Clomiphene: High Testosterone, Low Libido

Dear Members!
I am new to this forum, although i have read it more than 3 years ago.
I have hormone relevant problems, i have an andrologist, psychiatrist, who treat me this time.

I receive medications for my condition, so my total testosterone level is on the upper limit of the range.
My prolactin is midrange. My t3/t4 TSH is normal as my endocrinologist checked my thyroid and thyroid hormones.

The problem, i am working on, that i have very low libido but normal erection anytime i need to have one.

I think i have dopamine deficiency, this is why i started to take Bupropion SR 150 mg daily.
This make my libido for a higher level, although not thru the roof.

My medications/vitamins are the following:

For hormone therapy:
-Clomiphene citrate 25 mg every day
-Anastrazole 0,25 mg every day
-Bupropion SR 150 every day. (Edit: Discontinued since 2019)

For high blood pressure:

-Rilmenidine 1 mg every day
-Telmisartan 80 mg every day. (Edit: Discontinued since 2019, because BP dropped under 110/70)

Now i decide to start a dopamine agonist bromocriptine 1,25 mg every day (with my andrologist supervision). I hope it will help me on my still only mid-range libido.
(Edit: I will end this regimen in 2020 september and start Androgel+hCG therapy. It seems, despite my efforts, and despite the different medications i have tried, I Can Not Receive a good TRT therapy basing on Clomiphene citrate)

Please if You have any suggestion, or idea about what i do wrong way, or what should i do in a different manner, answer for my post here.

Thank You.

Please post blood work with ranges including T and E2. That’s a lot of anastrozole.

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This is the only thing I am concerned about right now honestly. Arimidex is poison.

What @NH_Watts Said also.


10/10 says this is the issue.

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I’m not a doctor and not nearly as knowledgable as many on this board but I’d start with trying to ‘naturally’ deal with your blood pressure… Like you, i suffered from High Blood Pressure, I switched up to an Intermittent Fasting lifestyle and my blood pressure dropped, like a rock. My understanding is a lot of people(myself included) suffer from constant inflammation and the less meals we eat the better we do… it’s worth a shot and honestly, I feel better with everything now; leaner, more energy, better sleep and libido has been consistently good.

Thank You for the answers, i definiately know i have more health problems which cause the effect on my sex drive and erection. I was obese (110 kg 180 cm), and am too now, but i have lost 20 kg in 3 years and i plan to lose another 10 kg for reach the 180 cm - 80 kg optimal readings.

Regarding Arimidex, i would say it is a must-have for me now. After i start clomiphene therapy, i get estradiol from normal level to 3 x normal level. My testosterone reading was hit the upper limit of the male medical range, which is/feels great, but some weeks later i get horrible anxiety, anger and irritability. My doc told me maybe it is because the high estradiol level. he prescribe me arimidex, 0,25 mg eod. It helps my anxiety problems, but i feel rollercoaster with the eod dosage, so i ask my doc to raise the dosage for 0,25mg everyday. This was great relief for anxiety, and my libido problems.
I can tell my lab readings, i will look after them in the following days.

I have many blood pressure medication in the 3 years, this combo which i use, gives me the less side effect on sexual health.

I know, my lifestyle is not so perfect, i mean it is somewhere the “sedentary” - -“rare sport activity” range.

Please forgive me about my poor english, sometimes i cant describe things as i would.
I will be here soon with more questions about my situation, and try to receive more answer on my questions.

-Clomiphene citrate 25 mg every day
Why so much of clomid? You could try EOD that dose or everyday half the dose. That should allow you to take less anastrazole.

Good Morning!

Sorry i did not have free time to be in front of my computer, and i had blood sample last week, so i have the recent values.

LAB results:

Value Range valid
TSH 3,202 mIU/l 0,4-4,0
LH 14,25 IU/l 1,24-8,20
FSH 21,89 IU/l 1,27-19,26
Prolactin: 151,3 mIU/l 56-278
Estradiol 80,7 pmol/l 0-172,5
Testosterone total 25,0 nmol/l 6,1-27,1
Free testosterone index: 66,6 % 24,3-110,2
PSA 0,16 Microgramm/l 0,00-4,00
SHBG: 37,50 nmol/l 13,3-89,50

My recent medications are still same like i was write in my comment last week.

(Clomid 25 mg/ed, Anastrazole 0,25 mg/ed Wellbutrin sr 150 mg/ed)

My recent vitamines:

D3 2000 IU/day
Magnesium+B6: 250 mg/day
K2 Vitamin 120 microgram/day

There are some changes in my lab results from the last time in July.

My prolactin raised from 120 to 151 mIU/l.
Estradiol decreased from 261 to 80,7 pmol/l

I have an opinion, that i have low libido issues regarding to my high prolactin level.
I am curious, what i should change in my medications/vitamins?

Recently i have no more idea…

Yes, it is not the minimal dose of CC, but i need it for the testosterone level 25 nmol/l.
Without the CC i have natural testosterone production 10,4 nmol/l which is at the bottom of range, and it is proper for a 70-80 years old man, but i am 39 years old.

I have had mechanical injuries to my testicles when i was born, at the delivery, later i have 2 times femoral hernia surgery left and right side both, and at my age 17-18 i have mumps and painful testicle inflammation.

These injuries to my testicles made my natural testosterone level so low. They produce normal test level only with help of CC, thanks to the raised LH and FSH.

TSH is high(ish) you need to have your Free T3, free and total T4 checked to see whats up with your thyroid.

A TSH >2.5 is indicating a problem, these ranges include those with hypothyroidism. TSH is a poor diagnostic tool by itself, it would be like checking testosterone by only running LH without regard for Total T and Free T.

Yes, my TSH was every time in this range in all of the last labs this year. My Andrologist told me it should be checked what is the cause.

Later i look up an Endocrinologist. She did more different blood lab test, including T3, T4, D25OH, cortisol morning/evening, and many other more, which i dont exactly remember this time.

The T3 T4 values are both at midrange level, every value was good, only D25OH was in the range: D-Vitamine deficiency. This is the reason for my daily 2000-3000 iu D3 vitamin intake.

She did an blood glucose level test with load of sugar, and it shows insulin resistance. but only slightly. I should aware of carbohydrates and high glycemic index foods.

The ultrasound examination shows no problem at my thyroids. The endocrinologist told me i dont need any medications for my high tsh situation, because it is in the value range, and i have to live with it. Finally I told her that my andrologist opinion aboput my TSH is too high, it should be near to 1,5-2. When ask her to prescribe me medication for this issue, she promptly denied it to me.

I cant see now exactly what is the truth.

Why is TSH higher range when my T3 T4 is in midrange? What can i do to decrease TSH level?
I usually do more attempts to solve some situation, but this time it seems, i run out of ideas.
I will go to andrologist next week, and i will write about the next steps.

Thank You for reading, and for helping me find a way!

It wouldn’t matter if Free T3 is midrange or not, if Reverse T3 is high than the majority of Free T3 will float right by the T3 receptor and you will have hypothyroid symptoms,

The value range is problematic, the population sample of people that created those ranges have many who have undiagnosed hypothyroidism, eat processed food and don’t exercise. Dig deeper and focus on optimal and not normal because normal these days is unhealthy if you look at the majority population. Look at the overweight men and women and you get a better look at the new normal.

We know TSH rises when the pituitary gland sense low Free T3 or high Reverse T3 which you haven’t had tested. Your insurance is dictating when a doctor takes action, top rate insurance would allow a doctor to take action.

Do not trust these statet healthcare doctors with your quality of life.

Thank You for the informations about the t3/reverse t3 levels, this will be the way i am going to work in the following weeks. I was not at a state health care doctor, but at a private doctor who seems to be good enough, but in this case he failed to find my problems source. I think i will look at another doctor who can help me find the cause of my elevated TSH level.

I would update the last week news: i was at my andrologist and i told him my libido problems, he told me i have nothing serious problem with my hormone levels after checking my latest lab results. I told him if he would write me some dopamine agonist, since his homepage has a section for low libido issues, and there is an option for off label treatment low libido with dopamine agonist. I was browse the net about the problem, and found more websites who recommends the same treatment.

My doctor told me he can write me cabergoline or bromocriptine, i choose bromocriptine because its cheap, and cabergoline is available only in other european countries but not at here.
I start bromocriptine at 1,25 mg daily , and my results are quite interesting. I have frequent morning wood every night, and my daytime thoughts are focused about sex and women. Since i start bromo, i have very vivid and realistic dreams at night. The dreams are extremely “high resolution”, harsh and realistic. The dreams are almost all the time fulfilled sexual/flirty scenes, which is very different from my dreams before the bromo. The wake up and insomnia at 1-o clock in the morning was gone.
It is one week since i start the treatment. I have to switch to 2.5 mg after two weeks regarding my doctor suggestion. I wonder if the higher dose will cause the effects more stronger or fade them. Anyway, i am waiting for the following weeks/months, to see the positive effects stay in the long run, or they will fade after the “honeymoon days of bromo” ends.
I will be here later with new lab test. If anyone has results with bromocriptine/dopamine agonist, please comment my topic. Thank You!

Is the bromocriptine helping with actually libido? I know you said it’s helped with morning wood and you’ve been thinking about sex and women but does it actually make you horny? I realise that sounds a bit odd but reason I’m asking is because I seem to get the same with just my testosterone. I’m thinking about women and checking them out and also have regular morning wood but don’t really feel the desire for sex. I have next to no libido… So I’m wondering if bromocriptine is worth a try if it’s helping you.

Same thing here Danny.

I think you have libido. Just don’t have the arousal response.

Well I dont have any any issue with arousal. Just don’t have the feeling that I actually want sex. When I wake up with morning wood I never feel like I want sex.

My libido has actually gotten worse since starting TRT… I suspect that the issue may be related to neurotransmitters being out of whack. In my case that would explain a few of my issues. (Low libido, no motivation or drive, feeling very sleepy in the day)

Apologies for slightly hyjacking your thread @cobguy :slight_smile:

Flatdanny, i am glad to see to read and comment my thread! In the first line, i have similar situation like yours.
Although, i think i am a rookie in testosterone therapy, but since 2017 september i have learned interesting thing about. Regarding your question, YES, bromo will make me HORNY with very good effectiveness, at daily 1,25 mg. If i can describe the effect, at bedtime, i usually felt in sleep besides my wife, but since bromo therapy, i feel like someone in my head tells me:" you need sex tonight, forget the sleep, man" And this feeling is very real, seems natural, and i cannot fight again it. Now i see every women more attractive, too. My only worry is about the bromo, that many comments say this impressive effect will fade in short time. Furthermore, the good efficiency must be in connect with my wellbutrin daily use, because it also raise dopamine levels (and noradrenaline, unfortunately).


As i get new info every day, i see the hormone manipulation of male is very difficult. I have never use any external testosterone source (like injection, gels or etc) only clomiphene citrate because i plan child in 1-2 years. Testosterone from external source will make your testis stop sperm production partially/totally. There are my present medications and vitamins, i will write them now.
Clomiphene c.: raise testo level from midrange to high range.
Arimidex: reduce estradiol, since it went from 90 to 300 as i start clomiphene
Wellbutrin: increase dopamine level, cause better confident, and libido
Bromocriptin: increase dopamine, and libido
Vitamin d3: there is deficiency regarding my lab results. Important for make all hormones.
Vitamin k2 mk7: it is know to decrease artery calcification. But i have find, this decrease my estradiol in very huge amount.
Magnesium + b6: decrease shbg.

So, i see it is a long road for me, but very interesting. I will be here later when i have new labs, because i need to see again the effect of k2 on estradiol.