Clomiphene is a medication that belongs to a class of drugs known as selective estrogen receptor modulators (SERMs). It is primarily used in medical settings to treat infertility in women and occasionally in men.

Medical Uses

Clomiphene is approved for the following medical uses:

1. Female Infertility: It is used to induce ovulation in women who do not ovulate regularly (anovulation), such as in cases of polycystic ovary syndrome (PCOS).
2. Male Infertility: Clomiphene is sometimes used off-label in men with infertility due to low sperm count or poor sperm motility.

Mechanism of Action

Clomiphene exerts its effects through the following mechanisms:

• Estrogen Receptor Blockade: Clomiphene binds to estrogen receptors in the hypothalamus, specifically the hypothalamic-pituitary axis. This blocks the negative feedback of estrogen on the hypothalamus, leading to increased secretion of gonadotropin-releasing hormone (GnRH).
• Gonadotropin Release: Increased GnRH secretion stimulates the pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This promotes follicular development in the ovaries and ovulation in women, and testosterone production in men.

Side Effects

While generally well-tolerated, clomiphene can cause several potential side effects:

1. Ovarian Hyperstimulation Syndrome (OHSS): In some women, particularly those with polycystic ovary syndrome (PCOS), clomiphene can lead to overstimulation of the ovaries, causing abdominal discomfort, bloating, and in rare cases, more severe complications.
2. Multiple Pregnancies: Clomiphene increases the risk of multiple pregnancies, such as twins or triplets, due to the stimulation of multiple follicles.
3. Visual Symptoms: Some individuals may experience visual disturbances such as blurred vision, flashes or spots, which usually resolve after discontinuing the medication.

Interactions

Clomiphene may interact with other medications or substances that affect estrogen levels or liver function. Specific interactions may include:

• Estrogen-containing medications: Concurrent use of estrogen-containing medications may reduce the effectiveness of clomiphene.
• Liver Enzyme Inducers: Drugs that induce liver enzymes may decrease the effectiveness of clomiphene.