How Does Clomid Work?

Clomid is the medication Clomiphene citrate.  It is a hormone used to induce ovulation, to correct irregular ovulation, to increase egg production and to correct a condition known as luteal phase deficiency.  Clomid is typically taken in doses from 59 mg to 200 mg, and taken for 5-9 days.  Clomid is among the most inexpensive fertility drugs.  It is easily taken (orally rather than by injection) and it is the first line drug used for ovulation induction in patients with PCOS and other ovulatory disorders.  It has been used for patients with luteal phase defect. It can also be used to assess ovarian reserve (the likelihood that a woman’s ovaries can still produce viable eggs). Clomid is not useful for women whose ovaries have reached the end of their working life.

Clomid is a potent and complicated medication.  Clomid is reacts with all of the tissues in the body that have estrogen receptors, such as the hypothalamus, pituitary, ovary, endometrium, vagina, and cervix.  Clomid influences the way that the four hormones required for ovulation, GnRH, FSH, LH and estradiol, relate and interrelate.  While we do not completely understand the mechanisms by which this drug works, in essence it appears that Clomid fools the body into believing that the estrogen level is low. This altered feedback information causes the hypothalamus (an area of the brain) to make and release more gonadotropin releasing hormone (GnRH) which in turn causes the pituitary to make and release more FSH and LH. More follicle stimulating hormone and more luteinizing hormone should result in the release of one or more mature eggs – ovulation.

Just as women’s bodies are so different from one another, their reactions to Clomid vary tremendously.  Some women have virtually no side effects. Others do, but they are more frequently related to emotions.  Side effects may include mood swings, hot flashes, breast tenderness, and thinning of the uterine lining.  About 10 percent of those who use Clomid will have a multiple pregnancy (twins).  Clomid can cause hostile fertile mucous and thins the uterine lining in over 30 percent of the women who use it. The hostile mucus kills sperm, and the thin uterine can prevent implantation or cause an early miscarriage.



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