Clomiphene Citrate: Uses, Dosage, and Fertility Benefits

Summary or Key Points

Clomiphene, also known as Clomiphene citrate, is a medication commonly prescribed to treat infertility in women by stimulating ovulation. It is also used for conditions such as polycystic ovary syndrome (PCOS) and male infertility. Clomiphene works by encouraging the body to produce hormones that support ovulation. Always consult a healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions or concerns regarding Clomiphene for fertility.

Names of Medication

US Brand Name: Clomid

Generic Name: Clomiphene

The generic name, Clomiphene, refers to the active ingredient, while the brand name, Clomid, is assigned by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category

Selective Estrogen Receptor Modulator (SERM)

Clomiphene Dosage

Clomiphene is used to treat various conditions related to ovulation and fertility. The dosage and duration of treatment may vary depending on the specific condition. Always consult your doctor before adjusting your Clomiphene dosage. You can also schedule a telemedicine visit with one of our providers for personalized advice.

Polycystic Ovary Syndrome (PCOS)

Initial dose: 50 mg once daily for 5 days, starting on the 5th day of the menstrual cycle. If ovulation does not occur, the dose may be increased to 100 mg in subsequent cycles.

Ovulatory Dysfunction

Initial dose: 50 mg once daily for 5 days, starting on the 5th day of the menstrual cycle. The dose may be increased to 100 mg if ovulation does not occur.

Infertility (Female)

Initial dose: 50 mg once daily for 5 days, starting on the 5th day of the menstrual cycle. The dose may be increased to 100 mg if ovulation does not occur.

Hypogonadism (Male)

Initial dose: 25 mg to 50 mg daily. Treatment duration may vary depending on the response to therapy.

Amenorrhea

Initial dose: 50 mg once daily for 5 days. If ovulation does not occur, the dose may be increased to 100 mg in subsequent cycles.

Oligomenorrhea

Initial dose: 50 mg once daily for 5 days. The dose may be increased if ovulation does not occur.

Anovulation

Initial dose: 50 mg once daily for 5 days. The dose may be increased to 100 mg if ovulation does not occur.

Secondary Amenorrhea

Initial dose: 50 mg once daily for 5 days. If ovulation does not occur, the dose may be increased to 100 mg in subsequent cycles.

Male Infertility

Initial dose: 25 mg to 50 mg daily. Treatment duration may vary depending on the response to therapy.

Irregular Menstrual Cycles

Initial dose: 50 mg once daily for 5 days, starting on the 5th day of the menstrual cycle. The dose may be increased if ovulation does not occur.

Dosage Forms and Strengths

Tablet: 50 mg

Administration Instructions for Clomiphene

Clomiphene is typically taken orally in tablet form. Follow your healthcare provider’s instructions regarding timing and dosage. For most women, Clomiphene is taken for 5 days, starting on the 5th day of the menstrual cycle. If you miss a dose, contact your healthcare provider for guidance. Do not take extra doses to make up for a missed dose. Always take Clomiphene with a full glass of water, and it can be taken with or without food.

Contraindications for Clomiphene

A contraindication is a specific condition where a medication should not be used due to potential harm. It’s important to know if you have any contraindications before starting Clomiphene. Below are the most common contraindications and why Clomiphene is not recommended in these cases:

Liver disease: Clomiphene is metabolized in the liver. If you have liver disease, your body may not process the medication properly, leading to potential toxicity or worsening liver function.

Abnormal uterine bleeding: If you have unexplained vaginal or uterine bleeding, Clomiphene should not be used until the cause is identified. The medication could potentially worsen an undiagnosed condition, such as endometrial cancer.

Ovarian cysts: Clomiphene may enlarge ovarian cysts, especially in women with polycystic ovary syndrome (PCOS). If you have ovarian cysts unrelated to PCOS, Clomiphene could worsen them.

Pregnancy: Clomiphene is not recommended during pregnancy, as it may harm the developing fetus. It is used to induce ovulation, so it should be discontinued once pregnancy is confirmed.

Uncontrolled thyroid or adrenal disorders: These conditions can affect hormone levels, and Clomiphene may further disrupt hormonal balance, leading to complications.

Hypersensitivity to Clomiphene: If you have had an allergic reaction to Clomiphene in the past, you should not take it again, as it could cause serious allergic reactions such as rash, swelling, or difficulty breathing.

Drug to Drug Interactions with Clomiphene

Clomiphene can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either drug. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Clomiphene:

Danazol (Danocrine): Both Clomiphene and Danazol affect hormone levels, and using them together may increase the risk of ovarian hyperstimulation syndrome (OHSS).

Gonadorelin (Factrel): This medication is used to stimulate ovulation, and taking it with Clomiphene may increase the risk of multiple pregnancies (twins, triplets, etc.).

Hormonal contraceptives (e.g., birth control pills): Since Clomiphene is used to induce ovulation, taking it with hormonal contraceptives would counteract its intended effect.

Selective estrogen receptor modulators (SERMs) like Tamoxifen (Nolvadex): Both Clomiphene and Tamoxifen affect estrogen receptors, and using them together may lead to unpredictable effects on hormone levels.

Clomiphene in Pregnancy

Is it safe to take Clomiphene when pregnant? No, Clomiphene is not safe to use during pregnancy. This medication is designed to stimulate ovulation, and once pregnancy is confirmed, it should be discontinued. Continuing Clomiphene during pregnancy may increase the risk of birth defects or other complications. If you suspect you are pregnant while taking Clomiphene, contact your healthcare provider immediately to discuss the appropriate next steps.

Clomiphene While Breastfeeding

Is it safe to take Clomiphene while breastfeeding? Clomiphene is generally not recommended for use while breastfeeding. It may reduce milk production and could pass into breast milk, potentially affecting the nursing infant. If you are breastfeeding and considering Clomiphene, it’s important to discuss the potential risks and benefits with your healthcare provider.

Estimated Cost of Clomiphene

The cost of Clomiphene citrate can vary depending on the pharmacy and your location. Without insurance, a 30-day supply typically ranges from $10 to $30 when using a GoodRx coupon. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRx to find the most affordable option.

Possible Alternatives to Clomiphene

If Clomiphene is not suitable for you, or if you are exploring other treatment options, there are several alternatives available. Below are some options for conditions commonly treated with Clomiphene. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are also available to help you explore these alternatives.

Polycystic Ovary Syndrome (PCOS)

Lifestyle changes, such as weight loss, regular exercise, and a balanced diet, can help improve symptoms. Medications like Metformin or Letrozole may also be prescribed to promote ovulation.

Ovulatory Dysfunction

In addition to Clomiphene, medications like Letrozole or Gonadotropins (injectable hormones) may be used to stimulate ovulation. Lifestyle modifications, including stress management and maintaining a healthy weight, can also support ovulation.

Infertility

If Clomiphene is not effective, other fertility treatments such as In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI) may be considered. Consulting with a fertility specialist can help determine the most appropriate course of action for your situation.

Hypogonadism

For men with low testosterone levels, testosterone replacement therapy may be an option. In some cases, lifestyle changes like weight loss and regular physical activity can also help improve symptoms.

Amenorrhea

Hormonal treatments, such as estrogen or progesterone therapy, may help regulate menstrual cycles. Addressing underlying causes, such as stress, significant weight loss, or excessive exercise, can also be beneficial.

Oligomenorrhea

Hormonal treatments or lifestyle adjustments, such as improving diet, reducing stress, and maintaining a healthy weight, may help regulate irregular menstrual cycles.

Anovulation

In addition to Clomiphene, medications like Letrozole or Gonadotropins may be used to induce ovulation. Lifestyle changes, such as weight management, can also improve ovulation.

Secondary Amenorrhea

Treating the underlying cause, such as stress or weight fluctuations, is often the first step. Hormonal treatments may also be considered to help restore regular menstrual cycles.

Male Infertility

In addition to Clomiphene, lifestyle changes such as improving diet, reducing alcohol consumption, and managing stress can enhance sperm quality. Other treatment options, including Gonadotropins or IVF, may also be considered.

Irregular Menstrual Cycles

Hormonal treatments, such as birth control pills or progesterone therapy, can help regulate menstrual cycles. Lifestyle changes, including stress management and maintaining a healthy weight, may also be beneficial.

Recent Updates on Clomiphene Research

Recent research on Clomiphene has focused on its use in treating male infertility and hypogonadism. Studies have shown that Clomiphene can increase testosterone levels in men with low testosterone, offering a potential alternative to traditional testosterone replacement therapy. Additionally, ongoing research is examining the long-term effects of Clomiphene use in both men and women, particularly its impact on fertility and hormonal balance.

Researchers are also exploring the use of Clomiphene in combination with other medications, such as Letrozole, to improve ovulation rates in women with PCOS. Early findings suggest that combining these medications may enhance the chances of successful ovulation and pregnancy, though further studies are needed to confirm these results.

If you have any questions about Clomiphene or would like to discuss the latest research, our telemedicine providers are available to help you make informed decisions about your treatment plan.

James Kingsley

Learn More