Off-label Therapy of Hypogonadotropic Hypogonadism in a 35-year-old Male Patient Using Clomiphene Citrate – A Case Study

Hypogonadism is either hypergonadotropic (primary) or hypogonadotropic (secondary). When the pituitary gland is secreting an excess of gonadotropins, primary hypogonadism is diagnosed. In secondary hypogonadism, the levels of gonadotro-pins in the serum remain low. Male patients affected with hypogonadism present numerous symptoms due to a lack of testosterone, e.g., erectile impairment, feminization of the body, and infertility. The deterioration of self-confidence and quality of life underlines the importance of the correct diagnosis and effective treatment. Clomiphene citrate is registered in Europe for the treatment of ovulatory failure in women. It is often used as an off-label drug to treat hypogonadism in men, as it proves efficient in some cases and is relatively safe and easily administered in comparison to other medicaments, e.g., testosterone and gonadotropin analogs. We report on a 35-year-old Caucasian male patient who was admitted to the Department of Endocrinology with symptoms of erectile dysfunction, lowered self-esteem, hypersomnia, and trouble conceiving. A complex diagnostic procedure was performed, which led to the final diagnosis of hypogonadotropic hypogonadism and reactive hyperprolactinemia. The treatment with Clomiphene Citrate was implemented and brought significant improvement – the withdrawal of unwanted symptoms and restored hormonal balance – after two weeks.