T Nation

Androxal for TRT


Check out this article, you may already have heard of this:


Androxal, a new drug pending FDA approval, may be helpful as TRT for secondary hypogonadism. It is basically like Clomid, but without the "bad" isonomer that causes the estrogen sides and negating the need for an AI. It also helps fertility by inducing positive feedback on the HPTA, unlike T shots/creams and HCG that actually repress the HPTA cycle.

Since clomid worked for me (raised my T levels at a high enough dosage), I'm VERY interested in Androxal as a long term TRT remedy. Hoping it gets FDA approval by this time next year.

What do you all think?


TT levels reported were low.

I can't see any advantge VS Nolvadex. But the new drug will be way more expensive.

The side effects from Comid that some guys report, cannot be blocked by an AI, the SERM is the 'estrogen'.

All SERM's increase estrogens. That is a simple result of what is happening in the testes.

An AI should be used with a SERM if E2 becomes elevated. However, if the SERM dose is too much for the testes, there can be a lot of T-->E2 inside the testes and a competative AI cannot control that T-->E2

Comparing to transdermal T products is a silly soft target.
Some of the trandermal T reports of non-success probably include those who simply cannot absorb or have that problem because of hypothyroidism. In those cases, transdermals are simply inapropriate. Again cherry picking. Should compare to the gold standard - injections.

SERM's will not help with some forms of seconary hypogonadism and never with primary. And old testes often willl not produce decent levels of T with LH/FSH from a SERM or with hCG. SERM's can work well with younger men. That is a rather small market.

Based on the TT levels reported, I would judge this treatment as a total failure. We have young and old guys at the achived levels who feel like crap. Older men need to be high-normal to feel good.


Of course it may not be an option for everybody who needs TRT, but I feel it is a great option for me.

On clomid, my TT shot up from the 300s to over 900, and free T went up over the range. Androxal should be even better because it should be without the E sides (where I had to lower my dose). But you are right about Nolvadex, I, too am having a hard time seeing the advantage over Nolvadex. I should probably persuade my doc to switch me over to Nolvadex if he's not going to put me on shots.


Nolvadex does not have the estrogenic side effect of Clomid [that some guys experience].

Clomifene (INN) or clomiphene (USAN) (trademarked as Androxal, Clomid and Omifin) is a selective estrogen receptor modulator (SERM)

Androxol is an isomer of Clomid. The result will be high prices to pay for the high costs of FDA approval.

Because clomifene citrate has not been FDA approved for use in males it is prescribed off-label. Due to the fact that Clomifene is now a generic medication in most markets, it is unlikely that a drug company would pursue FDA approval for use in men now because of limited profit incentive, mostly due to the relatively small market potential.[15] However, the single isomer of clomifene, enclomiphene under the brand name Androxal, is currently under phase 3 trials for use in men.[16][17]

Clomifene is a mixture of two geometric isomers, enclomifene (E-clomifene) and zuclomifene (Z-clomifene). These two isomers have been found to contribute to the mixed estrogenic and anti-estrogenic properties of clomifene.

So someone is going after the [costly] one isomer to avoid the estrogenic effects in Clomid that generic Nolvadex does not have.


Few corrections to your post:

  1. The phase 3 trial was considered a "massive" success as 89% of subjects doubled their tt levels.
  2. Clomiphene is $1.12 per 50mg tablet. If androxal is sold at $100 per 50mg tablet...it will still be cheaper then test cyp for a 1 month supply.
  3. If tamoxifen worked better then enclomiphene, then $50 million dollars worth of research would be going into that drug and not this one.
  4. Enclomiphene does not promote estrogenic activity...it simply occupies the receptor site...similar to how suboxone occupies opiate receptors but doesn't get you high.
  5. Serms help with all forms of secondary as by definition, secondary hypogonadism is a failure in the chemical signaling between the 3 parts of the gonadal axis. If the serm doesn't work for someone who was diagnosed as secondary...them they were diagnosed wrong and they are really primary.

Your comment that the study was a total failure is your subjective opinion. Thankfully the FDA doesn't share your lack of objectivity. Normally I would supply clinical literature to support what I say but I'm not getting into a pissing contest with an undercover androgel cyber salesman.


"2. Clomiphene is $1.12 per 50mg tablet. If androxal is sold at $100 per 50mg tablet...it will still be cheaper then test cyp for a 1 month supply."

Not sure where you're pricing the test cyp at more than $3000 per month. Guys are paying $40 to $50 for a twenty week supply.


*$10 not $100 that was a typo....and an exaggeration. Enclomiphene will cost the same as clomiphene, maybe even less after the 7 year patent is up and other pharmaceutical companies can buy and rebrand.


Warrior knows best. I can quit now.

At Walmart USA:

Clomiphene 50mg tab $15 for 90 tablets, $60 per year.
For many men, 90 tablets would be all that they would need for a year.