Q: “My T levels are low-normal and for me there’s a drastic life quality difference when I use even small amounts of testosterone. Instead of injecting testosterone every week for the rest of my life, could I use Clomid or Nolvadex instead? When I’ve used Clomid post-cycle I had great results and felt much better. But I’ve never heard of permanent use.” A: This could be done, but I wouldn’t recommend it. There’s one small study where men with low fertility took Clomid at 100 mg/day for a year, and they had good results and no problems. So it’s not that there’s no medical evidence at all for somewhat long term Clomid use, but it’s very limited. There have been many women who have taken Nolvadex continuously for years, and there was a period where doctors were prescribing it as a prophylactic for women who were at inherited risk for breast cancer. lasix pregnancy The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH. Keywords: aromatase inhibitor; clomiphene citrate; enclomiphene; secondary hypogonadism How to cite this URL: Mc Cullough A. Alternatives to testosterone replacement: testosterone restoration. Asian J Androl [serial online] 2015 [cited 2019 Feb 27];1-5. 2015/17/2/201/143736 - DOI: 10.4103/1008-682X.143736 The etiology of late onset hypogonadism (LOH) has been attributed to a decrease in the secretion of hypothalamic and pituitary gonadotropins and a decrease in Leydig cell numbers and responsiveness in the aging male. 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