Clomiphene Citrate is a Safe and Effective Alternative to Testosterone Replacement in Male Hypogonadism with Type 2 Diabetes Mellitus

Abstract

Aims: The study was planned to evaluate the effect of Clomiphene Citrate (CC) treatment as compared to testosterone replacement for late onset hypogoandism in with type 2 Diabetes Mellitu. Methods: The study included 72 male patients with late onset hypogonadism (assessed by ADAM questionnaire, serum total testosterone and LH) and T2DM out of 250 patients screened. The subjects with serum testosterone in the range of 200-300 ng/dl and with serum Luteinizing hormone (LH) level ≤9.4 IU/ml were treated with Clomiphene Citrate 25 mg/day (Group 1 N= 40). Patients with serum testosterone levels less than 200 ng/dl and serum LH < 9.4 IU/ml received testosterone every month for 3 months (Group 2 N=32). The post treatment hormone estimation along with ADAM questionnaire value was evaluated 3 month after commencing treatment. Results: ADAM symptom scores were worse in group 2 (N=32) than group 1 (N= 40 ). There was a comparable increase in mean testosterone levels in both groups at 3 months (550.16 ± 85.05 vs 509.72 ± 39.18 ng/dl; p = 0.03). Mean ADAM scores also decreased significantly in both the groups. Conclusion: Treatment with clomiphene citrate in male patients with T2DM and hypogonadism showed improvement in both clinical and biochemical measures. The study suggested that clomiphene citrate might be considered as a safe and effective alternative treatment strategy for late onset hypogonadism in male patients with type 2 DM.