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A 6- to 12-month trial of clomiphene at a dosage sufficient to increase serum testosterone to the upper half of the normal range is reasonable in these men. The potential benefits of the drug for reducing testosterone concentrations and associated health risks may offset the risks associated with its use. The long-term effects of clomiphene on prostate cancer in patients with normal testosterone levels will require independent confirmation. It is strongly recommended that testosterone level should be tested in all patients who are treated with clomiphene for male infertility before initiating treatment with clomiphene. Patients should have periodic blood sampling for testosterone levels with the advice that follow-up testing should be considered if their testosterone level drops below 12 ng/dL. The data suggest that clomiphene reduces the risk of prostate cancer in patients with normal testosterone levels. However, the benefits of this drug for reducing the incidence of prostate cancer in patients with testosterone levels at or above the normal range in the treatment of men with low testosterone levels remain to be determined. Clomiphene and PSA screening for prostate cancer The use of a PSA screen for detecting men with low testosterone levels (as in the past the use of luteinizing hormone, or LH) is not recommended in men who have normal testosterone levels or with no indication for any other hormone treatment. It may be advisable, in addition, to do testosterone treatment studies. Clomiphene and prostate biopsy It is not recommended that men with low testosterone levels be treated with clomiphene because of the increased risk for prostate cancer in these men after starting the treatment. Use in pediatric patients Clomiphene has not been studied in adults or children. Pediatric patients should receive medical therapy with testosterone and estrogen until they are older than middle age because of the increased risk of breast and prostate cancer in children. In addition, men who are older than middle age, and who are in a high-risk category, should not receive clomiphene. Pediatric patients should be advised to contact their local or state cancer registrar or physician for more information about the benefits and risks of testosterone therapy in these patients. Top of Page Side effects Clomiphene has been administered to hundreds of patients in the United States and Europe. These included individuals with testosterone deficiency (testosterone deficiency or hypogonadism), and with reduced levels of other important hormones or not receiving recommended therapies. Clomiphene may cause side effects. There is a possibility of adverse reactions to clomiphene. These are not listed in this section. Acid Similar articles: