Clomiphene citrate, widely known by its brand name Clomid, is a first-line oral medication specifically designed to treat ovulatory dysfunction in women struggling with infertility. As a selective estrogen receptor modulator (SERM), it represents a cornerstone of fertility treatment, offering a non-invasive and highly monitored approach to inducing ovulation. Its mechanism of action cleverly tricks the body’s endocrine system, leading to the stimulation of follicle development and the subsequent release of a mature egg, thereby creating the fundamental opportunity for conception. Trusted by reproductive endocrinologists for decades, Clomid continues to be a pivotal tool in helping countless individuals and couples build their families.

Features

• Active Pharmaceutical Ingredient (API): Clomiphene Citrate
• Standard Tablet Strengths: 50 mg
• Administration Route: Oral
• Drug Class: Selective Estrogen Receptor Modulator (SERM)
• Treatment Cycle: Typically administered in 5-day courses, timed to the menstrual cycle
• Monitoring Protocol: Requires cycle monitoring via transvaginal ultrasound and/or blood tests (e.g., progesterone levels)
• Prescription Status: Available by prescription only

Benefits

• Effectively induces ovulation in a significant majority of women with anovulatory disorders, such as Polycystic Ovary Syndrome (PCOS).
• Provides a less invasive and more cost-effective initial treatment option compared to injectable gonadotropins.
• Offers a predictable treatment schedule that can be easily integrated into a couple’s routine.
• Facilitates timed intercourse or intrauterine insemination (IUI) by precisely controlling the timing of ovulation.
• Has a well-established safety profile and decades of clinical data supporting its use under expert supervision.
• Can be used for controlled ovarian hyperstimulation in certain assisted reproductive technology (ART) protocols.

Common use

Clomid is primarily prescribed for the treatment of infertility in women who do not ovulate regularly or at all (anovulation). Its most common application is in patients diagnosed with Polycystic Ovary Syndrome (PCOS), where anovulation is a hallmark feature. It is also used in cases of unexplained infertility to stimulate the development and release of more than one egg (superovulation), thereby increasing the statistical probability of conception per cycle. Furthermore, it may be employed in certain ovulatory women to correct a luteal phase defect. It is crucial to understand that Clomid is only effective if other factors contributing to infertility, such as tubal patency and adequate sperm parameters, have been evaluated and are within normal limits or are being concurrently addressed.

Dosage and direction

Clomid therapy is highly individualized and must be strictly supervised by a fertility specialist. Treatment is always initiated at the lowest effective dose to minimize the risk of side effects and complications like multiple gestation.

A typical treatment course begins on day 3, 4, or 5 of the menstrual cycle (with day 1 being the first day of full menstrual flow). The standard starting dose is 50 mg (one tablet) taken orally once a day for five consecutive days.

The patient’s response is then monitored. This typically involves a transvaginal ultrasound around cycle days 12-14 to track follicular growth (number and size of developing eggs) and may include a mid-luteal phase progesterone blood test to confirm that ovulation occurred. If ovulation is not achieved at the 50 mg dose, the dosage may be increased in 50 mg increments in subsequent cycles, up to a maximum recommended dose of 150 mg per day for five days. Doses exceeding 100 mg per day are associated with a significantly increased risk of side effects and may adversely affect the uterine lining. Treatment is usually limited to 3-6 ovulatory cycles, as success rates plateau beyond this point.

Precautions

• Medical Supervision: This is not a medication for self-diagnosis or use. Treatment must be managed by a physician experienced in infertility and ovulation induction.
• Ovarian Hyperstimulation Syndrome (OHSS): Be aware of the symptoms of OHSS, a potentially serious condition where the ovaries become swollen and painful. Symptoms include severe pelvic pain, nausea, vomiting, sudden weight gain, and decreased urination. Seek immediate medical attention if these occur.
• Visual Disturbances: Some patients experience blurring, spots, or flashes of light. These symptoms are usually reversible upon discontinuation but must be reported to your doctor immediately, as they may necessitate stopping treatment.
• Ovarian Cysts: Clomid can cause the formation of functional ovarian cysts, which usually resolve spontaneously but may require a break from treatment.
• Endometrial Effects: Prolonged use or high doses can cause a thinning of the uterine lining (endometrium), which may impair embryo implantation.
• Multiple Births: The chance of a multiple pregnancy (twins, triplets, or more) is significantly increased (up to 10%) compared to the general population. This carries higher risks for both the mother and babies.

Contraindications

Clomid is contraindicated and should not be used in patients with:

• Pregnancy: Clomid is a pregnancy category X drug, meaning it is known to cause fetal harm. It must not be taken if you are already pregnant.
• Liver Disease: Pre-existing liver disease or a history of liver dysfunction.
• Abnormal Uterine Bleeding: Undiagnosed causes of abnormal vaginal bleeding.
• Ovarian Cysts: Pre-existing ovarian cysts not related to polycystic ovarian syndrome.
• Endometrial Carcinoma: Known or suspected carcinoma of the endometrium (uterine lining).
• Uncontrolled Thyroid or Adrenal Dysfunction: Hormonal imbalances must be corrected prior to initiation.
• Hypersensitivity: A known allergy to clomiphene citrate or any component of the tablet formulation.

Possible side effect

While many women tolerate Clomid well, a range of side effects can occur, primarily due to its anti-estrogenic effects. These are often dose-dependent.

• Very Common (>10%): Hot flashes (vasomotor flushes), abdominal bloating or discomfort.
• Common (1-10%): Breast tenderness, nausea/vomiting, headaches, visual disturbances (blurring, spots, photophobia), mood swings, irritability, insomnia, abnormal uterine bleeding, ovarian cyst formation.
• Uncommon (<1%): Hair loss (alopecia), dizziness, weight gain, depression, skin reactions (e.g., rash, urticaria), pelvic pain.
• Rare: Ovarian hyperstimulation syndrome (OHSS), severe visual problems.

Drug interaction

Inform your doctor of all medications you are taking, including prescription, over-the-counter, and herbal supplements.

• Danazol: May inhibit the ovulation-stimulating effect of Clomid.
• Tamoxifen: Another SERM; concomitant use is not recommended due to similar mechanisms and potential for additive effects.
• Thyroid Hormones & Corticosteroids: Your doctor will monitor and adjust doses of these medications as needed, as Clomid can affect their efficacy.
• Estrogens: May interfere with the therapeutic action of Clomid.

Missed dose

If you miss a dose of Clomid, take it as soon as you remember on the same day. If you do not remember until the next day, do not double the dose. Simply continue with your regular dosing schedule. Contact your fertility specialist or pharmacist for advice specific to your situation. Consistency is important for the drug’s efficacy, so strive to take it at the same time each day.

Overdose

Overdoses of Clomid are rare but serious. Symptoms of an overdose may include severe nausea, vomiting, vasomotor flushes (hot flashes), visual blurring, and abdominal pain. In severe cases, it could lead to ovarian hyperstimulation syndrome. There is no specific antidote. In case of suspected overdose, seek emergency medical attention immediately or contact a Poison Control Center. Treatment is supportive and focused on managing the symptoms.

Storage

• Store Clomid tablets at room temperature, between 20°C to 25°C (68°F to 77°F).
• Protect from light and moisture. Keep the bottle tightly closed.
• Keep out of reach of children and pets.
• Do not use after the expiration date printed on the packaging.
• Do not flush medications down the toilet or pour them down a drain unless instructed to do so. Properly discard any unused medication through a medicine take-back program or by following FDA disposal guidelines.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• “After a year of trying with no success due to PCOS, my RE started me on Clomid. We did three cycles with monitoring. The hot flashes were intense, but it was worth it. I’m now 16 weeks pregnant with our first. The monitoring is key—don’t skip it!” – S.K., Verified Patient
• “As a healthcare professional, I appreciated the evidence-based approach my doctor took. Started on 50mg, which didn’t work, but 100mg successfully induced ovulation. We experienced some mood swings, but the structured, monitored process gave us confidence.” – J.M., Verified Patient
• “We moved to Clomid + IUI after timed intercourse wasn’t working. The first cycle gave us two beautiful follicles, and it was successful. The process can feel clinical, but our medical team was fantastic at explaining every step.” – A.L., Verified Patient
• “It didn’t work for us after four cycles, which was emotionally difficult. However, our doctor was clear from the start about success rates and when to move on. It provided valuable diagnostic information about how my body responds to stimulation.” – P.D., Verified Patient