What’s the Difference Between Clomiphene and Enclomiphene?

March 26, 2024

5 mins

Clomiphene and enclomiphene are both medications that were initially developed to treat infertility in women. Both medications are often used to manage hypogonadism and male infertility, as well.

The main difference between the two is the molecular structure of the drug.

Clomiphene is a medication composed of two mirror-image forms – or enantiomers known as the R and S enantiomers. It contains equal amounts of both enantiomers, which makes it a racemic mixture. 

Enclomiphene is a specific form of clomiphene that contains only the R-enantiomer, essentially a purified version of one of the mirror-image structures found in the racemic mixture. 

So, while clomiphene contains both R and S forms in equal proportions, enclomiphene exclusively contains the R-enantiomer.

These medications are typically prescribed off-label for men with hypogonadism and are usually taken orally under the supervision of a healthcare provider experienced in treating male hormone imbalances.

What Do Enclomiphene and Clomiphene Do?

Enclomiphene and clomiphene can also be used in men to treat hypogonadism – a condition characterized by low testosterone levels.

Similar to their action in women, enclomiphene and clomiphene work by blocking the negative feedback of estrogen on the hypothalamus and pituitary gland. 

This leads to an increase in the secretion of gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) from the pituitary gland. 

Elevated levels of LH stimulate the Leydig cells in the testes to produce more testosterone.

By increasing testosterone production, enclomiphene and clomiphene can help improve symptoms associated with low testosterone levels – such as low libido, erectile dysfunction, fatigue, and decreased muscle mass. 

They are often used as an alternative to testosterone replacement therapy (TRT) in men who wish to preserve their fertility, as TRT can suppress sperm production.

Are There Any Side Effects of Enclomiphene and Clomiphene?

For men taking enclomiphene or clomiphene for the treatment of hypogonadism, common side effects may include:

• Hot flashes

• Mood changes

• Nausea and vomiting

• Headaches

• Breast tenderness or enlargement (gynecomastia)

• Vision changes

While the overall side effect profiles are similar, individual responses to each medication may vary. Some individuals may tolerate one medication better than the other or experience different side effects. 

Additionally, enclomiphene – being a purified form of the R-enantiomer of clomiphene – may potentially have a more targeted effect with fewer side effects related to the S-enantiomer present in clomiphene. 

However, this does not guarantee that all individuals will experience fewer side effects with enclomiphene.

Do Enclomiphene and Clomiphene Have the Same Results?

Choosing between enclomiphene and clomiphene for the treatment of hypogonadism in men depends on several factors, including efficacy, side effects, and individual patient characteristics.

One reason to consider enclomiphene over clomiphene is its specificity. Enclomiphene contains only the R-enantiomer of clomiphene, which is believed to be responsible for the beneficial effects on testosterone levels while potentially reducing side effects associated with the S-enantiomer. 

This means enclomiphene may offer a more targeted approach with potentially fewer side effects compared to clomiphene.

Additionally, enclomiphene may have a more predictable pharmacokinetic profile, as it is not influenced by the presence of the S-enantiomer. This could lead to more consistent testosterone levels and potentially improved treatment outcomes.

For some men, the choice between enclomiphene and clomiphene may also depend on factors such as cost and accessibility. Enclomiphene is not widely available and may be more expensive compared to clomiphene.

The decision to use enclomiphene or clomiphene should be made in consultation with a healthcare provider who can assess individual patient needs, preferences, and treatment goals.

Overall, the main difference between clomiphene and enclomiphene lies in their molecular structure and potential side effects, with enclomiphene being a more targeted and potentially safer option for treating infertility in women.

How Much Do Enclomiphene and Clomiphene Cost?

The cost of enclomiphene can fluctuate depending on factors such as location, the type of formulation (generic or brand name), and whether or not the individual has insurance coverage.

For those without insurance, the price for a monthly supply of enclomiphene tablets can range from approximately $50 to $150 or even higher.

Similarly, the cost of clomiphene may also vary depending on these factors. Typically, the price of a one-month supply of generic clomiphene typically ranges from around $10 to $100, while brand-name versions may be more expensive, sometimes exceeding $200 for a month's supply.

It's advisable to check with local pharmacies or online retailers for the most accurate pricing information. Additionally, insurance coverage may help offset the cost of clomiphene for some individuals.

How Can Rex MD Help?

With the Rex MD TestoRx program, you’ll have access to testosterone-boosting medications like Clomid – which contains enclomiphene – that will help you feel like yourself again. 

If you and your healthcare provider find that enclomiphene isn’t right for you, Rex MD offers alternative testosterone therapies that may be better suited for you. Other Rex MD offerings include:

• Testosterone cypionate – a biweekly testosterone injection (prescription only)

• Generic Androgel – a daily topical testosterone gel (prescription only)

With the Rex MD TestoRx program, you’ll have access to quality care from a team of licensed clinicians and testosterone solutions, if appropriate.

To find out if the program is right for you, just answer some about your symptoms and medical history. Your provider will order lab work for you to help determine if you’re eligible for testosterone injections or another treatment option.

Then, you’ll be able to schedule a virtual call with the Rex MD care team to further discuss your results, eligibility, and which treatment option would be most suitable for you, if any.

Get started today.