What Is Enclomiphene? How It Works, Typical Doses and Cost

Enclomiphene is an oral prescription drug that raises a man's own testosterone instead of replacing it. Chemically, enclomiphene citrate is one of the two forms (isomers) that make up clomiphene, better known as Clomid, as the FDA's 2022 briefing describes. It belongs to a class called SERMs, selective estrogen receptor modulators.

Online men's health clinics now prescribe it widely, mostly to men who want higher testosterone without losing fertility. Here is how it works, what the trials showed, and what it costs.

How enclomiphene works

• Step 1: Estrogen normally tells the brain to slow down hormone signals to the testes.
• Step 2: Enclomiphene blocks that estrogen signal at the hypothalamus and pituitary.
• Step 3: The pituitary releases more LH and FSH.
• Step 4: LH tells the testes to make more testosterone, and FSH supports sperm production.

Because it works through the testes, enclomiphene suits men whose testes still function but are under-stimulated. Doctors call this secondary hypogonadism: low testosterone with LH that is low or normal.

What the trials showed

In a 2013 pilot study of 12 men, morning testosterone averaged about 165 after stopping testosterone gel. After six months, men on enclomiphene averaged 525, similar to the 545 seen on gel, and only the enclomiphene group had higher LH, FSH and sperm counts.

Two larger 16-week phase III trials in overweight men aged 18 to 60 confirmed it: enclomiphene restored normal testosterone and kept sperm counts in the normal range, while testosterone gel reduced sperm production. A phase II trial reached the same conclusion.

These trials measured hormone levels and sperm, not symptoms such as energy or libido. That gap is one reason regulators have not approved it.

Typical enclomiphene doses

The phase III trials tested 12.5 mg and 25 mg once a day, according to the FDA briefing. In earlier dosing work, blood levels at 25 mg were about 4.5 times those at 12.5 mg, so small dose changes matter. Online programs set their own strengths; TRT Nation, for example, lists 25 mg capsules in a 30-day supply.

Your prescriber sets the dose from your labs and adjusts it after follow-up tests. Do not change it on your own. For one provider's instructions, see our guide to T-TIME enclomiphene dosage.

Is enclomiphene FDA-approved?

No. There is no FDA-approved enclomiphene product. The European Medicines Agency refused to authorize one (EnCyzix) in 2018, citing insufficient safety data and a blood clot risk. In its 2022 briefing, FDA proposed not adding enclomiphene to the list of bulk substances 503A pharmacies may compound. Online programs today supply it from compounding pharmacies on a prescription, so it is worth asking which pharmacy fills yours.

Who it is for, and who it is not for

• Often discussed for: men with confirmed low testosterone and low or normal LH, especially those who want to keep fertility.
• Not likely to help: primary hypogonadism, where the testes themselves do not respond.
• Needs extra caution: a history of blood clots, heart disease, or eye problems, given the trial safety signals.

The AUA guideline says low testosterone should be confirmed with two early-morning blood tests below about 300 ng/dL, plus symptoms, before any treatment.

Side effects in brief

Headache, hot flushes, nausea and muscle spasms were the most common in trials. Rare blood clots were reported. Our enclomiphene side effects guide covers the full list and the labs to track, and our enclomiphene vs Clomid and enclomiphene vs TRT guides compare it with the alternatives.

How to get it and what it costs

In the United States, enclomiphene is prescribed after an online or in-person visit and a lab test. Programs we track range from about $69 a month at T-TIME to $199 a month, before labs, and they differ on commitment length and whether follow-up labs are included. Compare them side by side on our enclomiphene provider comparison, or estimate a full year with labs in the cost calculator.

Questions to ask before you start

• Which pharmacy compounds the medication, and is it a licensed U.S. pharmacy?
• Is the prescriber a physician, and will they review my follow-up labs?
• Which labs are included, and what do extra tests cost?
• Is there a minimum commitment, and what is the refund policy?

These answers differ a lot between programs. TRT Nation, for example, states a no refund and no return policy, while other programs are month to month. Reading the terms before you pay avoids most complaints we see in customer reviews. Our T-TIME review shows how we check one provider against these points.

FAQ

What is enclomiphene used for?

It is used off-label to raise testosterone in men with secondary hypogonadism, often when they want to preserve sperm production. It is not FDA-approved for any use.

Is enclomiphene a steroid or testosterone?

No. It contains no testosterone. It is a SERM that increases the hormones that tell your testes to make testosterone.

How long does enclomiphene take to work?

In trials, testosterone rose significantly by about three months, and results were measured at 16 weeks to six months. Your clinician will usually recheck labs within the first few months.

What is the usual enclomiphene dose?

Trials used 12.5 mg or 25 mg once daily. Your prescriber chooses the dose from your labs.

Common misconception: is enclomiphene just a supplement?

No. It is a prescription drug supplied by compounding pharmacies. Products sold without a prescription as enclomiphene are not part of regulated medical care.

What happens when you stop taking it?

Testosterone tends to fall back. In one small trial it returned to pre-treatment levels within a month of stopping.