CLOMID study in men with ED
I found this article very interesting and may help and answer few questions some members may have or have been ask for..
“Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?”
Secondary hypogonadism is more common than primary gonadal failure and is seen in chronic and acute illnesses. Although testosterone has a role in erections, it’s importance in erectile dysfunction (ED) has been controversial. Hypogonadism produced by functional suppression of pituitary gonadotropins has been shown to correct with clomiphene citrate, but with a modest effect on sexual function. We wondered if longer treatment would produce improved results. A total of 178 men with secondary hypogonadism and ED received clomiphene citrate for 4 months. Sexual function improved in 75%, with no change in 25%, while significant increases in luteinizing hormone (P<0.001) and free testosterone (P<0.001) occurred in all patients. Multivariable analysis showed that responses decreased significantly with aging (P<0.05). Decreased responses also occurred in men with diabetes, hypertension, coronary artery disease, and multiple medication use. Since these conditions are more prevalent with aging, chronic disease may be a more important determinant of sexual dysfunction. Men with anxiety-related disorders responded better to normalization of testosterone. Assessment of androgen status should be accomplished in all men with ED. For those with lower than normal age-matched levels of testosterone treatment directed at normalizing testosterone with clomiphene citrate is a viable alternative to giving androgen supplements.
Keywords: clomiphene citrate, erectile dysfunction, hypogonadotropic hypogonadism
General patient population
In the Center for Sexual Function, 990 men who presented with sexual dysfunction during a 2-y period were evaluated with retrospective chart review. The clinical characteristics and medical risk factors of the population were previously reported.25 All men had testosterone and luteinizing hormone levels monitored, and 58 men (5.8%) had hypergonadotropic hypogonadism (primary gonadal failure), while 302 men (30.5%) had hypogonadotropic hypogonadism (ie, low testosterone and inappropriately low or normal luteinizing hormone levels). Of these 302 men, 272 (90.7%) had ED as part of their presenting complaint, defined as the inability to achieve or maintain an erection long enough to complete sexual intercourse satisfactorily in more than 50% of attempts.
Treatment with clomiphene citrate
Of the 272 men with hypogonadotropic hypogonadism and ED, 228 (83.8%) completed a 4-month course of clomiphene citrate, 50 mg orally on Monday, Wednesday, and Friday. Most of these men were married in a stable heterosexual relationship; the single men were in a steady relationship for at least 6 months. A home log was kept in which the couple recorded the number of sexual attempts and successes at intercourse. A successful response was defined as the ability to complete intercourse in more than 75% of attempts; a partial response was defined as successful intercourse in from 50 to 75% of attempts. The men who failed did not notice any change in their sexual activity. No men reported side effects caused by clomiphene citrate.
FULL INFORMATION OF THE STUDY CLICK LINK:http://www.nature.com/ijir/journal/…l/3900981a.html