Comparing Enclomiphene and TRT

March 26, 2024

4 mins

Testosterone is thought to be what makes men “manly.” While testosterone is responsible for the traditionally masculine traits in men – such as muscle growth, energy, and high libido – it supports men’s health in so many more ways. 

In this article, we’ll discuss two popular treatment approaches for men who have a testosterone deficiency, or hypogonadism. While both options boost testosterone in the body, the way in which they do so is very different. Let’s compare enclomiphene and testosterone replacement therapy. 

Understanding Hypogonadism

Hypogonadism is a condition characterized by inadequate testosterone production. It can manifest with a variety of symptoms, including decreased libido, erectile dysfunction, fatigue, and reduced muscle mass. 

Testosterone plays an important role in numerous bodily functions, including the development of secondary sexual characteristics, bone density maintenance, and overall energy levels. 

When testosterone levels are low, it can have significant impacts on physical and mental health. Hypogonadism can stem from various causes, including primary testicular failure, hypothalamic-pituitary dysfunction, genetic disorders, chronic illnesses, and certain medications or treatments. 

Risk factors for hypogonadism may include aging, obesity, diabetes, testicular injury, chemotherapy, and radiation therapy. 

What is Testosterone Replacement Therapy (TRT)?

TRT is a medical treatment aimed at restoring normal testosterone levels in individuals with hypogonadism, a condition characterized by low testosterone production. The primary goal of TRT is to alleviate symptoms associated with low testosterone levels.

TRT works by introducing external testosterone into the body. Once administered, the exogenous testosterone enters the bloodstream and reaches target tissues throughout the body – including the testes – where it exerts its effects. 

In the testes, the presence of this testosterone signals to the Leydig cells – which are responsible for testosterone production – to reduce natural testosterone production.

This decrease in testosterone production is due to a negative feedback loop — the body senses the increased levels of testosterone and reduces its own production to maintain hormonal balance.

As a result of TRT, circulating testosterone levels rise, reaching levels within the normal range and help alleviate the symptoms associated with low testosterone levels. 

It's important to note that TRT does not permanently cure hypogonadism but rather provides ongoing maintenance of testosterone levels.

Forms of TRT

TRT typically involves the administration of exogenous testosterone through various forms such as injections, patches, gels, or pellets. Exogenous testosterone just means testosterone that is sourced externally, rather than being produced by the body. 

It can be made from various different androgen and anabolic steroid medications, depending on which form of testosterone replacement it is. 

Injections: Testosterone injections are typically administered intramuscularly and can provide a sustained release of testosterone over a period of time. 

Transdermal patches: These patches are applied to the skin and deliver testosterone gradually through the skin into the bloodstream.

Topical gels or creams: These formulations are applied to the skin, where the testosterone is absorbed and enters the bloodstream.

Subcutaneous pellets: Testosterone pellets are implanted under the skin and slowly release testosterone over several months.

While testosterone itself is not a steroid, it is classified as an androgenic steroid hormone. When used therapeutically in TRT under the supervision of a healthcare provider, testosterone is considered a medication rather than an illicit steroid. 

However, misuse or abuse of testosterone, particularly in high doses or without medical supervision, can have serious health risks and may be associated with the abuse of anabolic steroids.

Benefits and potential side effects of TRT

Testosterone replacement therapy offers several potential benefits for individuals with hypogonadism or low testosterone levels. 

Increasing testosterone levels through TRT can lead to improvements in libido, energy levels, mood, muscle mass, bone density, and cognitive function. Many individuals experience enhanced sexual function, increased vitality, and improved overall well-being with TRT. 

This being said, TRT also carries potential risks and side effects that individuals should be aware of. These may include:

• Fluid retention

• Acne

• Sleep disturbances

• Increased risk of cardiovascular events

• Exacerbation of benign prostatic hyperplasia (BPH)

• Suppression of sperm production (potentially leading to infertility)

It's crucial for men considering TRT to discuss the potential benefits and risks with a healthcare provider before starting treatment. Regular monitoring during TRT is essential to assess treatment efficacy, manage side effects, and adjust treatment as needed.

Considerations for TRT

When considering TRT, several factors should be taken into account to ensure the most effective and safe treatment plan.

One consideration is the cost of TRT, as it can vary depending on factors such as the specific formulation, dosage, and method of administration. Men should inquire about the cost of TRT medications, as well as any associated expenses such as doctor's visits, laboratory tests, and supplies (e.g., needles for injections or patches). 

Without insurance coverage, the cost of testosterone injections may range from $30 to $100 per month. Transdermal patches or topical gels and creams may cost between $100 to $400 per month. Subcutaneous pellets can range from $500 to $1500 for each insertion, with effects lasting several months.

However, these estimates are approximate and may vary significantly depending on individual circumstances and healthcare providers' fees. Additionally, insurance coverage can greatly reduce out-of-pocket costs for TRT, so it's essential to check with your insurance provider to understand your coverage and potential costs.

The frequency of administration is another aspect of TRT to consider. TRT can be administered through various methods, each with its own recommended dosing schedule. For some men, daily administration may interfere with daily life. For others, an implant may feel like too big a commitment. 

Be sure to discuss the pros and cons of each administration method with your healthcare provider to determine which option best fits your lifestyle and preferences. Additionally, adherence to the prescribed dosing schedule is crucial for maintaining stable testosterone levels and optimizing treatment outcomes.

Regular monitoring is also essential during TRT to assess treatment efficacy, manage potential side effects, and ensure overall safety. Monitoring may include regular blood tests to measure testosterone levels, as well as monitoring for any changes in symptoms or the occurrence of adverse effects. Healthcare providers may also monitor other health parameters, such as blood pressure, cholesterol levels, and prostate health, to assess the overall impact of TRT on an individual's health.

What is Enclomiphene?

Enclomiphene is a selective estrogen receptor modulator (SERM) that has emerged as an alternative treatment option for men with hypogonadism or low testosterone levels. 

Unlike traditional testosterone replacement therapy, which directly supplements the body with exogenous testosterone, enclomiphene works by modulating the body's natural hormone production. 

Enclomiphene is typically taken orally in the form of tablets. Generally, it’s taken once daily, preferably in the morning, with or without food. 

Enclomiphene primarily acts by blocking estrogen receptors in the hypothalamus and pituitary gland. This leads to increased secretion of certain hormones that stimulate the testes to produce more testosterone. As a result, testosterone levels can be restored to within the normal range.

One key distinction between enclomiphene and TRT lies in their mechanisms of action. 

While TRT directly introduces externally sourced testosterone into the body, enclomiphene stimulates the body's testosterone production. This difference is significant because enclomiphene may help preserve the natural testosterone production process. This may help in reducing the risk of long-term suppression of natural testosterone production.

In terms of benefits and side effects, enclomiphene offers several potential advantages compared to TRT. 

Enclomiphene may help preserve fertility in men by maintaining or even stimulating sperm production. As previously mentioned, TRT can suppress sperm production and lead to infertility in some men. 

Additionally, enclomiphene may have a lower risk of estrogen-related side effects – such as gynecomastia (enlargement of breast tissue) – compared to TRT. However, enclomiphene may also carry some potential side effects, including hot flashes, mood changes, and gastrointestinal symptoms, which should be considered when weighing treatment options.

How Do Enclomiphene and TRT Compare?

When considering treatment options for hypogonadism or low testosterone levels, men often have a tough choice to make between enclomiphene and TRT. Both approaches aim to restore testosterone levels to within the normal range, but they differ in several key aspects. Here’s how they compare across a few key factors:

Efficacy

While both of these treatment routes have proven effective in raising testosterone levels, their efficacy differs in delivering the specific needs of men. 

For example, for a 26 year old man who worksout often but wants to be a parent one day, enclomiphene may be a better option as there is no risk of infertility. It may also be a more suitable option since enclomiphene is intended for short-term use and appears to be generally safer. 

For older men not concerned about fertility, TRT may be a better option as it has faster results and can be taken indefinitely. 

It should be noted that older men with a history of heart conditions should not take TRT. 

Fertility preservation

For men concerned about fertility preservation, understanding how each treatment affects fertility is essential. Enclomiphene may offer an advantage in this regard, as it stimulates the body's natural hormone production without suppressing sperm production. 

In contrast, TRT can suppress sperm production in some men, leading to infertility. Therefore, individuals of reproductive age who wish to maintain fertility may prefer enclomiphene over TRT.

Cost considerations

The price of enclomiphene and TRT can vary significantly depending on variables like location, type, and insurance status. 

Uninsured individuals may expect to pay anywhere from around $50 to $150 or higher for a monthly supply of enclomiphene tablets. 

For TRT, the cost ranges from $30 to $1500 depending on the mode of administration. 

Where Can You Learn More About Which Testosterone Treatment is Best for You?

Balanced testosterone levels are a key factor in men’s health, and fortunately, Rex MD has got what you need to boost your testosterone. 

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.