Rodriguez Katherine M, Pastuszak Alexander W, Lipshultz Larry I
a Baylor College of Medicine , Houston , TX , USA.
b Center for Reproductive Medicine , Baylor College of Medicine , Houston , TX , USA.
Expert Opin Pharmacother. 2016 Aug;17(11):1561-7. doi: 10.1080/14656566.2016.1204294. Epub 2016 Jul 4.
Hypogonadism is a growing concern in an aging male population. Historically treated using exogenous testosterone, concerns about possible adverse effects of testosterone have led physicians to seek alternative treatment approaches.
Enclomiphene citrate is the trans isomer of clomiphene citrate, a non-steroidal estrogen receptor antagonist that is FDA-approved for the treatment of ovarian dysfunction in women. Clomiphene citrate has also been used off-label for many years to treat secondary male hypogonadism, particularly in the setting of male infertility. Here we review the literature examining the efficacy and safety of enclomiphene citrate in the setting of androgen deficiency.
Initial results support the conclusion that enclomiphene citrate increases serum testosterone levels by raising luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, without negatively impacting semen parameters. The ability to treat testosterone deficiency in men while maintaining fertility supports a role for enclomiphene citrate in the treatment of men in whom testosterone therapy is not a suitable option.
性腺功能减退在老年男性群体中日益受到关注。过去采用外源性睾酮进行治疗，但由于对睾酮可能产生的不良反应的担忧，医生们开始寻求替代治疗方法。
枸橼酸恩杂鲁胺是枸橼酸氯米芬的反式异构体，枸橼酸氯米芬是一种非甾体雌激素受体拮抗剂，已获美国食品药品监督管理局批准用于治疗女性卵巢功能障碍。多年来，枸橼酸氯米芬也一直被用于非适应证治疗继发性男性性腺功能减退，尤其是在男性不育的情况下。在此，我们综述了有关枸橼酸恩杂鲁胺在雄激素缺乏情况下的疗效和安全性的文献。
初步结果支持以下结论，即枸橼酸恩杂鲁胺通过提高黄体生成素（LH）和卵泡刺激素（FSH）水平来增加血清睾酮水平，而不会对精液参数产生负面影响。在维持生育能力的同时治疗男性睾酮缺乏的能力，支持枸橼酸恩杂鲁胺在治疗不适合采用睾酮治疗的男性中的作用。
