[quote]SteelyD wrote:
DrSkeptix wrote:
I have cited this article before:[i]
Complete reversal of adult-onset isolated hypogonadotropic hypogonadism with clomiphene citrate.
Ioannidou-Kadis S, Wright PJ, Neely RD, Quinton R.
Department of Endocrinology, Royal Victoria Infirmary and University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, United Kingdom.
OBJECTIVE: Inhibition of pituitary gonadotropin secretion in men by T is principally mediated by aromatization to estrogen (E), which inhibits hypothalamic secretion of GnRH. We hypothesized that adult-onset isolated hypogonadotropic hypogonadism (IHH) might result from an altered central set-point for E-mediated negative feedback. DESIGN AND SETTING: Longitudinal clinical investigation unit-based evaluation of the clinical and biochemical response to E-receptor blockade. PATIENT(S): A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH 1.7 U/L, FSH 2.0 U/L, T 3.5 nmol/L). INTERVENTION(S): Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months. MAIN OUTCOME MEASURE(S): Baseline and stimulated T levels and LH pulsatility; effect on sexual function. RESULT(S): Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S): Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.
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Dr.Skpx-- what journal/pub is this abstract from?[/quote]
Here ya go, Bud; #2 is the article for which I pasted the abstract.
[i]
2:
Complete reversal of adult-onset isolated hypogonadotropic hypogonadism with clomiphene citrate.
Ioannidou-Kadis S, Wright PJ, Neely RD, Quinton R.
Fertil Steril. 2006 Nov;86(5):1513.e5-9.
PMID: 17070201 [PubMed - indexed for MEDLINE]
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3:
Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate.
Whitten SJ, Nangia AK, Kolettis PN.
Fertil Steril. 2006 Dec;86(6):1664-8. Epub 2006 Sep 27.
PMID: 17007848 [PubMed - indexed for MEDLINE]
Related Articles
4:
Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism.
Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, Goluboff E.
J Sex Med. 2005 Sep;2(5):716-21.
PMID: 16422830 [PubMed - indexed for MEDLINE]
Related Articles
5:
Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?
Guay AT, Jacobson J, Perez JB, Hodge MB, Velasquez E.
Int J Impot Res. 2003 Jun;15(3):156-65.
PMID: 12904801 [PubMed - indexed for MEDLINE]
Related Articles
6:
Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse.
Tan RS, Vasudevan D.
Fertil Steril. 2003 Jan;79(1):203-5.
PMID: 12524089 [PubMed - indexed for MEDLINE]
Related Articles
[/i]
The others are to show that this is not a “narrow” band of interest.
Whether other SERMs are interchangeable is arguable and testable but not proven equivalent. Yes, AIs and tamoxifen can cause a rise in T, but I do not know if the same is true for toremifene and raloxifene. KSman infers that pulsatile GnRH production would be obvious, and a effect common to the other SERMs, but there is no proof there. (i.e. enclomiphene may have very different CNS kinetics than entamoxifen and nortamoxifen.)
The prinicpal trials use only 4 months of clomiphene at a variety of doses. It is hard to think that there are important lasting side effects, and none were reported among the hundreds of men in these trials.