Comparison
Testosterone vs enclomiphene (TRT vs enclomiphene): what is the difference for low testosterone?
Testosterone therapy (TRT) replaces the hormone directly, is FDA-approved, and usually suppresses sperm production. Enclomiphene is a pill that prompts the body to make more of its own testosterone; it is not FDA-approved and is available only from compounding pharmacies. In its phase 3 trials, sperm counts held steady while testosterone gel lowered them.
How do Testosterone and Enclomiphene compare?
| Attribute | Testosterone | Enclomiphene |
|---|---|---|
| Regulatory status | FDA-approved · Prescription | Compounded · Prescription |
| Human evidence | Strong human evidence | Moderate human evidence |
| Comes as | Injection, Topical gel, Patch, Pellet, Oral capsule | Oral capsule (compounded) |
| How you get it | A prescription from a licensed clinician, filled by a licensed pharmacy. 7 providers are listed on DiscoverMedica. | A prescription, prepared by a licensed compounding pharmacy. Not FDA-approved. 6 providers are listed on DiscoverMedica. |
| How it worksAUA | Replaces testosterone from outside the body | Blocks estrogen feedback in the brain so the testes make more testosterone |
| FDA approvalFDARepros Therapeutics | Approved; a Schedule III controlled substance | Not approved: FDA declined the application in 2015 |
| FertilityAUAEnclomiphene phase 3 | Usually suppresses sperm production | Sperm counts held steady in phase 3 trials |
| Who it can helpAUA | Men with low testosterone confirmed by symptoms and repeat morning tests, from any cause | Only men whose testes can still respond (secondary hypogonadism) |
| Long-term safety dataTRAVERSEEnclomiphene phase 3 | TRAVERSE found no increase in major heart events | Limited long-term safety data |
| Tested sportWADA 2026 Prohibited List (as published in the Austrian Federal Law Gazette) | Prohibited | Prohibited |
| Key risksFDAAUA | Suppresses sperm production and can cause infertility. Raises red blood cell counts and blood pressure, so regular labs are needed. Gels can transfer to children and partners. | Headache, hot flashes, mood changes and nausea are reported. Clomiphene-type drugs are linked to vision changes and blood clots. Compounded products are not FDA-reviewed. |
| Listed prices | Listed starting prices run from $28 to $250 across 6 providers, checked October 7, 2026. | Listed starting prices run from $42 to $99.99 across 4 providers, checked October 7, 2026. |
Status, evidence, formats, routes and prices come from each compound’s page. Prices are the providers’ own listed starting prices, which may exclude a membership fee and change often; they are not DiscoverMedica’s prices.
Does testosterone or enclomiphene affect fertility?
Testosterone usually does: outside testosterone tells the body to stop making sperm, and the AUA guideline says it should not be prescribed to men currently trying to conceive. In enclomiphene’s phase 3 program, testosterone rose into the normal range while sperm counts held steady; testosterone gel lowered them in the same studies. Enclomiphene phase 3
The AUA guideline says men who want children later should be counseled about fertility before starting testosterone. AUA
Is testosterone or enclomiphene FDA-approved?
Testosterone is FDA-approved and prescription only. Enclomiphene is not: its developer received a Complete Response Letter from FDA in 2015. It sits in FDA’s 503A Category 1, so pharmacies can compound it for an individual prescription while FDA evaluates it. FDA
In February 2025 FDA updated every testosterone label with the TRAVERSE results, removed the cardiovascular language from the boxed warning and added a blood pressure warning. FDA
Who might testosterone or enclomiphene help?
Both are for men with symptoms and low testosterone confirmed on two separate early-morning tests. Enclomiphene works through the brain-to-testes signal, so it is not expected to help when the testes themselves cannot make testosterone. Testosterone replacement works regardless of the cause. AUA
The Endocrine Society recommends against routinely treating all older men with low levels, and advises deciding case by case. Endocrine Society
Which might suit whom: Testosterone or Enclomiphene?
The choice depends on the cause of your low testosterone, your fertility plans and how you weigh approval status. Questions to bring:
- Has my low testosterone been confirmed with repeat early-morning tests?
- Is my low testosterone primary or secondary, based on my LH and FSH?
- Do I want children now or later, and how would each option affect that?
- How do I feel about using a compounded, non-FDA-approved drug?
- What labs would we check on each, and how often?
DiscoverMedica does not recommend one over the other. Only a licensed clinician who knows your history can decide.
Start My Journal with these.
Adds Testosterone, Enclomiphene to My Journal, with the questions to ask a clinician. It stays in this browser, and nothing on it is a commitment.
Where to get each
Licensed providers that list each one on DiscoverMedica, by name. The full list is on each compound’s page.
- See all 9 offers for Testosterone$64/mo with membershiplisted, checked October 7, 2026Visit
- See all 6 offers for Enclomiphene$60/mo + membershiplisted, checked October 7, 2026Visitsee siteVisitFrom $42/mo + membershiplisted, checked October 7, 2026Visit
Prices as listed by the provider when we checked; they change.
Testosterone vs Enclomiphene: questions, answered
Is enclomiphene better than testosterone?
Not in general. Enclomiphene preserved sperm counts in trials, which matters to men who want children, but it is not FDA-approved, has limited long-term data, and only helps when the testes can still respond. Testosterone is approved and has large safety trials. Which fits depends on your cause and goals.
Enclomiphene vs TRT: which keeps fertility?
Enclomiphene is designed to. In its phase 3 trials in men with secondary hypogonadism, sperm concentration stayed in the normal range while testosterone gel caused a marked fall. The AUA guideline says testosterone therapy should not be prescribed to men currently trying to conceive. Enclomiphene is not FDA-approved, though, and its long-term safety data are limited.
Enclomiphene vs Clomid: what is the difference?
Clomid is a brand of clomiphene citrate, a fertility drug that is a mix of two chemical forms (isomers), enclomiphene and zuclomiphene. Enclomiphene is the single form developed to raise testosterone in men, and it is not FDA-approved. The AUA guideline says clinicians may use drugs in this class for men with low testosterone who want to keep fertility.
Can I get enclomiphene or testosterone through telehealth?
Yes. Several licensed telehealth providers prescribe testosterone after labs, and some prescribe compounded enclomiphene. Testosterone is a controlled substance, so federal and state rules on telehealth prescribing apply.
What do testosterone and enclomiphene cost?
Testosterone: Listed starting prices run from $28 to $250 across 6 providers, checked October 7, 2026. Enclomiphene: Listed starting prices run from $42 to $99.99 across 4 providers, checked October 7, 2026. Some programs bundle labs and visits into the price, and listed prices change often.
Is testosterone therapy bad for the heart?
The large TRAVERSE trial found no increase in major heart events in men with low testosterone and heart risk. FDA added a blood pressure warning to all testosterone labels in 2025. Your clinician will weigh your own risks.
Sources
- AUA: Testosterone Deficiency guideline (2018, validity confirmed 2024)
- Endocrine Society: Testosterone therapy in men with hypogonadism, clinical practice guideline (JCEM 2018)
- FDA: Class-wide labeling changes for testosterone products (Feb 2025)
- TRAVERSE: Cardiovascular safety of testosterone-replacement therapy (NEJM 2023)
- Enclomiphene phase 3: raises testosterone and preserves sperm counts (BJU Int 2016)
- Repros Therapeutics: FDA Complete Response Letter for enclomiphene (SEC filing, Dec 2015)
- Serum enclomiphene and zuclomiphene during clomiphene citrate therapy (Fertil Steril 1999)
- FDA: 503A bulk drug substance categories list (May 14, 2026)
- WADA 2026 Prohibited List (as published in the Austrian Federal Law Gazette)
- PubChem: Enclomiphene (CID 1548953)
Last reviewed October 7, 2026. Every source above was checked on or before that date. Educational information only, not medical advice; it does not replace a conversation with a licensed clinician. DiscoverMedica does not employ clinicians.