Benefits and side effects of clomid medication
Clomid (clomifene citrate-clomiphene citrate) is commonly prescribed for stimulating ovulation. It's taken at the start of the menstrual cycle from around day 2 at a dose of clomid 50mg daily for 5 days. If a second course is prescribed the dose can be increased to 100mg, 3 treatment cycles is considered a course of treatment.
It is licensed for 6 months use for ovulation induction and is not recommended for more than that as it can increase the risk of developing ovarian cancer, however some consultants will prescribe it up to 12 months (doctors should advise their patients of the risk).
It is often the first drug given to women by their doctors for infertility treatments. It's cheap and easy to administer. It works by blocking the feedback actions of oestrogen thereby tricking the pituitary gland to produce more follicle stimulating hormone (FSH) to make the eggs grow and mature.
Clomid treatment is sometimes combined with metformin to try and help regulate the menstrual cycle for woman trying to conceive naturally.
Traditional Chinese medicine viewpoint
In traditional Chinese medicine, clomid is hot in nature and gets the blood moving to the follicles. It's suitable for women who feel cold (a deficiency of yang) but who don't sweat at night (a deficiency of yin) and know the increased risk of having a child with birth defects. However, if the woman feels warm or hardly ever feels the cold and can sometimes sweat at night, then clomid is too warm and will damage yin, like being on a slow cook, it will burn and damage the body's fluids, i.e. less cervical mucous. This can actually worsen a woman's fertility.
It has also been shown to reduce gland development in the uterus wall, thereby damaging implantation. To partially offset this side effect, progesterone can be given from ovulation or acupuncture, which has been shown in research to stimulate the thickening of the uterus wall (uterine glandular development) thereby improving implantation.
A research study conducted in 2008 compared acupuncture (plus moxibustion) to clomid in 120 women with infertility due to ovulatory problems. After treatment for 3 menstrual cycles women in both groups showed similar increases in ovulation rates. However, the pregnancy rate in the acupuncture group was significantly higher than that in the medication group, due to lower levels of miscarriage.
Recent research has shown that combining clomid with Chinese herbs significantly improves polycystic ovary syndrome (PCOS).
Clomid has numerous side effects, including:
- Raise LH levels
- Reduce cervical mucous (egg white)
- Reduce the thickness of the uterus lining
- Mood swings
- Ovarian hyperstimulation syndrome (OHSS)
- Birth defects (see below)
Tamoxifen is often used as a substitute if the woman experiences too many side effects from clomid. Letrozole, also known as femara, it is sometimes used instead of clomid. Its normally used in women with breast cancer. It doesn't reduce cervical mucus or thin the endometrial lining as much as clomid. Dexamethasome is sometimes used in conjunction with clomid to enhance ovulation.
There is evidence that using fertility drugs such as clomid when trying naturally or using FSH/LH drugs during an IVF cycle increases the mother's hormones levels to a point at which girls are more likely to be conceived than boys. It has also been linked to Autism.
Evidence suggests that even after clomid has successfully assisted ovulation, it can remain in the mother's system well into the initial weeks of pregnancy, which can put the fetus at risk of exposure to a dangerous drug. Clomid is classified as a category x drug by the FDA, meaning it is known to cause birth defects.
Animals or humans have developed foetal abnormalities in clinical research and there is evidence to suggest human foetuses may be at risk. As a category X drug, the risks may outweigh the potential benefits. A 2010 study at the Harvard school of public health found that ovulation-inducing drugs like clomid nearly doubled the risk of autism spectrum disorder in children, whilst a study by the Centers for Disease Control and Prevention (CDCP) in the USA identified the following as serious clomid birth defects:
- Anencephaly (open cranium with the absence of a brain)
- Heart defects
- Esophageal atresia (closed or underdeveloped oesophagus)
- Omphalocele (the infant's intestine or other abdominal organs protrude from the bellybutton)
- Craniosynostosis (premature fusion of the skull bones)
- Dandy Walker malformation syndrome (a brain malformation involving the cerebellum and the fluid filled space around it)
- Cloacal exstrophy (involves multiple abnormalities of the gastrointestinal and genitourinary tracts)
- Hypospadias & penoscrotal hypospadias (opening of the urethra is on the underside rather than the end)
- Muscular ventricular septal defect (a birth defect in which all or some of the limbs of a foetus do not completely form while in the uterus
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