Injection
Gonadorelin
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Fertility supportTesticular function
Clomiphene Capsules
RxPrescription onlyTaken by mouth · Once a day · 25–51 mg · Fertility support · Testicular function
Starting at $89/mo
Clomiphene (Clomid, off-label for men): selective estrogen receptor modulator that stimulates endogenous testosterone and preserves testicular function and fertility during hormone therapy.
How many capsules per month?
MonthlyEvery 3 months
30 capsulesper month
You'll receive 30 capsules per month. $109 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Stimulates pituitary and testicular testosterone production
- Maintains sperm production and testicular size on testosterone therapy
- Oral, daily dosing; preserves fertility potential
Every plan includes
- Personalized, physician-guided plan
- 30 capsules per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is clomiphene?
(KLO-mi-feen)
Clomiphene is a selective estrogen receptor modulator (SERM) that blocks negative feedback on the pituitary gland, triggering release of luteinizing hormone (LH). This stimulates the testicles to produce testosterone and sperm on their own, even while taking exogenous testosterone. It is used off-label in men to preserve testicular function and fertility. Typical dose: 25–50 mg daily or every other day.
- How it is taken
- Taken by mouth
- How often
- Once a day
- Dose range
- 25–51 mg
- Form
- Fertility support · Testicular function
Fertility-preserving
stimulates natural testosterone and sperm production
Clomiphene maintains testicular size and sperm count during testosterone therapy, useful for men planning family or concerned about fertility. It does not prevent the need for injectable testosterone if treating hypogonadism; it supplements exogenous therapy to maintain endogenous production.
How it works,
week by week.
Day 1
US-licensed physician reviews your fertility goals, testicular health, and plans on testosterone therapy. Discussion of clomiphene vs. enclomiphene vs. hCG or combination.
Week 1
Start clomiphene 25–50 mg daily or hCG 500–2,500 IU once weekly, depending on your plan. Baseline semen analysis or testicular ultrasound may be ordered to track changes.
Weeks 4–8
LH and testosterone levels rise as clomiphene/hCG stimulates the testicles. Testicular function is preserved. Sperm production remains normal or improves.
Month 2–3
Follow-up labs (LH, FSH, testosterone, sperm count). Dose adjusted if needed. If combining hCG with testosterone therapy, check testosterone levels.
Beyond
Continue fertility support as long as you take testosterone therapy. If you stop testosterone, fertility usually returns within 3–6 months with continued clomiphene/hCG support.
What you may notice,
and when.
Testicles stay healthy
size and function maintained on testosterone therapy
Sperm production continues
fertility potential preserved even during testosterone use
Faster recovery if you stop
endogenous testosterone and sperm return quickly when therapy ends
Lab monitoring required
LH, FSH, sperm count tracked to ensure response
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Clomiphene, enclomiphene, and hCG are prescribed off-label to preserve fertility and testicular function during testosterone therapy. Common side effects: mild headache, mood changes, abdominal discomfort. Clomiphene and enclomiphene may cause visual changes (blurred vision, floaters) in ~1% of users, report immediately if vision changes occur. hCG carries a small risk of ovarian hyperstimulation-like syndrome in some men if doses are very high. Tell your physician about prior fertility issues, current fertility plans, or any family history of gynecomastia or testicular disease. Stop and seek care for severe vision changes, severe headache, or testicular pain.
The research behind
clomiphene.
Clomiphene is approved for female ovulation; its use in men is off-label. The male evidence is observational case series and small reviews, not large randomized trials.
- Long-term usemean 19 months
In a prospective study of young hypogonadal men, most seeking fertility, clomiphene was given for a mean of 19 months. The authors reported it as a safe and effective alternative to testosterone for men who want to keep fertility. This is a case series with no control group.
Katz et al., BJU Int 2012 - Extended treatment400 men
A larger series of 400 men treated for a mean of 25.5 months (range 0 to 84) reported no significant adverse event and few side effects. Results did not differ between men treated for more or less than three years.
Krzastek et al., J Urol 2019 - Fertility reviewsperm up, pregnancy unclear
A review of nine clomiphene studies in male infertility found that only one showed a significant gain in pregnancy rate, while most showed higher sperm concentrations. Clomiphene was well tolerated at doses used for infertility.
Willets et al., Reprod Sci 2013
What the studies found
- Raises testosterone substantially: in 46 men followed for a year, mean testosterone rose from 228 to 612 ng/dL (Moskovic et al., BJU Int 2012).
- Keeps fertility: it is used by men who want to preserve fertility; in a series of young men, 64% sought treatment for infertility (Katz et al., BJU Int 2012).
- Symptom scores fell: in the 46-man series, the ADAM symptom score fell from 7 to 3 after one year (Moskovic et al., BJU Int 2012).
- Raised testosterone more than anastrozole in a randomized comparison: 571 vs 408 ng/dL (Helo et al., J Sex Med 2015).
These are the results of observational series of clomiphene citrate in men with a clinic setting, not of a trial against placebo. Compounded and generic tablets were not the product in these reports in all cases, and dosing varies. Clomiphene is used off-label in men.
What this does not say
- No large randomized trial has compared clomiphene with placebo for male hypogonadism.
- Visual changes and mood changes are reported side effects; men with eye disease should be cautious.
- Long-term safety beyond several years depends on monitoring that is not standardized.
The research
behind it.
Clomiphene blocks estrogen feedback in the hypothalamus and pituitary, allowing LH and FSH to rise. This stimulates Leydig cells (testosterone) and Sertoli cells (sperm production) in the testicles.
In off-label use for men on testosterone therapy, clomiphene preserves testicular function. Men stopping exogenous testosterone often recover endogenous production faster if they used clomiphene alongside therapy.
Testosterone beyond the gym:
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Clomiphene Capsules?
Taken by mouth, once a day. The starting prescription is 1 capsule (25 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Clomiphene Capsules come in?
The pharmacy carries 2: 25 mg, 51 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Will clomiphene restore my fertility if I am on testosterone therapy?
Clomiphene helps maintain sperm production and testicular function while you are on testosterone therapy by keeping LH and FSH elevated. It is most effective at preserving fertility if you plan to stop testosterone and return to natural production. If you stop therapy, fertility often returns within 3–6 months with clomiphene support.
Do I need clomiphene or hCG if I am on testosterone therapy?
Not always. If you are not concerned about fertility or testicular size, and your testosterone therapy is working well, neither is necessary. But if you want to preserve sperm production, prevent testicular atrophy, or plan a family in the future, your physician will recommend one.
Can I use clomiphene and hCG together?
Yes. Some physicians combine them for synergistic fertility preservation: clomiphene stimulates the pituitary (LH/FSH), hCG directly stimulates the testicles (testosterone/sperm). This combination is off-label but used clinically.
If I stop testosterone, will my fertility return?
Yes, usually within 3–6 months if you used clomiphene or hCG alongside testosterone. Without fertility support, recovery can take 6–12 months or longer. This is why fertility preservation on testosterone is important if you plan a family.
How often do I check sperm count or testicular health?
Initial baseline: before starting or at first visit. Then: every 3–6 months on clomiphene/hCG, or annually if on testosterone long-term. Semen analysis is the gold standard for sperm count; testicular ultrasound tracks size.
Clomiphene educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Capsule
Anastrozole - Men
A low-dose aromatase inhibitor for men on testosterone therapy whose blood work shows high estradiol, easing breast tenderness and water retention. Slow-release capsule, prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Capsule
Anastrozole Capsules
Anastrozole, an aromatase inhibitor used in men to control estrogen levels during testosterone therapy. Prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Tablet
Anastrozole Tablets
FDA-approved anastrozole tablets, an aromatase inhibitor used at low doses in men on testosterone therapy whose estradiol runs high. Prescribed by a licensed physician only after blood work.
5 tablets per month
Starting at $63/mo
References
- 1.Clomiphene citrate for men with testosterone deficiency: a review of pharmacology and outcomes. Fertil Steril, 2016
- 2.Human chorionic gonadotropin in testosterone replacement therapy for hypogonadal men: a review. J Androl, 2012
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.