Enclomiphene
Enclomiphene citrate
Also known as: Androxal, trans-clomiphene
The trans isomer of clomiphene, prescribed off-label through compounding to raise testosterone while preserving sperm production; never FDA-approved on its own after repeated complete response letters.
Overview
Enclomiphene blocks estrogen receptors in the hypothalamus so the pituitary releases more LH and FSH, raising the body's own testosterone. Randomized trials against topical testosterone showed higher testosterone with preserved sperm counts, and a 2025 meta-analysis supports the hormonal effect. The FDA declined to approve it as Androxal (most recently in 2015) on questions about clinical benefit, so it is available only as a compounded prescription. Telehealth clinics built around it launched in 2026. Long-term outcome data (fractures, cardiovascular events) do not exist.
Mechanism of action
Selective estrogen receptor antagonism at the hypothalamus, increasing GnRH, LH and FSH and therefore endogenous testosterone.
Key studies & citations
- Human2014
Enclomiphene citrate versus topical testosterone in men with secondary hypogonadism
Raised testosterone while preserving sperm concentration.
Fertility and Sterility - Review2025
Enclomiphene for male hypogonadism: systematic review and meta-analysis
Consistent testosterone increase; limited long-term outcome data.
Archives of Endocrinology and Metabolism
Frequently asked questions
Enclomiphene or TRT?
Enclomiphene raises your own testosterone and keeps fertility; TRT replaces it and suppresses sperm production. Which is appropriate is a medical decision with trade-offs neither this page nor a vendor can make.
Why is it not FDA-approved?
The FDA issued complete response letters on the Androxal application, questioning whether raising testosterone in this population produced a proven clinical benefit.