Clomiphene

General information

Clomiphene is a very weak non-steroidal estrogen; it blocks the feedback effect of endogenous estrogens on the pituitary, promoting the further secretion of gonadotropins. The primary use of clomiphene in women is in the induction of ovulation. In men, it has been used to treat infertility in view of its ability to increase endogenous production of testosterone [ ].

Drug studies

In one large study, some adverse reactions in treated women were due to its ovulatory effects and others were direct reactions to the substance itself [ ]. The most common problem was ovarian enlargement (14%), followed by hot flushes (11%), abdominal and pelvic discomfort (7.0%), and nausea and vomiting (2.1%). Incidental symptoms were breast discomfort, vaginal changes, psychological symptoms, headache, heavier menses, and increased urinary frequency. Sporadic case-reports on clomiphene in the literature relate to fetal ovarian dysplasia or maternal psychosis [ ], either of which may have been coincidental. However, it must be borne in mind that the substance is related structurally to triparanol, an obsolete drug that produced a series of disastrous adverse effects some 40 years ago.

In another study, the adverse effects of the antiestrogenic effects of clomiphene citrate were hot flushes (10%), mood swings, depression, headaches (1%), pelvic pain (5.5%), nausea (2%), breast tenderness (2–5%), dryness and loss of hair (0.3%), visual symptoms, halos and streaks around lights (particularly at night), blurring, and scotoma (1.5%) [ ].

Organs and systems