IS CLOMID RIGHT FOR YOU?
It can be a good fit — or a poor fit.
Clomid is the very first line in many fertility treatments. It's an inexpensive and well-established oral medication that is typically prescribed and taken for a handful of days early in the menstrual cycle. It works by essentially tricking the body into thinking the estrogen level is very low (which it doesn't love), and in an effort to fix this, makes the body step extra hard on the gas to grow some follicles which in turn give off estrogen and get the level "back up". For a more in-depth explanation including charts on how this works, check out the Follicular Phase video in the Nursery module within The Baby You Want course.
Clomid is sometimes referred to as "the fertility gateway drug" because it's often prescribed first by regular OBGYNs, or even GPs, without a lot of in-depth fertility experience. Since this is often — but not always — the context that it's used, it means there's often very little education or monitoring of the cycles it's used in.
Because this is the case, here are the things I wish every woman (and their doctor) would understand and consider before deciding if it Clomid is right for them.
Clomid is fiery.
Clomid is a very hot and invigorating drug from a holistic and energetic perspective. Energetically, it is like putting fuel on a fire. Which can be great if what you are lacking is energetic fire, but terrible if you have plenty of fire and that's not your issue.
People who do well (holistically) on Clomid.
If you are:
Chilly (not just your hands and feet, but your whole body)
Often fatigued
Anxious, sad, weepy or fearful when faced with stress or in general
Struggling with slow metabolism or hypothyroidism and tend to gain weight easily
Then Clomid may be right for you.
This list will often speak to people with typical PCOS, and Clomid can be a good fit for these folks. That said, due to PCOS typically also involving a very high follicle count (the number of eggs on deck in the ovaries), people with PCOS must — no ifs, ands, or buts — be closely monitored on Clomid to avoid developing the always-serious OHSS and to decrease the risk of conceiving high-level multiples. As in triplets or more.
How it feels when Clomid is a good fit.
Overall, for most women with the above symptoms, the first 1 - 3 months on Clomid will feel fine with no big side effects. Sometimes it'll even feel better than fine! I once had a patient with these sorts of energetic issues feel so good on Clomid she called it her "performance-enhancing drug."
People who do poorly (holistically) on Clomid.
If you are:
Already prone to overheating, having hot flashes or night sweats
Already struggling with high or nervous energy or have insomnia
Irritable, angry or frustrated when faced with stress or in general
You exercise, drink alcohol or have sex to keep your stress levels down
Already struggling with migraines that are worse with stress
Then Clomid is probably not for you.
Ask your provider about alternatives like Letrozole or injectables that don't have these same issues but do tend to cost more.
How it feels when Clomid is a poor fit.
For people who already have the above symptoms prior to taking Clomid, Clomid will likely make these things worse both during and after taking it. But more on this in a minute. These are the types of folks you see blogging about how taking Clomid turned them into raging maniacs, gave them horrible migraines, sent them into a spiral of six months of horrible night sweats and weird periods, and more. You get the idea. It does not feel like a performance-enhancing drug for them ... it's not good!
More to know if you're taking Clomid.
1.
The half-life of Clomid is suuuuuper long. Drug half-life refers to the length of time it takes the body to eliminate the concentration of a medication down to half of its starting dose. With Clomid, the half-life is 5 - 7 days. This means if you take a fairly typical fertility dose of 50mg, in 5 - 7 days the concentration in your body is down to 25mg. 5 - 7 additional days later you'd be down to 12.5mg, and 5 - 7 more days you'd be down to 6.25mg and so on. All in all, it'll take about two months before that initial dose is fully cleared out of your body! This explains why women who are a poor fit for Clomid will often experience side effects for months - and it's not fun.
2.
Back-to-back Clomid cycles build on each other because of the long half-life. This can be good early on in some cases if it's agreeing with the person's body, but bad in others when it is causing side effects and not good results. It also explains why side effects tend to get worse and worse with each subsequent cycle, especially when there is no break in between.
3.
Eventually, even people who felt good on Clomid at the start begin to feel bad. Prolonged use of Clomid will energetically burn up the good coolant (yin energy) in the body which has lasting negative effects including vaginal dryness, dizziness, hot flashes and other menopause-like symptoms. Women who are on Clomid for too long may be left with really horrible new imbalances that make "next-step treatments" like moving on to other medications even less likely to work. This is totally unnecessary when you know when to say stop - but not all clinics do. It's worth noting, if this is ever the case, taking some time to focus on whole-person balance and build back up the coolant in the body can help so much!
4.
If Clomid is going to result in a pregnancy, it will in three or four cycles max. Numerous studies have shown that if pregnancy will occur with Clomid, 75%+ will occur within the first 3 - 4 cycles. In all my years working with women using Clomid, I can only recall two patients who got pregnant on a round of Clomid that was beyond a 3rd - and both were on their 4th.
5.
Be proactive about protecting your cervical mucus (especially if you aren't doing IUI) and your endometrial lining if you take Clomid. If your uterine lining is super lush and you've got ample cervical mucus you might be able to do three cycles of Clomid and be just fine, especially if you are using IUI with Clomid to bypass the sperm needing to swim through the mucus. But if you're using Clomid with sex, already have thin uterine lining concerns, or generally worry you're already hot, it's not a bad idea to work on protecting these things.
As an FYI, there is an entire A La Carte video on troubleshooting lining concerns, and there are supplements (such as Fertile CM) and sperm-friendly lubes (like Preseed) that can help with cervical mucus. You may also want to read about taking Guaifenesin, which is in certain cold medicines (like Mucinex), to thin your cervical mucus which can help with sperm getting to their destination too. Talk with your provider.
And last but not least...
6.
Get monitored if you take Clomid! The ultimate goal of Clomid is to insure that you a) ovulate if you were not ovulating, and b) induce more than one follicle/egg to ovulate and increase your odds of conceiving any given month. And if possible, without risking multiples or OHSS! For all of these reasons, it is VERY important to insist on being monitored or else you'll have absolutely no idea what your body is actually doing. Monitoring should include one or two ultrasounds to see how many follicles are growing, as well as a progesterone blood draw to see if ovulation did indeed happen. To understand these things better check out the Follicular Phase and Luteal Phase videos in the Nursery module of the program.
So, that's my two cents on Clomid. Okay, maybe a bit more than two cents. Remember, I'm not an RE or OBGYN and you always need to take your unique circumstances (insurance, clinic, preferences, views on multiples, body signs and symptoms, etc) into account when making your best truly-holistic fertility care choices.
This article is written from the perspective of a person who has seen a lot of Clomid, and other fertility cycles, through a big picture, whole-person point of view. Always talk through things with your own provider and listen to your unique body. I hope this information is helpful to you on your journey!
Warmly,
Nicole
Nicole Lange
LICENSED ACUPUNCTURIST
HOLISTIC FERTILITY EDUCATOR
