Clinical Analysis Of Clomiphene Citrate In Middle-aged Men With Late-onset Hypogonadism

Objective：To investigate the effect of clomiphene citrate in middle-aged men with late-onsethypogonadism(LOH) from the sides of the production of edogenous testosterone and theimprovement of the clinical symptoms.Methods：Totally47patients were randomly divided into two groups:study group with24patients were treated by clomiphene citrate50mg, oral,every other day,,and control groupwith23patients were treated with testosterone undecanoate capsules80mg,twice a day.The therapeutic efficacy of the two groups were compared by the symptom scores ofpartial androgen deficiency of the middle and aging male (PADAM) and relevant sexualhormones which recorded before and after the treatment of eight weeks. The results wereanalysised by SPSS17.0statistical software,where P<0.05was considered statisticallysignificant.Results：1.Patients with the TT values were significantly increased after treatment in the twogroups(P<0.01),the study group increased from (240.6+41.5) ng/dL to (604.7+131.9)ng/dL,and the control group increased from (238.2+42.6) ng/dL to (614.6+108.1)ng/dL,the symptom scores of PADAM in two groups were significantly decreased(P<0.01), the study group decreased from (29.4+5.6) points to (20.4+4.1) points,and thecontrol group decreased from (29.2+4.6) points to (19.5+3.8) points, but between the twogroups after treatment,whether it is the TT value or the symptom scores of PADAMwere no significant differences（P>0.05）.2.The leve of LH and FSH in the patients of study group,increased after treatment(P<0.01),LH increased from (3.5+1.1) mIU/mL to (6.8+2.1) mIU/mL,FSH increasedfrom (4.7+1.7) mIU/mL to (8.1+1.7) mIU/mL,and E2increased too(P<0.05);the rate of TT/E2significantly increased(P<0.01), from10.0to22.4.3.The PADAM symptom scores of patients in the study group was significantdecreased from after treatment,firstly, byphysical+vasomotor symptom scores decreasedmost significantly,from(10.5+3.2) points to (6.5+2.3) points, and then the psychologicalsymptom scores and the symptom scores of sexual function, decreased from (9.1+2.2)points and (9.8+2.7) points to (5.8+2.1) points and (8.0+2.2) points respectively,therewas a significant difference compared with original treatment(P<0.01).Conclusions：1.Clomiphene citrate can promote endogenous testosterone production in themiddle-aged men with LOH.2.Clomiphene citrate can improve the clinical symptoms in the middle-aged menwith LOH.3.Clomiphene citrate maybe as the first treatment in yong or middle-aged men withLOH, especially suited to the man who wish to remain fertile.4.The long-term safty and efficacy of clomiphene citrate used in the treatment of thepatients with LOH are needed more research to confirm.