Clomiphene citrate (Clomid) is a synthetic non-steroidal drug that is very similar in structure to estrogen. It is widely used as an ovulatory stimulant. Because of its similarity to estrogen, it can bind to the estrogen receptors in the hypothalamus. This blocks the hypothalamus from sensing “real” estrogen and the hypothalamus in turn acts by stimulating the pituitary to release more Gonadotropins like FSH and LH. The FSH and LH stimulate the ovaries/testes to produce more estrogen/testosterone. This property of clomiphene has been widely used to treat women with ovarian failure and induce ovulation. However, long term use (> 1-2 years) of this drug may not be safe because of the increased risk of ovarian cancer.
Pharmacology
Clomid is recommended for the treatment of women who have ovulatory dysfunction. Many women who fail to get pregnant have been found to have dysfunction in the ovulation cycle. Women with ovulation problems include those with polycystic ovarian syndrome and some with unknown causes of amenorrhea. Clomid is only prescribed after a thorough evaluation of the menstrual cycle is done to determine where the problem occurs.
To achieve ovulation with Clomid, timing is of great importance. The woman’s body temperature is monitored and blood work is done to determine if ovulation has occurred. Once ovulation is established, Clomid is started. In general Clomid is started on or about the 5th day of the cycle. Clomid is generally administered for 3-6 cycles. Long term therapy is not recommended
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