BHRC BLOG
Enclomiphene Dosage Guide: How to Raise Testosterone and Protect Fertility
Medically reviewed by the BHRC Clinical Team · Last reviewed 2026-11-14
Enclomiphene is a daily oral medication that raises testosterone by getting your own body to make more, rather than replacing it. For men with low testosterone who want to keep their fertility, or who aren’t ready to commit to injections, it is one of the most common alternatives to standard TRT.
This guide explains how enclomiphene works, the doses used in clinical trials and in our practice, what results to expect and when, and the blood work that tells us it’s working.
Important: Enclomiphene is not FDA-approved. It is prescribed off-label and dispensed only by licensed compounding pharmacies, and the FDA has raised concerns about compounded enclomiphene. It requires a prescription and medical supervision. This guide is educational and is not a substitute for medical advice.
Quick Enclomiphene Dosing Summary
Enclomiphene is usually started at 12.5 mg by mouth once daily and increased to 25 mg if testosterone hasn’t reached the target range after 4-6 weeks. It raises your own LH, FSH and testosterone while preserving sperm production.
- Starting dose: 12.5 mg orally once daily (6.25 mg for sensitive patients or maintenance)
- Usual range: 12.5-25 mg daily
- First labs: Total testosterone, LH and estradiol at 4-6 weeks
- Best for: Men with low testosterone from the brain’s signal (secondary hypogonadism) who want to protect fertility
- Not for: Men whose testes can’t respond (primary hypogonadism, shown by high LH)
- Regulatory status: Not FDA-approved; compounded and prescribed off-label
What Is Enclomiphene?
Enclomiphene citrate is one of the two mirror-image forms (isomers) that make up clomiphene citrate (Clomid). Clomiphene is roughly 60% enclomiphene and 40% zuclomiphene. Enclomiphene does the useful work of raising testosterone. Zuclomiphene has a much longer half-life, builds up over time and acts more like estrogen, which may explain some of clomiphene’s side effects in men.
Repros Therapeutics developed enclomiphene as a drug for men (Androxal) and completed phase III trials, but the FDA did not approve it in 2015. Today it is available only from compounding pharmacies. We prescribe it in 6.25 mg and 12.5 mg capsules.
How Enclomiphene Raises Testosterone
Your brain controls testosterone production through a feedback loop. When the hypothalamus and pituitary sense estrogen, they release less LH and FSH, the two hormones that tell the testes to make testosterone and sperm.
Enclomiphene blocks estrogen receptors in the hypothalamus and pituitary, so the brain reads estrogen as low and turns the signal up. LH and FSH rise, the testes make more testosterone, and because FSH and intratesticular testosterone also rise, sperm production is maintained.
This is the key difference from testosterone injections. Outside testosterone switches the same loop off, which lowers sperm count and shrinks the testes.
Enclomiphene Dosage Chart
Typical enclomiphene dosing
| Situation | Dose | When to recheck labs | Notes |
|---|---|---|---|
| Standard start | 12.5 mg once daily | 4-6 weeks | Most men stay at this dose |
| Testosterone still below target | Increase to 25 mg daily | 4-6 weeks after change | Highest dose used in the phase III trials |
| Sensitive to side effects, or maintenance | 6.25 mg daily or 12.5 mg every other day | 6-8 weeks | Individualized by your provider |
| Coming off TRT (restart protocol) | 12.5-25 mg daily, often alongside hCG | 4-6 weeks | Provider-directed; see our hCG guide |
Doses reflect published trials (12.5 mg and 25 mg daily) and urology practice. Your provider sets the final dose.
Take enclomiphene at the same time each day. It can be taken with or without food. Its half-life is about 10 hours, so daily dosing keeps the signal steady.
Enclomiphene 12.5 mg vs 25 mg
In the phase III trials, both doses raised morning testosterone into the normal range in most men with secondary hypogonadism. 25 mg produced somewhat higher testosterone and LH levels. Most men reach their target on 12.5 mg, and starting low keeps side effects to a minimum. If labs at 4-6 weeks show testosterone still below target with good LH response, the dose usually goes to 25 mg.
What Results to Expect, and When
| Timeframe | What typically happens |
|---|---|
| 2-4 weeks | LH and testosterone begin to rise |
| 4-6 weeks | First lab check; many men notice better energy and libido |
| 3 months | Steady-state testosterone; mood and libido benefits are clearer |
| 3-6 months | Sperm counts maintained. In trials, men on topical testosterone saw counts fall while men on enclomiphene did not. |
Enclomiphene usually raises testosterone into the low-to-mid normal range rather than the higher levels possible with injections. Some men with severe symptoms or a high body-weight-related estrogen load still do better on TRT.
Enclomiphene vs. TRT
| Enclomiphene | Testosterone injections (TRT) | |
|---|---|---|
| How it works | Turns up your own production | Replaces testosterone from outside |
| Sperm production | Maintained | Usually suppressed, often to zero |
| Testicle size | Maintained | Often shrinks |
| Form | Daily capsule | Injection once or twice weekly |
| Typical testosterone level | Low-to-mid normal | Mid-normal, adjustable |
| FDA status | Not approved; compounded | FDA-approved |
| Works for primary hypogonadism? | No (testes can’t respond) | Yes |
Clomiphene (Clomid) works the same way and has the longest track record in men, though it is also off-label. We cover that comparison in a dedicated guide.
Who Is a Good Candidate?
- Men with symptoms and two low morning testosterone results whose LH is low or normal (the brain’s signal is the problem, not the testes)
- Men who want children now or in the next few years
- Younger men who’d rather not start lifelong injections
- Men coming off TRT who want to restart their own production
Not a good fit: primary hypogonadism (high LH, where the testes themselves aren’t responding), a history of blood clots, liver disease, or certain eye conditions. Enclomiphene also isn’t a performance drug for men with normal testosterone.
Side Effects and Monitoring
In clinical trials enclomiphene was generally well tolerated. The most commonly reported effects were:
- Headache
- Hot flashes
- Nausea
- Mood changes or irritability
- Rising estradiol, sometimes with breast tenderness, since more testosterone also means more conversion to estrogen
- Rising hematocrit (less common than with injections)
Stop and call us right away for any vision changes (blurring, spots, flashes). Visual disturbances are a known effect of clomiphene-class drugs and need prompt review. Go to the emergency room for leg swelling and pain, chest pain or sudden shortness of breath.
Monitoring schedule
| When | What we check |
|---|---|
| Before starting | Two AM total T, LH, FSH, estradiol, prolactin, CBC, metabolic panel; semen analysis if fertility is the goal |
| 4-6 weeks | Total T, LH, estradiol, symptoms |
| 3 months | Total T, estradiol, hematocrit; semen analysis if trying to conceive |
| Every 6 months | Total T, estradiol, hematocrit, symptoms |
How We Prescribe Enclomiphene at BHRC
Before prescribing, our providers confirm low testosterone with two morning blood draws and check LH to make sure the brain’s signal is the cause. We talk through your fertility plans, your goals and the fact that enclomiphene is a compounded, non-FDA-approved medication, and you’ll sign an off-label medication consent.
Most patients start at 12.5 mg daily with labs at 4-6 weeks. If enclomiphene doesn’t get you where you need to be, we discuss testosterone therapy, often with hCG to protect fertility. Existing patients can reorder through our refill request form.
Men’s hormone care is available at our West Hollywood, West Los Angeles, Westlake Village, Valencia, Summerlin / Las Vegas, Paradise Valley / Scottsdale clinics.
Enclomiphene FAQs
What is the normal dose of enclomiphene?
Most men take 12.5 mg by mouth once daily. If testosterone is still below target after 4-6 weeks, the dose is often increased to 25 mg daily, the highest dose used in the phase III trials.
How long does enclomiphene take to work?
LH and testosterone usually start rising within 2-4 weeks. We check labs at 4-6 weeks, and most men notice better energy and libido around that time.
Does enclomiphene affect fertility?
Enclomiphene is used because it preserves fertility. It raises FSH and LH, which support sperm production. In trials, sperm counts were maintained on enclomiphene and fell on topical testosterone.
Is enclomiphene better than Clomid for men?
Enclomiphene contains only the isomer that raises testosterone, without zuclomiphene, which lingers in the body and acts more like estrogen. Clomiphene has a longer track record and is FDA-approved (for women), while enclomiphene is only available compounded. Both are off-label options for men.
Can I take enclomiphene with TRT?
Generally no. Testosterone injections suppress the same signal enclomiphene is trying to raise. Enclomiphene is used instead of TRT, or after stopping TRT to help restart natural production.
Is enclomiphene FDA-approved?
No. The FDA declined to approve it in 2015, and it is available only from compounding pharmacies. Your provider will discuss this and the alternatives before prescribing.
What happens when you stop enclomiphene?
Testosterone gradually returns to your previous baseline. Unlike TRT, enclomiphene doesn’t shut down your own production, so there’s no withdrawal crash.
References
- Wiehle RD et al. Enclomiphene citrate stimulates testosterone production while preventing oligospermia: phase II trial. Fertil Steril, 2014. PubMed
- Kaminetsky J et al. Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel. J Sex Med, 2013. PubMed
- Mulhall JP et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline, 2018. American Urological Association
- Bhasin S et al. Testosterone Therapy in Men With Hypogonadism: Endocrine Society Clinical Practice Guideline, 2018. Endocrine Society
- Clomiphene and enclomiphene for male hypogonadism: reviews. PubMed
Men’s Hormone Library
TRT Medication Guides
Doses, lab targets and how we prescribe each medication in our men’s hormone program.
