Netherlands: Clomiphene citrate is an effective treatment for improving both biochemical as well as clinical symptoms in males with hypogonadism, a recent study has shown. Also, the therapy showed few side effects and good safety aspects.
"Clomiphene citrate is a potentially safe and effective treatment and should be considered in men with symptomatic hypogonadism, particularly for those with an active or future child wish," Manou Huijben, University Medical Centre Utrecht, Utrecht, The Netherlands, and colleagues wrote in the journal Andrology.
According to the European Association of Urology, hypogonadism is a clinical and biochemical testosterone insufficiency syndrome, affecting various organ functions and quality of life. First-choice therapy is exogenous testosterone, however, its use is associated with several side effects, including negative feedback of the hypothalamic-pituitary-gonadal axis, resulting in suppression of intratesticular testosterone production and spermatogenesis.
Clomiphene citrate is used as off-label therapy to preserve these testicular functions while treating male hypogonadism. In the systematic review and meta-analysis, Dr. Huijben and the team aimed to evaluate the effectiveness and safety of clomiphene citrate therapy for men with hypogonadism.
For this purpose, the authors searched the online databases for effectiveness studies of men with hypogonadism treated with clomiphene citrate. Both intervention and observational studies were included.
The primary outcome measure was the evaluation of serum hormone concentration. Secondary outcomes included symptoms of hypogonadism, metabolic and lipid profile, side effects, safety aspects.
The meta-analysis included 17 studies with a total of 1279 patients. Therapy and follow-up duration varied between one and a half and 52 months.
Key findings of the study include:
Total testosterone increased by 2.60 during clomiphene citrate treatment.
An increase was also seen in free testosterone, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, and estradiol.
Different symptom scoring methods were used in the included studies.
The most frequently used instrument was the Androgen Deficiency in Aging Males questionnaire, which improved during treatment.
Reported side effects were only prevalent in less than 10% of the study populations and no serious adverse events were reported.
To conclude, clomiphene citrate for men with hypogonadism improves both clinical symptoms and the biochemical testosterone insufficiency. Also, the therapy had few reported side effects and good safety aspects.
Reference:
The study titled, "Clomiphene citrate for men with hypogonadism: a systematic review and meta-analysis," was published in the journal Andrology.
DOI: https://doi.org/10.1111/andr.13146