Olfactory Status and Response to Clomiphene in Male Gonadotrophin Deficiency

Clomiphene citrate, 200 mg daily for 7 to 14 days and 50 to 100 mg daily for 4 additional weeks, produces significant increases in plasma levels of gonadotrophins and testosterone in normal males. Patients with multiple anterior pituitary hormone deficiencies or with isolated gonadotrophin deficiency and type I hyposmia (absent response to vapors at the primary olfactory area) were unresponsive to clomiphene. With clomiphene treatment two of three patients with type II hyposmia (subnormal olfactory responsiveness) and one of two patients with normal olfaction and hypogonadotrophic hypogonadism had increases of levels of plasma testosterone and plasma or urinary gonadotrophins to the normal male range. Normal spermatogenesis was demonstrated in two cases and fertility in one. Clomiphene is effective treatment for certain males with gonadotrophin deficiency.