Hello doctor, I am a 36-year-old male. I have been having issues with ED, fatigue, irritability, and urinary urgency. I just felt like my nether regions are lacking in nutrition. Penis feels abnormally limp and dead a lot, and have trouble maintaining erections during sex. Also, I am leaking urine after I urinate, and have to do it without warning. I went to a urologist and got my levels tested, testosterone was 360, and free test 13.5. He said might be good to try Clomifene in order to raise T levels, and I was wondering, would one have to be on it for life? It seems like the side effect profile is not nonexistent, I do not want to go on TRT, and seems dicey to mess with hormones for too long. Can the Clomid permanently switch my T levels to normal? What is the goal? Have a hard time getting an answer from my doctor. Also, is it possible to get T levels to normal functional level through more exercise, etc,.? I could definitely stand to exercise more, though I am not fat. Also, my blood pressure has been high at 146. I eat pretty healthily. Trying to find the best way forward? Cialis has helped ED and erases urinary symptoms, but it gives me a lot of testicle pain, and I figure it is not good to be on that forever either, but instead treat the root causes. I also had minor gynecomastia in right breast since puberty.
Hello. The doctor basically gave you Clomifene because most likely he suspected that since you have gynaecomastia, therefore, there might be low prolactin levels as well and Clomifene is an anti-estrogen drug, therefore it will help to decrease the gynaecomastia and possibly help you with your erectile dysfunction. There is no harm in taking it for a few months. Although, it is an indirect treatment but might help and not that it has a bad adverse effect. So no harm in trying. Also, since your testosterone was not that low so I do not think that you would have to take it for long. You can try de-stress techniques instead of exercising to relax your mind mainly to achieve your cure. Since most of the times, it is just psychological.