Enclomiphene — Selective estrogen receptor modulator (SERM) — trans-isomer of clomiphene

Selectively blocks estrogen receptors at the hypothalamus/pituitary, preventing negative feedback. This increases GnRH pulsatility, raising FSH and LH, which stimulates endogenous testosterone production while preserving fertility (spermatogenesis).

Overview

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Compound Class

Selective estrogen receptor modulator (SERM) — trans-isomer of clomiphene

Mechanism of Action

Selectively blocks estrogen receptors at the hypothalamus/pituitary, preventing negative feedback. This increases GnRH pulsatility, raising FSH and LH, which stimulates endogenous testosterone production while preserving fertility (spermatogenesis).

Regulatory Status

Not FDA approved (FDA CRL 2015); available as compounded medication

Evidence Level

Moderate — Phase 3 trials completed but FDA did not approve (requested additional trials)