read the bold at the bottom--although the whole article is good. i too wondered about this---
CLOMID by: Carlton M. Colker, MD, FACN
Clomiphene citrate(also known as clomid) is an FDA approved drug for use in women struggling with fertility issues. Generally, it's the first fertility drug a couple will be introduced to if the issue arises. Among the more traditional reproductive endocrinologists, Clomid has not been thought of as a drug for men. Yet, in recent years the more cutting-edge practitioners have discovered a valued "off label" use for Clomid in men with low sperm counts due to genetic factors or after years of anabolic steroid drug abuse. That said, numerous male bodybuilders have begun exploiting Clmomid as a testosterone-supporting drug to optimize muscular development.
Clomid's complexity:
Clomid is used to induce ovulation in women with ovulatory disorders. It's also used to assess ovarian function and the likelihood that a woman can still produce viable eggs.
Interestingly, clomid is a somewhat mysterious and complex medication; its mechanism of action IS NOT FULLY UNDERSTOOD. it works in the body somewhere high up along the estrogen axis, but is capable of reacting with any tissue in the body that has estrogen receptors. While the action of clomid in the female physiology takes place at the level of the hypothalamus and pituitary, it may also involve the ovaries, endometrium, vagina and/or cervix.
The action in the male also appears to take place at the level of the hypothalamus and pituitary, but may also act at the level of the adrenals, peripheral fatty tissues, liver and/or testicles. Clomid influences the way the estrogen hormone, estradiol, influences three other hormones. The first is gonadotropin releasing hormone (GnRH), a hormone produced by the hypothalamus (a lgland located in the skull center above the pituitary gland) that affects the release of hormones in the pituitary and are called follicle stimulating hormones (FSH - follicle stimulating hormone - - follicle stimulating hormone - ) and luteinizing hormone (lh - leutenizing hormone - - leutenizing hormone - ).
While physicians ARE NOT IN AGREEMENT on the precise kinetics, it appears Clomid fools the body into believing the estrogen level is low. Furthermore, clomid competes with estrogen for estrogen-receptor-binding sites and probably delays the replenishment of intracellular estrogen receptors. There is also some data suggesting that clomid has both estrogenic and anti estrogenic properties, but the test results show a variable response form one species to the next and one receptor site to the next.
CLOMID AND MALE PHYSIOLOGY
The popular street and online lore is that clomid blocks production of estrogen. Unfortunately, this is a reckless misinterpretation of the mechanism because the drug won't reduce your estrogen or the problems that come along with having high estrogen. IN fact, in production the male physiology, it actually stimulates some degrees of estrogen production, though not nearly as much as testosterone.
Along the same estrogen blocking reasoning some morons claim that clomid is effective at reducing gynocomastia (bitch tits). More lies. In some cases, Clomid CAN CAUSE GYNOCOMASTIA. So from that standpoint, you need to watch not only your testosterone levels but also you estradiol.
The activity of Clomid is more than likely achieved by interfering with the inhibitory effects of estrogen at the level of both the hypothatlamus and the pituitary. In a process called negative feedback, the higher the estrogen, the more the HPT and pituitary reduce the production of gonadotropin hormones. Clomid seems to come in and occupy the estrogen receptors at these levelswhile at the same time not activating them, resulting in more GnRH, FSH and LH. In the female, FSH and LH cause the release of mature eggs ( a processs called ovulation). In the male, the release of these gonadotropins stimulates testosterone (via LH) and sperm production (via LH).
Typically, male bodybuilders use 50 mg tablets taken orally each day for up to six months each year. While clomid is not a steroid, has no androgenic activity and does not appear to interfere with pituitary-adrenal or pituitary-thyroid function, it's still not a drug for sport ergogenic use. IN FACT THERE ARE NO ADEQUATE OR Well DOCUMENTED STUDIES demonstrating the effectiveness of clomid in men. What is cited in the literature are GYNOCOMASTIA and TESTICULAR TUMORS reported in males using clomid long term. Although in fairness it should be noted that the cause and effect relationship between reports of testicular tumors and clomid may be nonesense. Yet, clomid abuse has risen sharply among male bodybuilders and athletes in recent years. I attribute this to the fact that it's not a drug typically tested for and is relatively easy to take because of its availability in tablet form. It's also more readily accessible when compared to more highly visible sporting drugs of abuse. As far as fertility drugs in this class go (and I think they are all grotesquely overpriced) it's relatively inexpensive.
SPERM PRODUCTION GRINDS TO A HALT
In my practice, when an experienced bodybuilder abuses anabolic steroids over a continuous period of time without going off-cycle (many months or years) sperm production shuts down making him infertile. This may also occur in a man with a legitimate reason to take continuous testosterone drugs. This side effect may not pose a health problem, but it sucks if you're trying to get your wife pregnant. In my experience, it's not as big a deal for older bodybuilders (50+) who have been through marriage and kids. As long as their wedding tackle still operates, they generally don't care if their ejaculate is bereft of sperm.
But for the younger set aspiring to have a family, the result can be alarming. The general profile is that of a bodybuilder between the ages of 28 and 43 years with a history of continuous anabolic steroid abuse and no time off between cycles. This scenario is growing with increasing frequency as more and more bodybuilders resist going off-cycle to clean out. It was only around contest time that they started the heavy juicing. Also, guys abuse much higher doses for longer periods. There was a time when guys were either on a low dose for a londer stretch, or a higher dose for a shorter period, depending on their philosophy. Only now have we see nigh0dose/long-duration abuse.
When this occurs, sperm production grinds to a halt. The condition is diagnosed by testing semen under the microscope for sperm. Typically, there should be 20 million or more sperm visible per cc. In men with infertility due to anabolic steroid use, often one doesn't see a single sperm!
Assuming this type of anabolic steroid abuse rather than some genetic factor is the root cause, sperm production should eventually resum, but it can take anywhere from six months to five yeras for the system to correct itself. Also, a small percentage of really heavy abusers never seem to recover and they remain infertile for life.
TRIGGERING SPERM PRODUCTION
So what good news can I offer if you don't want to roll the dice on the waiting game to see if your sperm production picks up while watching your hard forged muscle mass shrivel away to nothingness? The good news is Clomid. Though not yet FDA approved for this purpose, once off anabolic steroids, Clomid is being used to rescue the hormonal axis and thus trigger sperm pruduction. Gererally, we start with 25mg per day, but doses can go as high as 75 mg per day depending on the responsiveness of hormone production. The drug is started after anabolic steroids are stopped. Simply stated, if you're still abusing, you're cruisin for a bruisin'.
Four to six weeks after treatment starts, blood levels of testosterone, LH and FSH are retested to assess the responsiveness of the pituitary and testes. If the numbers don't budge much, the dose is increased. Approximately 2/3 of patients respond within a matter ofmonths and subjects can subsequentlyget their wives pregnant.
You won't see viable sperm in the semem again for about three months. So, unlike blood tests, there's no sense in retesting semen before that time. But once you do find sperm again, you're good to go. Of course, if your body successfully resumes producing viable sperm, there is always the option of immediately harvesting a sample and cryogenically storing it for future in-vitro fertilisation (IVF). This gives patients that truly have a medical need for testosterone the go ahead to resume uses if they so desire, while still having the ability to inseminate. Interestingly, there are occasions in which Clomid actually does the trick and the homonal cycle is reactivated. As a result, some patients never have to go back on testosterone drugs, as their levels spontaneously normalize after a little clomid stimulation. Once can always forgo Clomid, stop the juice and just wait it out. In my experience, most reproductive endocrinologists will tell you that you still have roughly the same chance of recovery. But as I said, you may be talking about years. Most couplesunderstandably don't want to wait that long or take the chance of finding out their plumbing hasn't fixed itself. So, in these cases, I actually adise patients that it's better to address it early with Clomid, because the longer the axis remains dormant, the less likely it will be successfully reawakened.
CLOMID"S GREATEST UTILITY
Finally, I've come across a number of bodybuilders who used Clomid as a regular part of their cycle. When I asked them why, none could explain. This ignorance is born out of lack of knowledge about why they were taking a drug in the first place. They only took it because someone they thought knew what they were talking about told them to do it. The fact is that is has no place in a cycle. For example, it defies logic to use it with testosterone becuse the effect of testosterone is to decrease production of LH at the level of the pituitary gland. This is the opposite action of Clomid.
[B]Provided there is no negative feedback driven by high testosterone levels, Clomid should cause LH to increase and in time, stimulate production of natural testosterone. Doubledipping by stacking Clomid on a backdrop of anabolic steroids is pointless because an unnaturally high anabolic steroid level will negatively modulate LH production at the level of the pituitary. This is the opposite of what Clomid does. As I see it, it's only off-cycle that Clomid has its greatest utility.[/B]
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