Other names: Clomifene, clomiphene citrate.
Brand names: Clomid, Euro Med Clomid – counterfeit drug not TGA approved (dangerous).
Therapeutic Good Administration (TGA) Approval: Registered Medicine - Schedule 4 - Prescription Only Medicine.
World Anti-Doping Code Prohibited List 2024: S4.2 Hormone and Metabolic Modulators (prohibited at all times).
This substance meets at least two of the following three criteria, as determined by the World Anti-Doping Agency (WADA).
- It has the potential to enhance or does enhance sports performance.
- It poses an actual or potential health risk to the athlete.
- It violates the spirit of sport (as defined in The Code).
The Prohibited List is updated yearly after consultation with scientific, medical, and anti-doping experts to ensure that it aligns with the latest medical and scientific evidence and doping trends.
What is it: Clomiphene is a non-steroidal medication used clinically to induce ovulation in women and increase testosterone levels in males. Clomiphene is part of the selective estrogen receptor modulator (SERM) family which mimic estrogen, promoting estrogen activities in some tissue while inhibiting its actions in others. It is a taken as an oral tablet and requires a prescription for use.
How does it work: Clomiphene selectively binds to estrogen receptors in a variety of locations throughout the body and has both estrogenic and anti-estrogenic effects. It increases secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In males, LH is responsible for the production of testosterone, while in females, along with FSH, it helps regulate the menstrual cycle and stimulates steroid hormone production within the ovaries.
Uses: In women, clomiphene is a TGA approved fertility treatment and is used to stimulate ovulation and therefore increase fertility. In males, it is used off label as fertility treatment to increase testosterone levels and been used to treat infertility, gynecomastia, and hypogonadism.
Side effects and risks: Side effects of clomiphene vary in severity and include headache, dizziness, hot flushes, pelvic pain, blurred vision, vomiting, trouble sleeping, seizures, liver damage and gynaecomastia in males. Results of a few clinical safety studies in men report that clomiphene has also been associated with ovarian, testicular, and thyroid cancer when used for a prolonged period.
What if an athlete has been prescribed clomiphene as part of fertility treatment: If an athlete is prescribed clomiphene by a medical practitioner as part of fertility treatment including IVF treatment, they may be eligible for a Therapeutic Use Exemption (TUE). Importantly, it is not necessary to try and fail alternative permitted fertility treatments before using clomiphene.
- The TUE application must include a clinical letter detailing reasons for fertility treatment or IVF and copies of any relevant investigations.
- For more information, please refer to Medical Evidence Needed on the Sport Integrity Australia website.