Enclomiphene / DHEA / Boron / Pregnenolone ODT
A dissolving tablet combining enclomiphene, DHEA, boron, and pregnenolone to support the body's own testosterone production.
- Supporting your own testosterone production rather than replacing it
- Preserving fertility, which direct replacement generally suppresses
- An oral route for men who would otherwise weigh injections
Effective only in secondary hypogonadism — it will not raise testosterone where the testes cannot respond. That is a lab finding, established before anything is prescribed.
Indicative price · confirmed after eligibility · prescription treatment
How enclomiphene works
Most men who arrive at low testosterone assume there's one answer: replace it. Testosterone replacement works, it's well established, and for many men it's the right call.
But replacing testosterone and restarting your own production are two different strategies with different consequences — and the difference matters most to men who want to keep their options open. Enclomiphene is the second strategy. This page explains how it works, where it fits, what its regulatory status actually is, and who it isn't appropriate for.
Your testosterone production runs on a feedback loop. The hypothalamus and pituitary sense circulating hormone levels and adjust their signaling — LH and FSH — to the testes accordingly. When testosterone is adequate, that signal dials down; when it isn't, it should dial up. Estrogen is part of how the brain reads that signal, and in some men the feedback runs stronger than it should, holding LH and FSH lower than the situation warrants. Enclomiphene is a selective estrogen receptor modulator. It blocks estrogen's signal at the hypothalamus and pituitary, which the brain interprets as a shortfall — so it increases LH and FSH output, and the testes respond by producing more testosterone. The key point is that the testosterone comes from you. Nothing is being supplied from outside.
How it works here
Every plan follows one path. Each step feeds the next. See the Men's Testosterone Therapy approach.
- 01
Measure
We baseline your labs, history, and goals.
- 02
Plan
A clinician decides whether this fits — and what else might serve you.
- 03
Act
If appropriate, you start with clear guidance and high-touch support.
- 04
Track
We monitor how you respond on a defined cadence.
- 05
Adjust
Protocols are refined over time. Guided care, not a kit in the mail.
How this differs from testosterone replacement
This is the distinction that decides which route makes sense.
Testosterone replacement supplies the hormone directly. It's reliable and effective. But because the feedback loop is doing its job, external testosterone tells your brain to stop signaling — LH and FSH fall, and your own production winds down. That includes the signal that drives sperm production.
Enclomiphene works upstream. By raising your own LH and FSH rather than suppressing them, it supports testosterone production without shutting down the axis — which means it generally preserves fertility rather than impairing it.
For a man in his forties or fifties who may want children, or simply doesn't want to commit to indefinite replacement, that difference is often the deciding factor. Men's testosterone therapy covers the wider picture.
Enclomiphene vs the alternatives
The three routes to addressing low testosterone that we're asked to compare most often.
| Enclomiphene ODT | Kyzatrex® — Oral T | Injectable TRT | |
|---|---|---|---|
| How it works | Raises your own LH and FSH so the testes produce more | Supplies testosterone directly | Supplies testosterone directly |
| Effect on your own production | Supports it | Suppresses it | Suppresses it |
| Effect on fertility | Generally preserved | Suppressed | Suppressed |
| Works if the testes can't respond? | No — requires secondary hypogonadism | Yes | Yes |
| FDA status | Not FDA-approved; compounded | FDA-approved, dispensed as manufactured | FDA-approved |
| Route | Dissolving tablet | Capsule, taken with food | Injection |
| Needles | No | No | Yes |
| Reversibility | Axis was never suppressed | Own production needs time to recover | Own production needs time to recover |
| Monitoring focus | Testosterone, LH, FSH, estradiol | Testosterone, hematocrit, PSA, blood pressure | Testosterone, hematocrit, PSA, blood pressure |
| Typical cost position | Middle | Highest — branded | Lowest |
| Best suited to | Men with secondary hypogonadism who want to preserve fertility or avoid indefinite replacement | Men needing replacement who want to avoid needles | Men needing replacement where cost matters most |
Scroll the table sideways to compare →
The single most important row is “works if the testes can't respond” — enclomiphene is the only option that has a hard prerequisite, and it's a lab finding rather than a preference.
Who this doesn't work for
Enclomiphene needs a working system to stimulate. That produces one hard eligibility gate that a surprising number of pages omit.
If your testes aren't capable of responding, enclomiphene won't help. This is the difference between secondary hypogonadism — where the signal from the brain is inadequate — and primary hypogonadism, where the signal is fine but the testes can't act on it. Enclomiphene amplifies the signal. If the signal was never the problem, amplifying it changes nothing.
Distinguishing between the two is a lab question, not a symptom question, and it's the single most important thing your baseline lab work establishes before this is prescribed. It's also why we won't prescribe this from a questionnaire.
Beyond that, enclomiphene isn't appropriate if you have a history of blood clots or certain visual conditions, if you have significant liver impairment, or if you're already on testosterone replacement and haven't discussed the transition with a clinician.
What to watch for
Enclomiphene is generally well tolerated, but as a SERM it carries some class-related effects worth naming.
Mood changes — irritability or low mood are reported and worth flagging early if you notice them.
Visual disturbances — blurring or floaters are uncommon but are a recognized SERM effect and should prompt a call rather than a wait-and-see.
Headache and hot flushes.
Shifts in estradiol, which is part of why monitoring tracks more than testosterone alone.
What monitoring looks like
A baseline first: total and free testosterone, LH and FSH, estradiol, SHBG, a complete blood count, and a broader metabolic and thyroid picture — because low testosterone is frequently downstream of something else, and treating the number without finding the cause is how people end up on therapy they didn't need.
Then follow-up on a defined cadence to confirm the axis is responding as intended, that estradiol hasn't moved somewhere unhelpful, and that your symptoms have actually improved rather than just your labs. Those two don't always move together, and when they diverge it's a signal worth taking seriously.
Delivery
An oral dissolving tablet taken as directed by your clinician. The dissolving format matters for a practical reason: absorption through the mouth avoids some of the first-pass metabolism an ordinary swallowed tablet undergoes. For men who'd otherwise be weighing injections, an oral route is often the reason they engage with treatment at all.
Is it right for you?
Enclomiphene comes up most often among men in midlife with confirmed secondary hypogonadism who want to support their own production rather than replace it — particularly those who want to preserve fertility, or who aren't ready to commit to indefinite replacement. If an oral route appeals but you have primary hypogonadism, Kyzatrex — an FDA-approved oral testosterone — is the more appropriate conversation. If you're weighing routes more broadly, testosterone replacement covers the alternatives, and andropause in midlife men covers the wider context.
Often considered alongside
Kyzatrex® (Oral Testosterone)
An oral testosterone option that may help support energy, strength, and body composition.
View treatmentTestosterone Replacement Therapy (TRT)
A monitored testosterone program built from your labs, with dosing and delivery chosen with your clinician.
View treatmentProducts marked Compounded are prepared by a licensed compounding pharmacy under a prescription written for you. Compounded medications are not FDA-approved and are not equivalent to or interchangeable with any branded product.
An honest word on the evidence — and on its FDA status
Enclomiphene is not FDA-approved, and the history is worth knowing because most pages selling it skip past this. It was developed as Androxal by Repros Therapeutics. In 2015 the FDA issued a Complete Response Letter — the trials submitted weren't designed well enough to demonstrate clear clinical benefit. The agency asked for additional Phase 3 work. That work was never completed, and development effectively ended after the company was acquired in 2017. In 2022, FDA's Pharmacy Compounding Advisory Committee voted against including enclomiphene citrate on the 503A Bulks List, which governs substances permitted for routine compounding. Compounded enclomiphene remains available largely because it is a component of an FDA-approved medication, clomiphene — a narrower legal basis than most patients realize. None of that means enclomiphene doesn't work. There is real published evidence that it raises LH, FSH and testosterone while preserving sperm parameters, and clinical experience with it is substantial. But “studied and used” is not the same as “FDA-approved”, the regulatory footing is less settled than for testosterone replacement, and you should know that before starting rather than after. On the other three ingredients: DHEA, boron and pregnenolone are included to support broader hormonal balance. Their evidence base is considerably weaker than enclomiphene's, and we'd rather say so than imply the combination is uniformly well supported. Your clinician can explain the rationale for including them in your particular plan.
References
Government and professional-society sources consulted for this page.
- Testosterone Injection — MedlinePlus (U.S. National Library of Medicine)
- Compounding and the FDA: Questions and Answers — U.S. Food and Drug Administration
Frequently asked questions
It works to support your body's own testosterone production rather than supplying the hormone directly. Enclomiphene raises the brain's signal to the testes; testosterone replacement supplies hormone from outside and suppresses that signal.
No. It was developed as Androxal and received a Complete Response Letter in 2015; the additional trials FDA requested were never completed. In 2022 FDA's Pharmacy Compounding Advisory Committee voted against adding it to the 503A Bulks List. Compounded enclomiphene remains available largely because it is a component of FDA-approved clomiphene.
Generally it preserves it, which is one of its main advantages over testosterone replacement. By raising LH and FSH rather than suppressing them, it supports rather than shuts down the signaling that drives sperm production. Testosterone replacement does the opposite.
Only if your low testosterone is secondary — meaning the signal from the brain is inadequate — rather than primary, where the testes themselves can't respond. That's a lab question, and it's the first thing we establish.
They're included to support broader hormonal balance. Their evidence base is weaker than enclomiphene's, and your clinician explains the rationale for including them in your plan rather than treating the combination as automatically necessary.
Mood changes, headache and hot flushes are the more common reports. Visual disturbances such as blurring or floaters are uncommon but are a recognized effect of this drug class and should prompt a call rather than a wait-and-see.
Response builds over weeks rather than days, and labs typically move before symptoms do. A defined checkpoint is part of the protocol — including a genuine willingness to change course if it isn't working.
Sometimes, but it isn't a straight swap. Coming off replacement means your own axis has to restart, and how that goes varies considerably between men. It needs planning and monitoring, not a substitution.
Yes. We track labs and response and adjust over time — testosterone, LH, FSH, estradiol and blood counts, alongside how you actually feel.
See if Enclomiphene / DHEA / Boron / Pregnenolone ODT fits your plan
The right plan begins with knowing where you are. Start with a short eligibility check and a baseline — and we'll tell you, honestly, what fits.
We measure first. Then we act.
ACT 2 Health provides clinician-led care. Treatments described are available only to eligible patients following clinical evaluation and within applicable regulations. This page is educational and is not medical advice. Individual results vary.