Restoring testosterone levels in men.

Testosterone Restoration Using Enclomiphene Citrate in Men with Secondary Hypogonadism: A Pharmacodynamic and Pharmacokinetic Study:

Goals: To determine the pharmacodynamic profile of serum total testosterone and luteinizing hormone levels in men with secondary hypogonadism after initial single dose and long-term oral administration of enclomiphene citrate compared with transdermal testosterone.

To determine the effect of enclomiphene citrate versus transdermal testosterone on other hormones and markers in men with secondary hypogonadism.

Patients and Methods: This study was a randomized, single-blind, two-center, phase 2 study to evaluate the effect of three different doses of enclomiphene citrate (6.25, 12.5, and 25 mg) versus transdermal testosterone on 24-hour LH and total testosterone levels in patients. with secondary hypogonadism without comorbidities.

Forty-eight men were included in the study, with 4 men having basal testosterone levels greater than 350 ng/dl. Forty-four patients completed the study in accordance with the protocol. All subjects included in this study demonstrated low testosterone levels (<350 ng/dL) and low to normal LH levels (<12 IU/L) on at least two measurements.

Total testosterone and LH levels were measured at 1 hour intervals over 24 hours to evaluate the effect of each of the three treatment doses of enclomiphene citrate compared to a standard dose (5 g) of transdermal testosterone. To assess the effect of the initial single dose, total testosterone and LH were determined in the control population after a single oral or transdermal dose (day 1). These data were contrasted with those obtained after 6 weeks of continuous oral or transdermal therapy (day 42).

The pharmacokinetics of enclomiphene citrate have been evaluated in a selected group of patients.

Restoring testosterone levels in men – Results

After 6 weeks of regular dosing, mean (standard deviation, SD) total testosterone by day 42 was 604 (160) ng/dL for men taking the highest dose of enclomiphene citrate (enclomiphene citrate, 25 mg once daily) and 500 (278) ng/dl in men treated with transdermal testosterone. These values were greater than day 1 values but were not statistically different from each other (p=0.23, t-test).

All three doses of enclomiphene citrate increased testosterone concentration to time point 0 of each 24-hour study interval, mean, maximum, minimum and range of testosterone concentrations over the 24-hour period. Transdermal testosterone also caused an increase in total testosterone levels, although with great variability and LH suppression.

The patterns of change in total testosterone over a 24-hour period after 6 weeks of use can be described by a non-linear function with a morning rise, daytime troughs, and nighttime rises.

Enclomiphene citrate and transdermal testosterone increased total testosterone levels for 2 weeks, while having opposite effects on FSH and LH.

Treatment with enclomiphene citrate had no significant effect on levels of TSH, ACTH, cortisol, lipids, and bone markers. Both transdermal testosterone and enclomiphene citrate reduced insulin-like growth factor-1 levels (p < 0.05), but the suppression was more pronounced in the enclomiphene citrate group.


Enclomiphene citrate increases LH and total serum testosterone levels; however, no temporal relationship was noted between peak levels of the drug and these hormones.

Enclomiphene citrate consistently increased serum total testosterone levels within normal limits and increased LH and FSH levels above normal limits. The effects of LH and total testosterone were present for at least 1 week after treatment was stopped.

Preparations for stimulating ovulation

Preparations for stimulating ovulation. Injections and pills to help get pregnant.

To get pregnant, you need to fulfill three basic conditions:

  1. the woman has ovulated;
  2. the sperm has fertilized the egg;
  3. the fetus is firmly fixed in the uterus.


  1. drugs that enhance the production of FSH and LH, which help to get pregnant, stimulate ovulation – the growth of follicles on the ovaries;
  2. HCG helps the largest follicle to stay big enough to release an egg for a sperm to fertilize;
  3. progesterone prepares the inner layer of the uterus to secure the embryo and helps to carry the fetus.

Who needs preparations for stimulating ovulation

If the question “Why can’t I get pregnant?” is relevant for you, then you need to undergo an examination. Well, if your spouse does the same, it would help to establish the cause of infertility.

Ovulation stimulation should be recommended by a doctor after a series of examinations that will give accurate data on the cause of problems with independent conception. The doctor prescribes drugs to stimulate ovulation in cases where:

  • The patient noted a rare maturation of the egg and its release from the ovaries;
  • The couple has been trying to conceive for over a year to no avail;
  • Spouses older than 35-40 do not get pregnant within 6 months.

In this case, stimulation of ovulation is prohibited in the following cases:

  • Partner infertility
  • The presence of inflammation of the appendages, with andexitis
  • With pathologies of the uterus
  • In case of poor patency of the fallopian tubes

Drugs that help get pregnant, such as Clomid, are selected individually, depending on the results of tests and ultrasound examinations.

Frequently Asked Questions Related to Getting Pregnant

Can I get pregnant with PCOS?

The chance of getting pregnant with PCOS is very low. The greater the number and size of cysts, the less chance of conceiving a child.

Can I get pregnant with uterine fibroids?

The presence of fibroids significantly reduces the likelihood of pregnancy. The larger the diameter of the nodes, the less chance of pregnancy.

Can I get pregnant with endometriosis?

The probability of conceiving a baby with a diagnosis of endometriosis is, but very small. Severe stages of endometriosis can cause infertility.

Will I be able to get pregnant in the future if my first pregnancy ended in an abortion?

Doctors do not recommend ending the first pregnancy with a surgical abortion – the likelihood of infertility in this case is high. However, this is not the rule: some women safely bear children even after several abortions.

How to use prescribed preparations for stimulating ovulation

Drug regimens depend on the stimulation protocol, so you must strictly follow the doctor’s recommendations. Most drugs are administered intramuscularly or subcutaneously. Many of them have their own characteristics regarding the use and storage, and they are associated not only with the drug itself, but also with the form of release proposed by the manufacturer. In this regard, we advise you to make the first injection in our treatment room, where the nurse will tell you, and most importantly, show you how to properly administer a particular drug. We categorically do not recommend making injections according to the description on the Internet – the price of an error may be too high.