Clomiphene, which is commonly known by its brand name Clomid, is a selective estrogen receptor modulator (SERM) that is made of a mix of two isomers — enclomiphene and zuclomiphene.
The FDA label for clomiphene is for treatment of female infertility by inducing ovulation. In men, they can also be used to increase testosterone production and improve fertility through similar pathways.
To better understand how it works, we’re going to focus the discussion first on the mechanism and effects of the more important isomer, enclomiphene. I’ll also cover zuclomphene, which will help in understanding why we prefer the pure enclomiphene isomer over the combination enclomiphene+zuclomiphene that comes as Clomid. Last, I’ll give my recommendations for the use of enclomiphene (who should consider it and how).
Mechanism and Effects of Enclomiphene
Enclomiphene is an estrogen receptor antagonist (blocks the estrogen receptor) at the level of the hypothalamus.
Because estrogen provides negative feedback on the release of of GnRH from the pituitary, blocking estrogen results in the opposite effect which is increased GnRH release.
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