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Subjectively, not much difference between the three options, though I seem to lean towards EC/HCG, don't ask me why (I don't know)
Hey @aneuman

Are you using this protocol to remain fertile? How is your libido? Thanks for sharing. I enjoy your posts a lot and have learned a few things from your experiences.
 
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Presumably because Repros wasn’t confident in their ability to show symptomatic benefit?

Do we know for sure that’s the reason Repros gave up?

It's speculation. In this detailed article Peter Bond reaches the same conclusion:

Importantly, the only endpoints were testosterone, LH, and FSH levels, and sperm concentration. Clinically relevant endpoints, such as sexual desire, erectile function, fatigue/vitality, etc. were not investigated. Seemingly also not in the other (published) trials. Or, perhaps, they were investigated, but simply never reported in the study results because the results were disappointing. And I think it might’ve been the latter, as the FDA did not approve the drug for the treatment of secondary hypogonadism, because there was a lack of measurable symptomatic improvement [10]. The EU equivalent of the FDA, the EMA, also refused the marketing authorisation for enclomiphene some time later, with similar concerns:
“The CHMP [Committee for Medicinal Products for Human Use] noted that although the studies showed an increase in testosterone levels with EnCyzix [enclomiphene], they did not look at whether EnCyzix would improve symptoms such as bone strength, weight gain, impotence and libido. In addition, there is a risk of venous thromboembolism (problems due to the formation of blood clots in the veins) with the medicine.”
 
It's speculation. In this detailed article Peter Bond reaches the same conclusion:

Importantly, the only endpoints were testosterone, LH, and FSH levels, and sperm concentration. Clinically relevant endpoints, such as sexual desire, erectile function, fatigue/vitality, etc. were not investigated. Seemingly also not in the other (published) trials. Or, perhaps, they were investigated, but simply never reported in the study results because the results were disappointing. And I think it might’ve been the latter, as the FDA did not approve the drug for the treatment of secondary hypogonadism, because there was a lack of measurable symptomatic improvement [10]. The EU equivalent of the FDA, the EMA, also refused the marketing authorisation for enclomiphene some time later, with similar concerns:
“The CHMP [Committee for Medicinal Products for Human Use] noted that although the studies showed an increase in testosterone levels with EnCyzix [enclomiphene], they did not look at whether EnCyzix would improve symptoms such as bone strength, weight gain, impotence and libido. In addition, there is a risk of venous thromboembolism (problems due to the formation of blood clots in the veins) with the medicine.”
Thank you @Cataceous for this article.

This theory always seemed plausible to me but one thing I don’t understand is that there are several studies demonstrating symptomatic improvement with CC. You would think that if you could conduct studies showing symptomatic improvement with CC, then you could also conduct studies showing symptomatic improvement with EC. Unless:

1. The FDA has a high bar for research methodology and the CC symptom studies are not well designed and potentially biased (which I think appears to be the case from my own reading of these studies).

2. Clomid actually is stronger for symptomatic improvement. This doesn’t seem likely but it’s possible the zuclomiphene can be beneficial in balancing out the estrogen agonism/antoganism.
 
2. Clomid actually is stronger for symptomatic improvement. This doesn’t seem likely but it’s possible the zuclomiphene can be beneficial in balancing out the estrogen agonism/antoganism.
I Agree.
I don't see why enclomiphene alone would be superior to clomiphene in terms of symptomatic improvement, (something that has not been proven and is not an experience that many can report). estrogens are necessary for men as well, and a pure antagonist could only generate deficiency, hindering the effect of testosterone.
Clomiphene, for which there is also no demonstrable evidence that it produces significant symptomatic improvement, has zuclomiphene, with a partially estrogenic effect, which, in my opinion, would mitigate the deficiency caused by the blockade that it produces in enclomiphene.
Clomid has been shown to improve bone density, for example, which is probably not the case with enclomiphene alone, which probably does the same thing as tamoxifen: decrease bone density.
In my opinion, it is only my thought, enclomiphene is the one that brings with it both the desired effect, as well as the undesirable effects and the blocking of symptomatic improvement, although at the hormonal and fertility level, the positive effect is more than evident .
For my part, given the choice, I prefer clomiphene, even when I have tried many times and the loss of libido and depression have been unbearable. I also do not tolerate HCG very well when at doses for fertility, however, during the last few weeks I have combined HCG and clomiphene and this combination is much better for me, with more libido and good mood. I am also taking 0.25mg cabergoline once a week. No testosterone replacement at this moment.
 
Hey @aneuman

Are you using this protocol to remain fertile? How is your libido? Thanks for sharing. I enjoy your posts a lot and have learned a few things from your experiences.
Hi Nelson,

Regarding fertility, no, absolutely not my objective. My main objective now is is health well being in general. Libido is okay. I'm 60, not 16, so there are changes you can't fight, but things are working alright. I came to realize that you cannot chase forever the fountain of youth, that's too elusive, and I would spend the time I have left chasing a dream instead of enjoying what I have now.

I did get a glance at being 20 years old a couple of years ago when I first tried HCG at 2000 IU a week. For a month I was over the moon in every sense, overconfidence, libido, well-being, etc, etc, etc, but then, after 3 or 4 weeks, it disappeared never to return again. I was presented with two choices then: continue the chase with every new possible medical treatment, protocol and dosage, or focus on the net positive and try to enjoy what I have instead of missing what I want. So I made my peace and I'm enjoying what I have.

I do feel better in general, more confident, I'm sleeping better, I hope my next bloodwork is good, I don't have any major health problems other than BPH, I started working out again, so for the moment life's good.

Here are the full numbers to compare. HCG+EC produce a much better profile (more balanced in my opinion) so I intend to go back to it. I was trying to see if I could reduce dependency on medication, that's why I dropped HCG for 15 days. Notice that the "Optimal levels" are what I consider optimal levels for me and my goals. It is based on research, as solid science as possible, but also on what works for me and what I want.

Green means optimal (for me)
White means normal (accepted lab ranges)
Red means outside lab ranges

Note on estradiol, there's a mix of sensitive and not sensitive. Those in the 20s are sensitive, those in the 40 and 50s are not sensitive.

1679322178040.png
 
Thank you @Cataceous for this article.

This theory always seemed plausible to me but one thing I don’t understand is that there are several studies demonstrating symptomatic improvement with CC. You would think that if you could conduct studies showing symptomatic improvement with CC, then you could also conduct studies showing symptomatic improvement with EC. Unless:

1. The FDA has a high bar for research methodology and the CC symptom studies are not well designed and potentially biased (which I think appears to be the case from my own reading of these studies).

2. Clomid actually is stronger for symptomatic improvement. This doesn’t seem likely but it’s possible the zuclomiphene can be beneficial in balancing out the estrogen agonism/antoganism.
@Cataceous
Which of the above two theories do you think is more plausible?
 
This is an update a year later. My total T went from 390 to 1200. I felt great on clomid. Estrogen was controlled. I do have spikes of anxiety. Would love to hear anyone's experience switching over to enclomiphene.


Hello there. Just started clomid, been on for one month. It has boosted my total t from 428 to 784.
25mg MWF. What is your dosage? R u still on?
 
Feeling good, levels improved and now just slowly but surely melting belly fat away while lifting weights. Energy and mood improved. Libido not yet but probably once the body fat has withered away.
 
Any anxiety? Or weird sides? Sounds like you are a decent responder. Keep that diet in check and train as hard you can with good sleep and you should be feeling even better.
 
Just started clomid

Libido not yet but probably once the body fat has withered away.
A dose of reality, it’s actually far more common to have libido at the start of clomid therapy with a deterioration of libido thereafter.

So if you don’t have a libido now, then it’s more than likely not going to happen for you at all going forward.

I’m sorry to be the bearer of bad news.
 
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A dose of reality, it’s actually far more common to have libido at the start of clomid therapy with a deterioration of libido thereafter.

So if you don’t have a libido now, then it’s more than likely not going to happen for you at all going forward.

I’m sorry to be the bearer of bad news.
Where is there any remotely objective data on this? AFAIK Dr. Mark Gordon has as many people on clomid on as any clinician, so it would be interesting to know if he has weighed in on this. Forums have valuable information but a lot of selection bias.
 
Where is there any remotely objective data on this?
Libido is typically the first thing to improve on hormone therapy, even before improved mood and energy.

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Effects on depressive mood become detectable after 3–6 weeks with a maximum after 18–30 weeks.
So if you go by this effect on sexual interest plateau is at six weeks and it takes 3-6 weeks to start seeing changes in mood with a maximum of up to 18 to 30 weeks to plateau. So effects on sexual interest resolve first.

For the fact that this guy is on Clomid, makes his situation on average worse. Low or zero libido is a common side effect of clomid therapy.
 


How are you feeling so far? Yeah still taking the same dose 50 mg twice a week.

A dose of reality, it’s actually far more common to have libido at the start of clomid therapy with a deterioration of libido thereafter.

So if you don’t have a libido now, then it’s more than likely not going to happen for you at all going forward.

I’m sorry to be the bearer of bad news.


Libido increased dramatically the first month on it, this is my 2nd month and it seems to have leveled out. I’m also a high body fat% and really am working on losing body fat/building muscle and now since my test has increased from 400-500 to now around 800-900 the visceral fat and belly fat is dwindling slowly but surely.
 
Any anxiety? Or weird sides? Sounds like you are a decent responder. Keep that diet in check and train as hard you can with good sleep and you should be feeling even better.

No sides, only a bit of vision fuzz if I take a whole 50mg. I’m doing MWF 25mg now. Good energy, libido spiked big time first month but now has leveled. Also noticing belly fat dwindling and I’m able to consume carbs so much better now. Before I was way too IR.
 
Libido increased dramatically the first month on it, this is my 2nd month and it seems to have leveled out.
This happens as the synthetic estrogen (which is an agonist or antagonist depending on the target tissue) in your bloodstream and binds to the estrogen receptors, partially or fully blocking the effects of estrogen.

You need estrogen for libido.

The whole point of clomid therapy is to prevent estrogen from binding to the estrogen receptors in the pituitary gland, effectively tricking the pituitary gland into thinking there’s no testosterone in the body and the pituitary gland increases LH to increase testosterone.

You have succeeded in doing that, but as a side effect your libido is suffering. This doesn’t happen to everyone.

The only way your libido will come back is if you stop clomid, end of story.
 
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