gives more stability if you miss a dose or two.

On average, enclomiphene treatment can increase testosterone by 150 to 340 ng/dL when taken daily. Men typically reach a normal range of testosterone within 2 to 6 weeks of taking enclompiphene.

• In one small 2015 study, men with low baseline total testosterone (<350 ng/dL) saw a mean increase of 154 to 230 ng/dL within 2 weeks, while those with normal baseline total testosterone (>350 ng/dL) experienced increases of 187 to 340 ng/dL.

• Another small study compared enclomiphene to clomiphene citrate (Clomid^®) in hypogonadal men. Findings reported that men taking enclomiphene saw a median increase of 166 ng/dL in their serum testosterone levels, compared to 98 ng/dL with clomiphene.

• In a small 2013 study that compared the efficacy of enclomiphene to testosterone gel, enclomiphene increased testosterone by about 350 ng/dL on average — from around 165 ng/dL at baseline to around 525 ng/dL after treatment — while also preserving fertility. This rise was comparable to the increase seen with testosterone gel, but the gel did not preserve sperm counts.

It’s important to note that although enclomiphene can lead to significant increases in testosterone, these improvements typically plateau within the normal physiological range (typically 300 to 1,000 ng/dL).

Most of the available research shows enclomiphene can work within 2 to 4 weeks, though results can vary depending on factors like age, dose, testicular function, and overall health. However, it may also take longer to notice changes in how you feel.

For now, enclomiphene is still considered an investigational medication, and there’s not enough data to specify for certain how quickly or effectively enclomiphene reduces symptoms of male hypogonadism.

It’s best to work closely with a healthcare provider to perform follow-up blood tests and track your symptoms so they can adjust your dose or treatment plan if you’re not seeing results.

No, enclomiphene is not yet approved by the Food and Drug Administration, but it’s one of the two isomers (a chemical compound) in clomiphene citrate, which is FDA-approved to treat female infertility.

A key difference between enclomiphene and clomiphene is that clomiphene also contains the estrogen agonist zuclomiphene, which acts like estrogen in the body. Enclomiphene’s elimination half-life is approximately 9 to 10 hours in men. By contrast, the zuclomiphene isomer (found in clomiphene) has a much longer half-life (on the order of weeks) and can persist in the body.

Though not FDA-approved, providers can prescribe enclomiphene, which certain compounding pharmacies can fill. Compounding pharmacies combine or alter ingredients to produce personalized medications to fit individualized needs.

Enclomiphene may cause side effects in some users, including headaches, hot flashes, nausea, visual symptoms, and muscle cramps.

Most adverse events in trials were mild to moderate, but serious risks, while uncommon, are possible. Specifically, some reviews warn of the possibility of blood clots.

Due to this slight risk of blood clots and cardiac events, enclomiphene may not be appropriate for men with a preexisting risk of blood clots or those taking blood thinners. The medication is also not suitable for men with primary hypogonadism, or low testosterone that originates in the testes.

It’s important to remember that enclomiphene isn’t FDA-approved, and while early studies suggest it’s generally well-tolerated with mostly mild side effects, long-term safety is still unknown. Robust trials are needed in order to confirm its full risk profile. Read more about enclomiphene’s side effects and safety.

Testosterone plays many roles in your body, helping to regulate your sexual function, muscle mass, mood, bone density, and sperm production. When your testosterone levels are too low or you have a testosterone deficiency, you may have symptoms like low libido, erectile dysfunction (ED), fatigue, brain fog, mood changes, weakness, and more.

For reference, the American Urological Association defines low testosterone as a level below 300 ng/dL. A diagnosis requires two separate early-morning blood tests on different days showing consistently low testosterone and the presence of symptoms of deficiency.

Hims offers access to prescription treatments for low testosterone, including enclomiphene as a monotherapy and a combination treatment of enclomiphene + tadalafil to target low T and ED at the same time. Schedule a consultation with a healthcare provider to test your testosterone levels at home and see if you qualify for treatment.

Your healthcare provider can offer you guidance on other ways to support natural testosterone production, either alongside medication or with lifestyle shifts. Such lifestyle factors may include:

• Eating a well-rounded diet. Healthy nutrition helps you get the vitamins and minerals you need in order to synthesize hormones, including testosterone. It also enables you to maintain a healthy weight, which is just as crucial to testosterone production.

• Exercising. Some research supports that regular exercise, specifically aerobic exercise, may help increase testosterone by burning fat and improving cardiorespiratory fitness.

• Considering supplementation. If your diet is limited or you have vitamin deficiencies, dietary supplements can help close gaps in your nutrition.

• Prioritizing sleep. Testosterone production peaks during sleep. Most adults should aim to get 7 to 9 hours of shut-eye per night.

• Lowering your stress levels. Chronic stress elevates your cortisol levels, which can suppress testosterone production. Explore ways to regulate your stress, such as mindfulness meditation, breathing exercises, and journaling.

Enclomiphene is emerging as a promising alternative to TRT, especially for men with secondary hypogonadism who want to boost testosterone without sacrificing fertility.

Research supports that enclomiphene can effectively raise testosterone levels within a few weeks and restore natural hormone signaling while maintaining sperm production.

Here’s what we know:

• Enclomiphene increases your testosterone levels by restoring natural hormone signaling. TRT, on the other hand, replaces testosterone with a synthetic version.

• Enclomiphene preserves fertility. Unlike TRT, which does not protect fertility, enclomiphene boosts LH and FSH, which are crucial for natural testosterone and sperm production.

• Enclomiphene typically raises testosterone into the normal range within 2 to 4 weeks. According to research, the average increase is about 150 to 340 ng/dL, depending on baseline levels and dose.

• There are still evidence gaps. Most trials are short-term, so while results are encouraging, more robust, long-term studies are needed to fully define enclomiphene’s safety and efficacy.

• Enclomiphene is not FDA-approved. It may be available only through certain compounding pharmacies.

Want to learn more about how enclomiphene works? Find out the difference between enclomiphene and steroids and discover what happens when you stop taking enclomiphene. You can also explore even more testosterone resources.

What is enclomiphene?

Enclomiphene is a selective estrogen receptor modulator (SERM) that helps your body produce more testosterone naturally. It works by improving signaling between the brain and the testes.

Does enclomiphene increase testosterone?

Yes. Studies show that oral enclomiphene can raise total testosterone by about 150 to 340 ng/dL, often restoring levels into the normal range within 2 to 6 weeks.

How does enclomiphene work?

Enclomiphene blocks estrogen’s feedback signals in the brain, prompting the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These signal the testes to make more testosterone and sperm.

How does enclomiphene compare to testosterone replacement therapy?

Both treatments can raise testosterone levels, but TRT replaces the hormone directly and may reduce fertility. Enclomiphene, on the other hand, can restore your body’s own testosterone production while preserving sperm count.

Is enclomiphene approved by the FDA?

No. Enclomiphene is not FDA-approved, but it is available at certain compounding pharmacies with a valid prescription.

How long does it take for enclomiphene to work?

Most studies show results within 2 to 4 weeks, though it may take longer for symptoms like energy and libido to improve.

Is enclomiphene safe?

Early research suggests it’s generally well-tolerated, with mild side effects such as headaches, nausea, or hot flashes. However, more studies are needed to confirm long-term safety.

Who should not take enclomiphene?

Enclomiphene may not be suitable for men with primary hypogonadism (where the testes can’t produce testosterone) or those with a history of blood clots or cardiovascular disease.