How does the SERM enclomiphene citrate work for low T?
Enclomiphene is a selective estrogen receptor modulator that raises LH and FSH, which in turn raises endogenous testosterone. It preserves fertility, unlike traditional TRT.
Full answer
Enclomiphene is the trans-isomer of clomiphene and a selective estrogen receptor modulator (SERM). By blocking estrogen feedback at the hypothalamus, it raises LH and FSH, which in turn stimulates endogenous testicular testosterone production. The key distinction from traditional TRT: enclomiphene preserves fertility and testicular volume because it works through the HPG axis rather than replacing testosterone exogenously. Candidacy is best for younger men with secondary hypogonadism who want to maintain fertility. Workup mirrors TRT baseline plus LH/FSH; provider review titrates dose against testosterone response and symptom mapping.
Educational. Not a substitute for individualized provider review.
- Enclomiphene pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29