Arimidex

What do you need to know about Anastrozole (Arimidex)?

Arimidex is a medication that alters hormone levels within your bloodstream. Specifically, it reduces the production of estrogens by preventing the conversion of testosterone into a particular estrogen, estradiol. By doing so, testosterone levels rise and estradiol levels are lowered.1 To evaluate the effectiveness of Arimidex, your testosterone level, estradiol level, and the ratio of testosterone to estradiol will be monitored throughout your course of therapy.

Arimidex, by raising testosterone levels, has been found to reduce the symptoms of male hypoandrogenism such as low energy, reduced muscle mass, low libido (sex drive), and erectile dysfunction.2 It has also been found to improve sperm production and sperm recovery rates in oligospermic and azospermic men.3 Though research shows promising results, the use of Arimidex in males remains an off-label use of this medication.

As with any new medication, you may notice side effects while taking Arimidex.

Side effects may include:

  • Nausea
  • Insomnia
  • Bone Pain
  • Cough
  • Increased red blood cell count
  • Increased liver enzymes

Rare, but serious side effects that have been reported include:

  • Blood Clots
  • Cataracts
  • Stevens-Johnson Syndrome, a serious rash caused by a drug intolerance

Clomid

What do you need to know about?

Clomid is a medication that will work to elevate certain hormones released by the pituitary gland in the brain. These hormones, in turn, will stimulate both the production of testosterone and the production of sperm, or spermatogenesis, within the testis. It is anticipated that these actions will help reduce the symptoms of hypoandrogenism and/or, by increasing sperm count, may help to improve non-obstructive azoospermia. Large-scale studies have found sustained increases in testosterone, increases in strength, reduction of fatigue, and improvement of erectile function among men taking Clomid for hypoandrogenic symptoms.1,2 Studies have also found that the use of Clomid is correlated with a return of sperm to the ejaculate in up to 10% of azoospermic men who remained on the medication for 3 months. 3 While research shows promising results, the use of Clomid in males remains an off-label use of this medication.

As with any new medication, you may notice side effects while taking Clomid. Some of these symptoms are consequences of increased circulating testosterone while other symptoms may indicate more serious side effects.

Side effects may include:

  • Changes in libido (sex drive)
  • Changes in mood
  • Changes in energy level
  • Increased aggression
  • Male-patterned baldness
  • Blurred Vision
  • Headaches
  • Increase in hemoglobin (a blood protein that transports oxygen and adds viscosity, or thickness, to your blood)
  • Enlargement of the prostate gland

Please notify our offices if you are experiencing side effects that are limiting your quality of life. We may be able to change your Clomid dosing (titration) or alter other medications to limit these side effects. The laboratory values we ask to monitor throughout your treatment will be used to screen for some of these possible side effects and help us prevent them from becoming serious issues.

  1. Kim E, Crosnoe L, Bar-Chama N, Khera M, Lipshultz L. The treatment of hypogonadism in men of reproductive age. Fertility and Sterility. 2012 Mar;99(3):678-79.

Supplement CoenzymeQ10?

More information about your supplement (find this over-the-counter):

Coenzyme Q10

Coenzyme Q10 is a molecule produced in the body and frequently consumed both in food and as a nutritional supplement. This antioxidant has been shown to be beneficial for a variety of health conditions. In men with abnormal sperm parameters, it has been shown to improve both sperm integrity and sperm motility. 1,2 Thus, Coenzyme Q10 is a helpful therapy for men with asthenozoospermia, poor sperm motility, and/or poor sperm concentration. 3 Coenzyme Q10 may also be beneficial in men with pyospermia, or an elevated number of white blood cells in the semen. 3 You may have been prescribed Coenzyme Q10 for one or several reasons. It is important that you follow up with semen analyses and office visits to evaluate the effectiveness of this medication.

Though Coenzyme Q10 is made within the body and taken as a nutritional supplement, there may be side effects from taking Coenzyme Q10 at increased doses.

Possible side effects include, but are not limited to:

  • Itching or rash
  • Nausea, vomiting
  • Headache
  • Low blood pressure
  • Altered heart rate
  • Insomnia
  • Cough
  • Decreased appetite
  1. Mancini A, Balercia G. Coenzyme Q(10) in male infertility: physiopathology and therapy. Biofactors. 2011 Sep-Oct;37(5):374-80.
  2. Balercia et al. Coenzyme Q10 treatment in infertile men with idiopathic asthenospermia: A placebo-controlled, double-blind randomized trial. Fertility and Sterility. 2009 May;91(5):1785-92.
  3. Safarinejad. Efficacy of coenzyme Q10 on semen parameters, sperm function, and reproductive hormones in infertile men. Journal of Urology. 2009 Jul;182(1):237-48.

HCG

Human Chorionic Gonadotropin (HCG) Hormone Therapy

Human Chorionic Gonadotropin (hCG) is a hormonal treatment that can be used to increase testosterone levels in men. It is a treatment option for men who are suffering from symptoms of low testosterone, or hypogonadism. hCG stimulates the body’s own production of testosterone which is in contrast to direct testosterone replacement like testosterone injections and testosterone creams. Preserving the body’s production of testosterone is particularly important for testicular function and fertility, as intratesticular testosterone is required to maintain testis size and sperm production. Research has found hCG to increase energy, libido (sex drive), strength, and mood in hypogonadic men.1 This has been found in men who are hypogonadic for unknown causes as well as in men who have reduced testosterone production due to long-term exogenous testosterone supplementation. hCG can also be helpful in the infertile man. By increasing intratesticular testosterone, hCG has been found to increase the likelihood of sperm retrieval in men with non-obstructiveazospermia, or lack of sperm in the ejaculate.2 Goals for hCG therapy are highly individualized. Your treatment goals and dosing regimen were discussed during your office visit. Please contact your provider if you have additional questions or concerns about your new medication.

As with any medication, you may experience side effects with hCG therapy. Some of these are a result of increased testosterone levels while other symptoms may indicate more serious side effects.

Side effects may include:

  • Pain at the injection site
  • Changes in libido (sex drive)
  • Changes in mood
  • Changes in energy level
  • Weight gain
  • Increased hematocrit (red blood cell concentration) and risk for blood clot
  • Prostatic enlargement
  1. Kim E, Crosnoe L, Bar-Charma N, Khera M, Lipshultz L. The treatment of hypogonadism in men of reproductive age. Fertility and Sterility. 2013 Mar;99(3):718-24.
  2. Shinjo E, Shiraishi K, Matsuyama H. The effect of human chorionic gonadotropin-based hormonal therapy on intratesticular testosterone levels and spermatogonial DNA synthesis in men with non-obstructive azospermia. Andrology. 2013 Aug;1(6):929-35.
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