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Clomifene: Uses, Dosage & Side Effects

Clomifene is a medication used to treat female infertility. It stimulates ovulation and is commonly prescribed when ovulation is absent or irregular.

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Things worth knowing about "Clomifene"

Clomifene is a medication used to treat female infertility. It stimulates ovulation and is commonly prescribed when ovulation is absent or irregular.

What is Clomifene?

Clomifene (also known as clomiphene citrate) is a selective estrogen receptor modulator (SERM) widely used in reproductive medicine to treat female infertility. It is marketed under brand names such as Clomid and Serophene and is one of the most commonly prescribed medications for ovulation disorders.

Indications

Clomifene is primarily used in women who experience anovulation (absence of ovulation) or oligoovulation (irregular ovulation). Common indications include:

Polycystic ovary syndrome (PCOS)
Hypothalamic amenorrhea
Unexplained infertility
Luteal phase defect

Mechanism of Action

Clomifene acts as a selective estrogen receptor modulator. It blocks estrogen receptors in the hypothalamus, causing the brain to perceive low estrogen levels. In response, the hypothalamus increases the release of GnRH (gonadotropin-releasing hormone), which stimulates the pituitary gland to produce more FSH (follicle-stimulating hormone) and LH (luteinizing hormone). This promotes the maturation of ovarian follicles and triggers ovulation.

Dosage and Administration

Clomifene is taken orally as a tablet. The standard starting dose is 50 mg daily for 5 days, beginning on day 2 to 5 of the menstrual cycle. If needed, the dose may be increased up to 150 mg per day. Treatment is generally limited to a maximum of 6 cycles.

Standard dose: 50 mg/day for 5 days
Maximum dose: 150 mg/day
Duration: up to 6 treatment cycles

Side Effects

Clomifene may cause several side effects, most of which are mild and temporary:

Hot flashes (most common)
Abdominal discomfort or bloating
Mood changes
Visual disturbances (rare; requires immediate discontinuation)
Ovarian hyperstimulation syndrome (OHSS) (rare but potentially serious)
Increased risk of multiple pregnancies (approximately 8-10%)

Treatment Context and Monitoring

Clomifene therapy is always carried out under medical supervision. Regular ultrasound examinations are performed during treatment to monitor follicle development and minimize the risk of ovarian hyperstimulation. Women who do not respond to clomifene may be offered alternative treatments such as gonadotropin injections or in vitro fertilization (IVF).

References

World Health Organization (WHO) - Reproductive Health and Research: Infertility Guidance (2023).
Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group - Consensus on infertility treatment related to polycystic ovary syndrome. Human Reproduction, 2008.
Legro RS et al. - Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome. New England Journal of Medicine, 2007;356:551-566.

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