Clomid for Low Testosterone in Men: TTC Benefits

Many women undergoing fertility treatments are likely already familiar with Clomid. It’s a medication prescribed to help females ovulate, which in turn can increase the chances of becoming pregnant. 

But did you know that men can take Clomid as well? The drug is sometimes used as a treatment for low testosterone (low T), a condition where the testicles don’t produce enough of the male sex hormone. Low T symptoms include a reduced sex drive, erectile dysfunction, loss of armpit and pubic hair, shrinking testicles, and hot flashes. This condition can also have an impact on a couple’s attempts to conceive: “Low testosterone levels can affect a man’s fertility by decreasing sperm production and quality,” explains David Shusterman, M.D., a urologist and the Medical Director at NY Urology in New York City. Clomid, therefore, “works by boosting the body’s testosterone production,” says Dr. Shusterman. “For men wanting to start a family, Clomid can improve sperm production and quality, increasing the chances of conceiving.”

Although Clomid is a common fertility drug for women, “it is often the go-to treatment for patients with low testosterone, an abnormal semen analysis, and who are having difficulty conceiving,” says Jessica Boone, MPA, PA-C, infertility Physician Assistant, and owner of Fortitude Fertility Consulting.

Read on for Boone and Dr. Shusterman’s advice regarding Clomid as a low T treatment, and how it can potentially help with male fertility.  

Can men take Clomid for low testosterone?

The short answer is yes, but there are several caveats:

Clomid “can help boost testosterone levels by stimulating the pituitary gland to release more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn leads to increased testosterone production,” says Dr. Shusterman. But he also warns that prescribing Clomid for low testosterone in men “is not officially approved by the Food and Drug Administration (FDA).” The drug is usually prescribed off-label in these cases. 

“[Clomid] is typically not the first choice by many providers,” says Boone. This is because the medication “relies on the internal production of testosterone, which can take time as everyone responds differently to the medication, and fine adjustments of the medication are needed to find the right dose to help with the low T symptoms.” She goes on to say that Clomid on its own is not always enough to treat low testosterone, either. 

Is Clomid the right treatment for you?

If you’re experiencing low T, Boone recommends asking yourself this question: “‘Are you thinking about growing your family, or are you currently trying to conceive?’ The answer to this question is HUGE.” She explains that your intended conception timeline can directly impact the type of medication prescribed. (Clomid is a testosterone-enhancing drug; other low T treatments are of the testosterone-replacement variety.) 

“Many patients (and sadly many providers) do not realize that taking an outside source of testosterone (such as testosterone cypionate in testosterone-replacement therapy) can have a huge negative impact on sperm production,” she says. For those who choose testosterone-replacement therapy, Boone warns that it “can take three to nine months to get sperm production back on track.” And if you’re TTC, “three to nine months can feel like an eternity.”

But Boone says Clomid is “a great option for men who have low testosterone and are not done with their family planning.” The way the medication works – for men – is “by blocking the negative effects that estrogen has on the Hypothalamic Pituitary Axis (HPA), which monitors the production of testosterone and sperm” (see image below). This leads to an increase in LH and FSH production, “resulting in more internal natural testosterone production and better sperm production.”

What to expect while taking Clomid

Taking Clomid shouldn’t significantly impact your diet, but Boone and Dr. Shusterman recommend adopting an overall healthy lifestyle – and avoiding cigarettes and alcohol. “Eating healthy and staying active can help Clomid work better,” says Dr. Shusterman. “Alcohol consumption, smoking, and strenuous physical activities may reduce the effectiveness of Clomid and exacerbate side effects such as dizziness or drowsiness.”

It is critical to be mindful of these side effects. (Nausea and blurred vision are also possible reactions to Clomid.) “Increasing hydration and avoiding standing up too quickly are ways to improve the dizziness,” says Boone. “I always recommend that patients take the medication in the evening, so if they do experience side effects like nausea or headaches, [these] will occur while they are sleeping.”

Boone and Dr. Shusterman also emphasize the importance of consistency while on Clomid, as sticking to the prescribed dose will “prevent any symptoms from getting worse,” says Dr. Shusterman. 

Focusing on your fertility

If you think you may be suffering from low testosterone, make an appointment with your medical provider ASAP. Once you have a diagnosis, schedule a conversation with your physician to discuss treatment options – and to find out if Clomid is the right option for you. If having a family is a priority for you and your partner, “taking care of your health is crucial for boosting fertility,” says Dr. Shusterman, regardless of the treatment you choose.

Not sure where to start? Boone recommends these simple steps for optimizing men’s health and fertility: 

• Decrease alcohol to no more than two drinks in one day

• Avoid or cut back on tobacco and marijuana products

• Avoid wet heat exposures (hot tubs, saunas, steam rooms etc.)

• Maintain a healthy weight for your height

• Focus on a healthy, balanced diet, and consider a men's multivitamin with CoQ10 to fill in the gaps that are lacking in your diet

It’s also a good idea to incorporate exercise into your routine, because “exercise in men (regardless of weight loss) has been shown to improve semen parameters and sexual function due to increased testosterone production,” says Boone. She does, however, offer a word of caution to men who are avid cyclists: “Limit cycling to no more than one hour at a time and no more than five hours per week.”

Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.