title: Clomiphene citrate is safe and effective for long-term management of hypogonadism.
abstract: OBJECTIVE
  To assess the efficacy and safety of long-term clomiphene citrate (CC) therapy in symptomatic patients with hypogonadism (HG).
  
  
  METHODS
  Serum T, oestradiol and luteinizing hormone (LH) were measured in patients who were treated with CC for over 12 months. Additionally, bone densitometry (BD) results were collected for all patients. Demographic, comorbidity, treatment and Androgen Deficiency in Aging Men (ADAM) score data were also recorded. Comparison was made between baseline and post-treatment variables, and multivariable analysis was conducted to define predictors of successful response to CC. The main outcome measures were predictors of response and long-term results with long-term CC therapy in hypogonadal patients.
  
  
  RESULTS
  The 46 patients (mean age 44 years) had baseline serum testosterone (T) levels of 228 ng/dL. Follow-up T levels were 612 ng/dL at 1 year, 562 ng/dL at 2 years, and 582 ng/dL at 3 years (P < 0.001). Mean femoral neck and lumbar spine BD scores improved significantly. ADAM scores (and responses) fell from a baseline of 7 to a nadir of 3 after 1 year. No adverse events were reported by any patients.
  
  
  CONCLUSIONS
  Clomiphene citrate is an effective long-term therapy for HG in appropriate patients. The drug raises T levels substantially in addition to improving other manifestations of HG such as osteopenia/osteoporosis and ADAM symptoms.
authors.affiliation: Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Moskovic
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Katz
authors.forename: Ardavan
authors.initials: A
authors.lastname: Akhavan
authors.forename: Kelly
authors.initials: K
authors.lastname: Park
authors.forename: John P
authors.initials: JP
authors.lastname: Mulhall
mesh_terms: D000328:Adult; D015519:Bone Density; D002996:Clomiphene / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood
chemical_list: D004965:Estrogen Antagonists; D020845:Selective Estrogen Receptor Modulators; D002996:Clomiphene; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone