Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse

Objective: To report a case of symptomatic hypogonadism induced by the abuse of multiple steroid preparations that was subsequently reversed by clomiphene. Design: Case report. Setting: University-affiliated andrology practice within family practice clinic. Patient(s): A 30-year-old male. Intervention(s): Clomiphene citrate, 100-mg challenge for 5 days, followed by treatment at same dose for 2 months. Main Outcome Measure(s): Clinical symptoms, androgen decline in aging male questionnaire, total T, FSH, LH. Result(s): Reversal of symptoms, normalization of T levels with LH surge, restoration of pituitary-gonadal axis. Conclusion(s): Clomiphene citrate is used typically in helping to restore fertility in females. This represents the first case report of the successful use of clomiphene to restore T levels and the pituitary-gonadal axis in a male patient. The axis was previously shut off with multiple anabolic steroid abuse.