Hypogonadismis a condition where the body doesn’t produce enough of the hormone testosterone, which is mainly made in the testes in men. Testosterone plays a key role in things like energy, mood, and sexual function. When testosterone levels are low, it can lead to a number of changes in the body such aslow libido,erectile dysfunction,fatigue, and decreased muscle mass.

If you have low testosterone, you might notice low energy, reduced libido, mood changes, loss of muscle mass, increased body fat, decreased bone density, difficulty concentrating, hot flashes or sweating, smaller testicles, and sleep issues.

For primary hypogonadism, testosterone replacement therapy may be appropriate since the problem is in the testes, and external testosterone may help restore normal levels. However, for secondary hypogonadism, TRT is not ideal because it does not address the underlying problems with the hypothalamus or pituitary, leading to testicular atrophy and infertility, and creating a long-term dependence on external testosterone.

Instead, medications called selective estrogen receptor modulators (SERMs) such as clomiphene citrate and enclomiphene citrate that stimulate the natural hormone production process are preferred in secondary hypogonadism, as they work with the body’s systems to potentially restore natural testosterone production while minimizing the risks of infertility and dependence on external testosterone. These drugs act on the hypothalamus and pituitary gland to increase the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones, in turn, stimulate the testes to produce more testosterone.