Enclomiphene citrate, an investigational medication that has gained attention for its potential as a treatment for low testosterone levels, is not known to cause hair loss directly. Still, it’s a common misconception.
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Enclomiphene citrate, an investigational medication that has gained attention for its potential as a treatment for low testosterone levels, is not known to cause hair loss directly. Still, it’s a common misconception.
Here’s where the confusion may come from: Some research suggests that testosterone replacement therapy (TRT) may increase the risk of hair loss by raising levels of dihydrotestosterone (DHT), a byproduct of testosterone. This typically affects men who are already genetically predisposed to male pattern baldness.
Because enclomiphene also has the ability to raise low testosterone levels, you might wonder whether it carries the same risk, and if so, to what extent. Keep reading to explore the connection between enclomiphene and hair loss, how it compares to TRT regarding hair health, and what to do if you’re noticing hair thinning on either treatment.
Enclomiphene is a selective estrogen receptor modulator (SERM) and one of the isomers in clomiphene citrate (Clomid®). While Clomid is FDA-approved to treat female infertility, it’s often prescribed off-label for secondary hypogonadism, a type of low testosterone caused by disrupted signaling between the brain and the testes.
Enclomiphene is not FDA-approved. It might be available through compounding pharmacies with a valid prescription or by enrolling in a clinical trial.
Beyond their FDA approval status, enclomiphene and clomiphene differ because the latter also contains zuclomiphene, an estrogen agonist linked to adverse effects like gynecomastia (breast growth), hot flashes, and mood swings.
Both enclomiphene and clomiphene work by blocking estrogen receptors. This prompts the body to produce more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which signal the testes to increase testosterone and sperm production.
Male pattern hair loss, or androgenic alopecia, is a progressive condition tied to genetics. If you have a family history of hair loss, there’s a good chance you may be at risk, too.
The testosterone byproduct DHT is a key contributor to male hair loss. During puberty, your body relies on DHT to help develop external genitals, facial hair, and the prostate gland. But in adulthood, its role becomes less vital and potentially more problematic.
DHT is formed when testosterone is converted by the enzyme 5-alpha reductase. In men who inherit a genetic sensitivity in their scalp hair follicles, DHT triggers follicular miniaturization, causing follicles to shrink over time and produce thinner, shorter hairs until growth eventually stops.
While only a small portion of testosterone—roughly 5 to 10 percent in circulation—is converted to DHT, higher testosterone levels can lead to higher DHT levels, which may increase the risk of hair loss in men with a genetic predisposition.
No, hair loss is not a reported side effect of enclomiphene for now. This may have something to do with how enclomiphene affects DHT levels. That said, keep in mind that enclomiphene is not FDA-approved, and long-term effects—including on hair loss—are not well studied.
In a study comparing enclomiphene to topical testosterone, enclomiphene increased total and free testosterone over 14 days without increasing DHT disproportionately. However, topical testosterone was associated with a disproportionate increase in DHT relative to total testosterone.
There have been reports of hair loss in clomiphene users (including enclomiphene), but this side effect was seen in less than 1 percent of users, and they were all female.
We don’t know much about how clomiphene and enclomiphene affect DHT levels. Because SERMs raise the body’s own testosterone, and testosterone can turn into DHT, it’s possible enclomiphene could increase DHT and lead to hair loss in some men. However, we don’t have direct evidence, so it’s unclear if this actually affects hair loss.
Something else to keep in mind: The prevalence of hypogonadism increases with age, as does male pattern hair loss. So it’s possible that the two can occur together without a causal link.
Like any medication that affects your hormone levels, enclomiphene has a few potential side effects you should know about.
Enclomiphene side effects reported in trials included:
Headaches
Nausea
Hot flush
Back pain
Muscle spasms
Blurry vision
Increase in estradiol
However, these side effects occurred in less than 1 percent of users.
Like enclomiphene, TRT doesn’t directly cause hair loss but may accelerate the process in genetically predisposed men. TRT may carry a higher risk because of its pronounced effect on DHT.
One study investigated the effects of oral enclomiphene citrate compared with testosterone gels in men with hypogonadism, measuring serum total testosterone , and dihydrotestosterone (DHT) levels among other hormones. Both treatments were found to increase DHT levels alongside testosterone. Enclomiphene citrate raised DHT in proportion to its stimulation of endogenous testosterone, while testosterone gels increased DHT through direct administration. Both elevate DHT, but enclomiphene works by boosting the body’s own production, whereas gels rely on external testosterone.
In summary, while enclomiphene may be a more “hair-friendly” option than TRT, more research is needed to fully understand its impact on hair over time.
Whether you’re using enclomiphene, clomiphene, or TRT, there are hair loss treatments you can explore to prevent hair loss while addressing your hormone imbalances. They include:
Minoxidil. Minoxidil (the generic name for Rogaine®) is a topical, over-the-counter medication believed to stimulate hair growth by lengthening the anagen (active growth) phase of the hair growth cycle.
Finasteride. Finasteride (the active ingredient in brand-name Propecia®) is a hair loss prescription treatment that blocks the conversion of testosterone to DHT. This helps reduce DHT levels, minimizes damage to hair follicles, and potentially promotes hair regrowth.
Minoxidil + finasteride. The best of both worlds? A 2-in-1 treatment of minoxidil and finasteride offers a convenient, science-backed solution that tackles hair loss from two angles: stimulating follicles and reducing the hormone that causes them to shrink.
Low-level laser light therapy (LLT). This noninvasive treatment uses low-intensity light to stimulate cellular activity in hair follicles and promote hair growth.
Hair transplant. During a hair transplant, a surgeon removes hair follicles from the back and sides of the head and uses them to create extra hair density in the crown, hairline, or other areas of the scalp with noticeable hair loss. Unfortunately, hair transplant surgeries can be costly and are typically not covered by insurance.
You can also make lifestyle changes and use more natural solutions, though they may not work as quickly or effectively as the above options.
Get adequate protein. Research shows that the hair shaft is almost entirely made of protein, specifically, keratin. Therefore, it’s essential to eat enough protein to support healthy hair.
Consider vitamins and supplements. You can get most of the nutrients your body needs to support hair growth and overall well-being from a varied diet. But sometimes supplements can help close nutritional gaps that might contribute to your hair loss. One popular supplement is biotin, a B vitamin that supports hair, skin, and nails. Another popular supplement is saw palmetto, a natural DHT inhibitor that reduces DHT levels by a modest amount, which may slow the progression of hair loss in men with androgenic alopecia. Supplements such as biotin and saw palmetto have limited evidence for efficacy in androgenic alopecia and should not be relied upon as primary treatment.
Lower your stress levels. Stress exacerbates hair loss by altering cortisol and neurotrophic factor levels, even in people with androgenic alopecia. Regular exercise, quality sleep, and mindfulness can help lower your stress levels. Still, if you need extra support for chronic stress, it may be worth getting medical advice from a mental health professional.
Enclomiphene hasn’t been directly linked to hair loss, and some limited research suggests it may be a more hair-friendly alternative to TRT. While both treatments raise testosterone levels, enclomiphene doesn’t increase DHT disproportionately, which means it may not increase the risk of hair loss in genetically prone men.
Here’s what we know:
DHT plays a central role in male pattern hair loss. Elevated DHT levels, especially in men with a family history of hair loss, can shrink hair follicles and accelerate thinning.
TRT may increase hair loss risk by raising DHT disproportionately. It also suppresses the body’s natural hormone production, which may affect fertility.
Enclomiphene might be a more hair-friendly treatment. Limited research shows enclomiphene boosts testosterone without spiking DHT too much or shutting down LH and FSH, meaning it may not put your hair at higher risk of shedding.
If you’re struggling with symptoms of low testosterone like erectile dysfunction (ED) or low libido, get advice from a healthcare professional today to discuss treatment options.
Plus, explore more resources on hair loss and how to increase testosterone naturally.
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