Clomid for men: uses, side effects, and drug interactions 

Many people experience low testosterone. However, some treatments (like testosterone replacement therapy) can lead to side effects like infertility. Clomid may be one option to treat low testosterone while preserving fertility, or it may be prescribed to treat male infertility. Continue reading to learn more.

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Clomid (active ingredient, clomiphene citrate) is a drug originally developed to treat female infertility by encouraging ovulation but is sometimes used off-label to treat low T and/or infertility in men. This means the US Food and Drug Administration (FDA) doesn’t specifically approve clomiphene for this purpose, though many healthcare providers will prescribe it to improve low T and sperm production.

Testosterone levels decrease naturally with age. Signs and symptoms of low testosterone include decreased libido, erectile dysfunction (ED), fatigue, and muscle weakness. 

If you’ve experienced low T, you may have heard of testosterone replacement therapy (TRT) as a treatment option. While effective, there is one potential downside: TRT can adversely impact male fertility. That’s why some people opt for an alternative treatment like Clomid. 

In addition to treating low testosterone in some men, Clomid may be prescribed to treat male infertility (off-label), especially when low testosterone is detected. However, more research is needed to understand the efficacy of Clomid in treating male infertility. A recent review of studies testing the efficacy of Clomid in treating male infertility yielded “varied and unreliable” results (Chehab, 2015). Other small, limited studies showed promising results when combining Clomid with vitamin E, but more research is needed (ElSheikh, 2015).

Clomid treatment in men works by tricking your brain into thinking there’s not enough testosterone in your system. Your body responds by ramping up its natural production of the hormone. This way, you can increase testosterone levels without harming your fertility (Krzastek, 2019).

The testicles are the factories that make testosterone, but your brain is in charge of managing the whole thing. When the brain senses that your body has enough testosterone, it shuts down the factory. However, sometimes its sensors are a bit off, and it shuts down production even when testosterone levels aren’t quite where they should be. 

That’s where Clomid can help. Taking clomiphene encourages your brain to release two hormones: LH (luteinizing hormone) and FSH (follicle-stimulating hormone). These hormones tell the testicles when to ramp up testosterone production (Mbi Feh, 2022). 

Because Clomid doesn’t dull testosterone production like TRT, it maintains male fertility. Research also suggests clomiphene is safe and effective for treating low testosterone (Krzastek, 2019). 

Common side effects people reported while taking Clomid include (Krzastek, 2019):

• Mood changes

• Chest tenderness

• Blurry vision

• Weight gain

• Acne

Rarely, people will experience other adverse reactions like high blood pressure (hypertension), altered taste, asthma, flushing, nausea, excess thirst, and joint aches.

One study showed that Clomid is well tolerated over a three-year treatment period. It also found that Clomid helped the majority of participants to see symptoms improve and reach normal testosterone levels after three years of therapy (Krzastek, 2019).

If you’re prescribed Clomid to treat low testosterone or infertility, tell your healthcare provider about any other medications you take. There are no documented specific drug interactions with Clomid, but talk to your healthcare professional if you have any questions (DailyMed, 2021).

Low testosterone is a common condition that affects approximately 40% of men over age 45. Having low T can lead to a host of health problems like decreased muscle strength, low sex drive, and erectile dysfunction (Sizar, 2022). 

If you think you have low testosterone levels, the only way to know for sure is to have your blood levels tested. Your healthcare provider may order blood tests to check what’s called your total and free testosterone levels. Since these are the highest in the morning, most providers will recommend checking your levels between 8–10 AM (Nassar, 2022). 

Testosterone replacement therapy 

A common treatment for low T is testosterone replacement therapy (TRT). In essence, TRT gives your body the testosterone it isn’t producing. Testosterone therapy comes in several forms, including injections, pellets, gels, and patches. 

While effective, TRT does have side effects. One major one is that it can harm sperm production and cause male infertility. That’s because, over time, TRT shuts down your body’s natural production of sperm and testosterone (Patel, 2019).

In addition to medical interventions like taking Clomid, some people pursue ways to naturally boost testosterone production. Research suggests exercise––like high-intensity interval training (HIIT) or resistance training—may lead to higher hormone levels (Riachy, 2020).

Sleep is the time when your body produces the most testosterone. If you're not getting enough quality sleep (for example, if you have a condition like sleep apnea), your testosterone levels may drop. Aim to get 7–9 hours of sleep each night for your testosterone factories to work their best (Liu, 2019).

If you have questions about male infertility, low testosterone, or Clomid, speak with a healthcare provider or fertility specialist to create a treatment plan that’s right for you.

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Current version

September 23, 2022

Written by

Cale Li, MD

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.