Most patient who suffer from infertility have heard of the drug called Clomid (Clomiphene).It is without a doubt the most common drug given to patients who suffer from infertility or sub fertile conditions. In this blog, I want to explain what Clomid is, how it works and what patients can use it.
What is Clomid?
Clomid is a non steroidal drug that contains estrogenic properties that sometimes promotes a specific effect in the body and at other times suppresses that effect. This is what is called estrogen agonist and estrogen antagonist. In most cases, Clomid causes the antagonist effect, in other words an anti estrogenic effect. Clomid is cleared from the body via the liver and the stool, and the body , in 85% of the times gets rid of the effects in 1 week, but sometimes traces of the drug can last for weeks. .
How does Clomid works?
Because it is a drug with similar properties as estrogen, it competes with estrogen in the body ( produced by the ovaries and other tissues ) for receptors. Clomid attaches to those receptors in the cells and the body senses that there is a decrease in estrogen levels ( although this is not the case in reality) thus the body responds by increasing other hormones (GnRH) that stimulates release of other pituitary hormones and at the end more ovarian follicles to form. Pituitary hormones, LH and FSH increased during the clomid cycle and then return to normal after the end of your clomid cycle. In sum, clomid stimulates the endocrine hormones necessary to have the hypothalamus-pituitary-ovarian tissue work in sync.
What are the indications for Clomid ?
1) This is used most of the time for infertile patients, who does not have any other hormonal imbalance, including prolactin levels, thyroid hormones, estrogen levels etc.
2) Clomid can also be used for patient with a Luteal phase deficiency ( low progesterone levels)
3) Unexplained infertility.: When women have unexplained infertility, clomid can be very successful. Also it can be combined with intra uterine insemination for even better results.
How is it Used ?
It is taken orally, beginning on the first days after your menstrual cycle for 5 days, or if you don’t have a spontaneous period, after your doctor induces it. Obese patients need a higher dosage than normal weight patients. More than 50% of patients responds to the initial doses of clomid.
How is it monitored?
After the first 5 days of using the medication, doctors can measure the progesterone levels. If positive, this is a sign that ovulation occurred. However, proper timing of the lab must be done in order to have accurate results. Also there are commercial kits ( Ovulation Kit) that can be bought and used to determine when is ovulation happening. Ovulation kit turn positive around 5-12 days after finishing the drug and most likely on day 16-17 of your cycle.
What are the side effects of Clomid and its risks ?
Side effects are hot flashes, mood swings, breast tenderness, pelvic pain, formation of ovarian cysts, nausea and even visual disturbances. The biggest risk of using Clomid is multiple pregnancy (twins or triplets). Although clomid can help you get pregnant, you must take the risk that if you do get pregnant, having twins or even triplets. Talk to your doctor about Clomid if you suffer from infertility.
Clomid by Joel Rivera