Terpafen (clomiphene, also spelled clomifene) is predominantly used to treat impaired ovulation in women. Originally designed to treat infrequent menstruation, it was eventually noticed that women who were taking the medication were experiencing higher-than-average fertility rates. The active ingredient in this product is among the most widely-used fertility treatments for women in the world today.

Terpafen is sometimes used in other conditions, usually off-label. It is, for instance, sometimes used as an alternative to testosterone supplements in men experiencing low testosterone levels, and it is sometimes used to stimulate ovulation to gather eggs for in vitro fertilization.

This product is also sometimes used as a performance-enhancer in bodybuilding and some sports. It may be tested for in some sporting events, and if detected users will likely face punishment.

Used as directed, Terpafen is a remarkably safe medication. It has very few, and very rare, serious side effects associated with it and no known interactions with any other medication, supplement, or vitamin. It is also among the less costly fertility treatments.

How It Works

Terpafen blocks estrogen receptors in the body, which in turn causes the body to release hormones which stimulate ovulation. It is effective in approximately 80 percent of women who aren't ovulating normally, though it should be noted that it will not address fertility issues unrelated to ovulation impairment. Impaired ovulation is estimated to impact about 25 percent of women having difficulty conceiving.

While Terpafen will not impair fertility in men, it will not enhance male fertility either.

Terpafen may be used on its own, or it may be one of several medications tried to address multiple issues. If pregnancy does not occur after six menstrual cycles it is generally considered that Terpafen is not going to be effective and alternative medications should be tried. In some cases, however, a doctor may investigate other problems that may be hampering Terpafen's effects; for instance, the medication's estrogen-blocking properties may cause some estrogen-deficiency symptoms, one of which is changes in cervical mucus that can prevent sperm from reaching an egg, in which case a mild, localized estrogen supplement may resolve the problem.

Women who become pregnant during treatment with Terpafen have about a 10 percent chance of having twins or triplets. Chances in the general population are closer to 1 percent.

Taking Terpafen

Ideally any woman having difficulty conceiving will see a doctor prior to starting fertility treatment; as mentioned above, Terpafen will not help with fertility issues unrelated to impaired ovulation. If impaired ovulation is found to be a cause, however, odds are good that Terpafen can help.

For fertility, treatment is remarkably simple; a single 50 mg tablet is taken once daily for 5 days. It is generally less invasive, less expensive, and more convenient than other methods. Treatment is typically very similar to:

• Treatment begins either on the 3rd or 5th day of the menstrual cycle.
• One tablet is taken daily for 5 consecutive days.
• Ideally tablets are taken at the same time each day.
• Ovulation should occur about 7 days after taking the 5th tablet.
• Utilizing ovulation tests and timing intercourse properly will further increase odds of conception.

Ultrasounds may be performed to evaluate Terpafen's effectiveness, and, while relatively rare, a doctor may suggest increasing the medication's dosage to 75 or 100 mg per day for 5 days. Women who menstruate irregularly may be given a medication to induce menstruation so that Terpafen can be taken.

Treatment will most likely continue for at least 6 months, or 6 menstrual cycles, after which alternative treatments may be tried instead.

Use of this medication in men can deviate significantly from the above, in both dosage amount and frequency of use, and will also vary according to what is being treated as well as its severity. Doctor instructions should be followed.

Precautions & Side Effects

The majority of women take Terpafen with no problems at all, however, women with certain preexisting conditions are at significantly greater risk of serious complications. Speak carefully with a doctor before taking this medication if there is any history of:

• Ovarian cysts
• Enlarged ovaries
• Thyroid, pituitary, or adrenal gland problems
• Brain tumor
• Liver disease

In otherwise healthy women the vast majority of side effects are rare and mild:

• Hot flashes
• Irritability
• Drowsiness
• Mild stomach upset
• Tender breasts
• Spotting

The above are not cause for concern unless severe or persistant.

Though very rare, some women react a little too well to treatment. Ovaries may become hyperactive, swell, and leak fluid into the abdominal cavity. This is a potentially life-threatening condition which calls for the immediate end of treatment and medical attention. Warning symptoms are difficult to ignore:

• Swollen, bloated stomach or abdomen
• Painful or very tender abdomen
• Difficulty breathing
• Very rapid heart beat
• Extreme nausea or excessive vomiting

With prompt medical attention symptoms can be managed until the medication leaves the system.

Another very rare side effect is vision disturbances; blurred vision, double vision, or seeing spots or flashes. Again treatment should be stopped until a doctor is consulted. Symptoms should reverse when treatment ends.

Treatment should end immediately upon pregnancy. Terpafen may inhibit milk production; nursing mothers should discuss possible risks with a doctor before using this treatment.