Enclomiphene vs Clomid for Men: How They Differ and What Studies Show

Enclomiphene vs Clomid is mostly a question about one ingredient. Clomid is the brand name for clomiphene citrate, which is a mixture of two forms of the same molecule: enclomiphene and zuclomiphene, as the authors of an early enclomiphene trial in men explain. Enclomiphene is sold on its own through compounding pharmacies, while Clomid is an FDA-approved drug that doctors prescribe to men off-label.

Both raise testosterone the same basic way. The studies below suggest the differences show up mainly in estradiol, side effects, fertility results and price.

The short answer

• Both are oral SERMs (selective estrogen receptor modulators) that push the body to make more of its own testosterone.
• In one 66-man study, enclomiphene raised testosterone about as much as clomiphene but with a smaller estradiol rise and fewer reported side effects.
• In fertility studies, enclomiphene was linked to higher LH, FSH and sperm measures, while clomiphene sometimes produced higher testosterone.
• Clomid is cheaper and easier to fill at a regular pharmacy. Enclomiphene usually comes through a telehealth program and a compounding pharmacy.

How both drugs work

Estrogen tells the brain to slow down the signals that drive testosterone production. A SERM blocks that feedback, so the pituitary releases more LH and FSH, and the testes respond by making more testosterone. The FDA describes this mechanism in its 2022 briefing document on enclomiphene.

Because the drug works through your own hormone system, it is mainly studied in men with secondary hypogonadism: low testosterone with LH that is low or normal. The testes still work; they are not getting a strong enough signal.

What head-to-head studies found

Testosterone and estradiol

A 2024 study from Baylor College of Medicine followed 66 men who took clomiphene and later switched to enclomiphene. The median testosterone rise was 166 ng/dL on enclomiphene and 98 ng/dL on clomiphene, a difference that was not statistically significant. Estradiol, however, moved in opposite directions: down 5.92 pg/mL on enclomiphene and up 17.50 pg/mL on clomiphene.

Side effects

In the same study, men reported decreased libido, low energy and mood changes significantly less often on enclomiphene. The odds of any adverse event were about 82% lower (odds ratio 0.18). The authors note it was a retrospective, single-center study and call for larger trials.

Fertility

A 2023 University of Miami study compared 46 men on enclomiphene with 32 on clomiphene for male infertility. Both groups raised total testosterone. Only the enclomiphene group had significant increases in FSH, LH and total motile sperm count.

A 2023 American Urological Association meeting abstract compared 114 men on enclomiphene with 110 on clomiphene. Testosterone was higher on clomiphene (886 vs 547 ng/dL), but LH and FSH were higher on enclomiphene, and the pregnancy rate was 52% vs 34%. Meeting abstracts are not full peer-reviewed papers, so treat that number as early evidence.

University of Utah Health's male fertility page sums up the same picture: enclomiphene appears better tolerated and better for fertility, while Clomid is cheaper and more widely available.

Regulatory status

Clomid is FDA-approved for ovulation induction in women. Men take it off-label. Enclomiphene has no FDA-approved product in the United States. In 2018 the European Medicines Agency refused to authorize an enclomiphene product called EnCyzix, saying its safety had not been sufficiently shown, according to the FDA briefing. In that same 2022 briefing, FDA proposed not adding enclomiphene to the list of bulk substances that 503A pharmacies may use for compounding.

In practice, online programs supply compounded enclomiphene after a clinician reviews your labs. Ask which pharmacy fills the prescription and how it tests its products.

How long they take, and whether the effect lasts

Most studies measure results at around three to four months. In a small 2013 trial, testosterone rose significantly by three months on enclomiphene. It also fell back to pre-treatment levels within one month of stopping. Neither drug is a permanent fix; it works while you take it.

Clomiphene has longer follow-up. A 2019 study of 400 men found that among the 120 who stayed on it for more than three years, 88% reached normal testosterone, 77% reported better symptoms and 8% reported side effects such as mood changes, blurred vision or breast tenderness. Long-term data like this does not yet exist for enclomiphene.

Cost

Generic clomiphene from a retail pharmacy is usually the cheaper drug. Telehealth enclomiphene programs we track range from about $69 a month at T-TIME to $199 a month, before labs. Our enclomiphene cost calculator adds lab fees and plan length so you can compare a full year, and the provider comparison lists each program's terms.

Questions to ask your clinician

• Is my low testosterone secondary (low or normal LH), and was it confirmed with two morning tests?
• Do I want to keep my fertility now or in the next year or two?
• Which labs will we check, and how often: testosterone, estradiol, hematocrit and PSA?
• If I am already on clomiphene and doing well, is there a reason to switch?

FAQ

Is enclomiphene the same as Clomid?

No. Clomid (clomiphene) contains two isomers, enclomiphene and zuclomiphene. Enclomiphene is one of those two parts, given on its own.

Is enclomiphene better than Clomid?

It depends on the goal. Studies so far show similar testosterone gains, a smaller estradiol rise and fewer reported side effects with enclomiphene, but the studies are small and mostly retrospective. Clomid has more long-term data and costs less.

Does Clomid raise testosterone more than enclomiphene?

Sometimes. One 2023 meeting abstract found higher testosterone on clomiphene, while a 2024 study found no significant difference. Results vary by patient and dose.

Which is better for fertility?

Early data favors enclomiphene. It was linked to higher LH, FSH and motile sperm count, and one abstract reported a higher pregnancy rate. A fertility specialist should guide this choice.

Is enclomiphene FDA-approved?

No. There is no FDA-approved enclomiphene product. It is supplied by compounding pharmacies on a prescription.

Common misconception: does stopping either drug keep testosterone high?

Usually not. In a small enclomiphene trial, testosterone returned to its starting level within a month of stopping. Both drugs work only while you take them.