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Testosterone kinetics on hypogonadal men under clomiphene
Élcio Dias Silva1, Maurício Moreira da Silva1, Tomas B C Moretti1
1UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil.
International Urology and Nephrology
|May 16, 2022
Summary
Clomiphene citrate (CC) effectively raises testosterone in hypogonadal men. However, most require ongoing treatment, with about 24% maintaining elevated testosterone levels six months after a short CC trial.
Area of Science:
- Endocrinology
- Urology
- Male Reproductive Health
Background:
- Male hypogonadism is characterized by low testosterone levels.
- Clomiphene citrate (CC) is a treatment option for hypogonadism.
- Understanding testosterone kinetics after CC discontinuation is crucial.
Purpose of the Study:
- To evaluate total testosterone (TT) kinetics 6 months after stopping clomiphene citrate (CC).
- To identify predictors of sustained testosterone response after CC discontinuation.
Main Methods:
- Prospective evaluation of 75 hypogonadal men with normal testicles.
- Measured TT levels at baseline, after 40 days of CC, and 6 months post-discontinuation.
- Assessed predictors of testosterone recovery.
Main Results:
- 92% achieved TT > 300 ng/dl after CC treatment.
- 24% maintained TT > 300 ng/dl at 6 months post-treatment.
- Higher initial response to CC predicted better long-term outcomes; age was a negative predictor.
Conclusions:
- Clomiphene citrate is effective for male hypogonadism, but chronic treatment is often necessary.
- A short CC trial can 'reboot' physiology in approximately 24% of patients.
- Further research into long-term TT kinetics is warranted.
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