Podcast episode 126 (in German)

Enclomiphene – rejected twice, and the studies hold up anyway

November 3, 2026

Enclomiphene has failed twice at a regulatory agency, in America and in Europe, even though the studies showed what they were supposed to show. The contradiction resolves as soon as you distinguish a lab value from a life, and the sales pitch is still accurate.

What it is about

Taking testosterone from outside shuts down the body’s own production and with it the production of sperm. Enclomiphene starts at the other end: it blocks the estrogen sensor in the brain, the brain turns up the control hormones LH and FSH, and the testes make more of their own testosterone and sperm along with it. It is the blocking half of clomiphene, known for decades. The episode goes through the studies that show this in humans, the two rejections and what men report in clinic evaluations. At the end stands a question: is it about wanting children or about feeling better? For the first there are data, for the second so far only reports.

Key points

In 15 men who had been taking clomiphene for some time, the estrogen-like half, zuclomiphene, was ahead 20 to 1 in the blood, a good reason for the pure form.
In 2 randomized, double-blind phase 3 studies with 256 overweight men aged 18 to 60, testosterone after 16 weeks was 413 to 446 nanograms per deciliter on enclomiphene and 351 to 387 on gel.
On enclomiphene, 2 to 5 percent of men fell below the threshold of 15 million sperm per milliliter; on testosterone gel, 24 to 49 percent.
The US agency said no, as the manufacturer announced on December 1, 2015: the study design was no longer suitable for demonstrating a clinical benefit.
In January 2018, the European Medicines Agency refused after 4 main studies with 588 patients: bone, weight, erection and libido had not been studied, and there was also a risk of blood clots in the veins.
A 2025 review of 10 randomized studies with 819 men and both substances found around 274 nanograms per deciliter more testosterone versus placebo, only 5.4 versus gel, and 70 million more sperm per milliliter.
In an evaluation of 400 men on clomiphene, 77 percent said their symptoms had improved; 66 men who switched to enclomiphene complained less often afterwards about low libido, low energy and mood swings.

Where the data stop

Both agencies identified the same gap: the lab value moved, function was not measured. How the men in the approval studies felt was explicitly not assessed by the authors; symptom questionnaires existed only in a few studies, all with clomiphene, with mixed results, and once symptoms also improved on placebo. The clinic reports fit the mechanism but are records without a comparison group, and those who were disappointed left earlier. The safety data extend to 16 weeks; for testosterone, TRAVERSE covers 5,246 men over an average of 33 months.

Enclomiphene is approved neither in America nor in Europe, and clomiphene is on the World Anti-Doping Agency’s prohibited list. In February 2026 the British professional society for sexual medicine called it promising, especially for men wishing to have children, but owing to the lack of long-term data only in experienced hands. For a man wishing to have children, the sperm finding is a real argument for a consultation at a urology practice. Low testosterone has causes that should be clarified by a doctor, not by a provider who also sells the product.

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Published on November 3, 2026.

The topic in the database

The popular TRT alternative in tablet form: raises the body’s own testosterone while preserving fertility.Enclomiphene

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-10-09.