introduce
Hypogonadism is a growing concern among the aging male population. Historically, exogenous testosterone has been used for treatment, and concerns about the possible side effects of testosterone have led doctors to seek alternative treatments.
Covered areas
Enclomiphene citrate is the trans-isomer of clomiphene citrate, a nonsteroidal estrogen receptor antagonist approved by the FDA for the treatment of ovarian dysfunction in women. Clomiphene citrate has also been used for many years to treat secondary male hypogonadism, particularly in cases of male infertility. Here, we review the literature examining the efficacy and safety of enclomiphene citrate in the setting of androgen deficiency.
Expert Opinion
Preliminary results support the conclusion that enclomiphene citrate androxal ncreases serum testosterone levels by increasing luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels without negatively affecting semen parameters. The ability to treat testosterone deficiency in men while maintaining fertility supports the role of enclomiphene citrate in the treatment of men who are not candidates for testosterone therapy.
Epidemiology of hypogonadism
Hypogonadism is defined as low serum testosterone levels associated with symptoms such as decreased libido, erectile dysfunction, loss of lean muscle mass, loss of energy, and depression. The most sensitive symptoms supporting a diagnosis of hypogonadism include erectile dysfunction and decreased libido. [1-3] Although accurately estimating the prevalence of hypogonadism is challenging, especially given its varying definitions, in 2006 Mulligan et al. 40% of men over 45 years of age were observed to exhibit low serum testosterone levels. [4, 5] Combining serum testosterone levels and the three symptoms of hypogonadism, the European Male Aging Study (EMAS) reported that the prevalence of hypogonadism in men aged 40-79 years was only With a prevalence of 2.1%, the Boston Area Community Health Study (BACHS) estimates the prevalence of hypogonadism in men aged 30-79 years to be 5.6% when taking serum testosterone levels and symptoms into account.
