Two ways to raise testosterone
TRT (testosterone replacement) supplies testosterone directly as a gel, injection or other form. The brain senses it and lowers LH and FSH, so the testes make less of their own testosterone and less sperm.
Enclomiphene is one of the two isomers that make up clomiphene, a selective estrogen receptor modulator (SERM). It blocks estrogen feedback at the hypothalamus and pituitary, which raises LH and FSH so the testes make more testosterone themselves (Kaminetsky et al., J Sex Med 2013, PMID: 23530575). Because it depends on working testes, trials enrolled men with secondary hypogonadism, where the testes are intact but the brain’s signal is low.
This article is general information, not medical advice or a dosing recommendation. Decisions about starting, changing or stopping a prescription belong with a licensed clinician who knows your history.
What the trials show
• Phase IIb, 12 men switched off testosterone gel: at 6 months, testosterone levels were similar on enclomiphene and gel, but only enclomiphene raised LH and FSH and lifted sperm counts (Kaminetsky et al., 2013).
• Phase II randomized trial: enclomiphene raised morning testosterone similarly to 1% testosterone gel while raising LH and FSH and conserving sperm counts (Wiehle et al., Fertil Steril 2014, PMID: 25044085).
• Two phase III trials (ZA-304 and ZA-305): in overweight men aged 18 to 60 with secondary hypogonadism, 16 weeks of enclomiphene raised testosterone, LH and FSH and kept sperm concentration in the normal range, while AndroGel 1.62% raised testosterone but markedly reduced sperm production (Kim et al., BJU Int 2016, PMID: 26496621).
The limits: these trials were sponsored by the developer, ran 16 weeks to 6 months, and measured hormone levels and sperm counts rather than long-term outcomes such as heart events or fractures. No enclomiphene trial approaches the size of TRAVERSE.
Side by side
| Enclomiphene | TRT | |
|---|---|---|
| FDA status | Not FDA-approved; compounded only | FDA-approved products for hypogonadism with an associated medical condition |
| How it works | Raises the body’s own LH, FSH and testosterone | Replaces testosterone; suppresses LH and FSH |
| Sperm production | Maintained in trials | Can fall to zero (label warns of azoospermia) |
| Who it can work for | Secondary hypogonadism (working testes) | Primary or secondary hypogonadism |
| Form | Daily pill | Gel, injection, patch and others |
| Long-term outcome trials | None found in the published record | TRAVERSE: mean follow-up about 33 months |
FDA and compounding status
No FDA-approved drug contains enclomiphene as its active ingredient; its developer filed a new drug application that was not approved (FDA advisory committee transcript, 2022). The related drug clomiphene citrate (Clomid) is FDA-approved only for ovulatory dysfunction in women, so its use in men is off-label (Clomid label, DailyMed).
In 2022 the FDA proposed not adding enclomiphene citrate to the list of bulk substances pharmacies may compound under section 503A, and its advisory committee voted 8 to 4 against adding it (FDA PCAC minutes). As of the FDA list updated May 14, 2026, enclomiphene citrate sits in Category 1, “under evaluation”, where the FDA does not intend to take action against compounders who meet the interim policy’s conditions (FDA). That is an enforcement policy, not an approval, and it can change.
Compounded drugs are not reviewed by the FDA for safety, effectiveness or quality. Ask any provider which pharmacy fills the prescription.
Safety: what is known and unknown
• Unknown long-term effects: published trials lasted months; there are no long-term safety outcome data.
• Visual symptoms: the clomiphene label warns that blurring, spots or flashes can occur, increase with dose and duration, and may rarely be prolonged or irreversible; it advises stopping and having an eye evaluation if they appear (Clomid label). Enclomiphene has no FDA label of its own, so this is the closest official warning.
• Estrogen and blood counts: enclomiphene raised estradiol along with testosterone in the phase II trial (Wiehle et al., 2014); ask how a clinic monitors estradiol, hematocrit and symptoms.
• Tested athletes: clomiphene and related anti-estrogenic substances are prohibited by WADA.
• Men with primary hypogonadism (testicular failure) would not be expected to respond, because enclomiphene works through the testes.
This article is general information, not medical advice or a dosing recommendation. Decisions about starting, changing or stopping a prescription belong with a licensed clinician who knows your history.
Comparing providers and costs
Prices and providers for enclomiphene are on enclomiphene online. For testosterone, see the TRT comparison, online TRT clinics compared and what TRT costs online. Labs and risks for TRT itself are in TRT risks, labs and the 2026 FDA label.
Disclosure
CalcMyPeptide may earn commissions from some telehealth providers on our comparison and review pages, which list only vetted providers whose affiliate programs have approved us or are reviewing our application. This article contains no paid links. How we rank providers and get paid: telehealth disclosure and methodology.