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Wednesday, July 26, 2006

Clomid

Clomid
by Kelly

Otherwise known as Clomiphene Citrate

Why would you be taking clomid?

Clomid is generally the first fertility drug that women use and has been in use. It is (relatively) inexpensive as fertility drugs go, it is easily taken (orally rather than by injection) and it is the first line drug used for ovulation induction in patients with PCOS and other ovulatory disorders. It has been used for patients with luteal phase defect.

When used to induce ovulation, Clomid is taken for approximately five days early in the menstrual cycle. This may be either days 3-7 or days 5-9. Some women who do ovulate also use clomid to induce a 'stronger' ovulation.

Most women begin with 50 mg and this is increased if ovulation does not occur. Once ovulating, most pregnancies occur in the first 6 cycles of treatment. Clomid is said to be able to induce ovulation in as much as 85% of the women who use it, though only half of those will actually become pregnant. Most authorities agree that continuing for more than 6 ovulatory cycles in not likely to increase the chances of success.

What to expect

The most common side effects of clomid are hot flashes, multiple births (most commonly twins. There is a 7% chance vs. 2% in the general population), minor GI symptoms, visual symptoms, headache, ovarian hyperstimulation (OHSS), cysts, breast discomfort, weight gain, moodiness, stronger PMS symptoms--bloated, cramps, sore breasts, etc, allergies, rash, cervical mucus changes, and tubal pregnancy.

Problems that might arise and ways to troubleshoot

Many people advise on taking clomid at night--this way they say that the hot flashes are less severe and generally do not interrupt their sleep. I get dizzy and feel 'stoned' while on clomid and find that I actually like to take it in the morning. For me, those side effects don't get too bad until the afternoon. Also, the hot flashes at night are an annoyance but don't bother me as much as the other side effects. I think the 'stoned' effect of clomid lasts for me for the time while I am taking it until a day or two after finishing the pills. I usually get very weepy after taking the last pill. I always get very bad PMS while taking clomid too.

33 comments:

The Town Criers said...

A few other things about Clomid--take it at the same time every day within one hour. So, if you take it at 8 p.m. the first night, take it around 8 p.m. all other nights.

Some doctors will prescribe it without monitoring. This is actually semi-dangerous. It's not the most potent drug in the world, but because it can cause ovarian cysts, you want to make sure your doctor is running Day 3 blood work and a vaginal ultrasound to make sure that there aren't cysts before you take the drug again. If not, you could be developing cysts and compounding the problem each cycle.

I've read that if Clomid doesn't work in the first three months, it's probably not going to work. But I also know many, many more stories of people who took Clomid for months and months and finally conceived (usually the Clomid was taken in conjunction with other drugs).

Clomid can dry up cervical mucous. If you're very worried, request a post-coital test. This will let you know if you have sufficient cervical mucous. Other tricks--drink decaf green tea which some say helps produce more/better mucous. I always drank green tea starting on CD1 and continued until I ovulated.

mandolyn said...

I agree. I've been much less (crazy)symptomatic if I take it at the same time each day.

I think I'll try the decaf green tea thing this time around Clomid Avenue. Thanks for the tip!

Andrea E. said...

So how does Clomid work w/ women w/PCOS, since they already have ovarian cycts. Will it make it worse?

lunarmagic said...

Can someone talk a bit about the clomid challenge test? Is it usually done before doing clomid for 5 days during a cycle?

Also, for monitoring by ultrasound - how frequently do they ultrasound, most commonly? Day 10 and then after ovulation? Do they usually do several ultrasounds before ovulation?

Tina said...

I conceived with Clomid (diagnosis: PCOS). Because Clomid has a negative impact on the uterine lining, I was given estradiol to take as suppositories to boost the lining. It worked for me -- the lining was zilch the first cycle, but with estradiol, I eventually had just enough lining for implantation.

My understanding of Clomid's effectiveness for PCOS is that, while you may have a bunch of cysts already, they aren't releasing eggs -- so Clomid for me would not have worked alone (I would have just had more cysts). I did Clomid, estradiol supplements, an hcg trigger shot, an IUI, then prometrium suppositories for good measure. I went through 4 cycles (tweaking dosages and adding different drugs) before I had success.

Maggadoodle said...

I have just completed my first 5 doses of Clomid. I have noticed that I have more energy since taking the pills, which seems to not be a normal reaction. I havent had any side effects at all. I have a 3 year old after 13 years of trying and want another child.

Anonymous said...

I have taken my first dose of Clomid and I have experienced similar symptoms ie; HOT FLASHES!! very emotional and at times moody...yikes..I don't think I can do this again...what are other things that might help us get pregnant...I am desperate!!

griffin said...
This comment has been removed by a blog administrator.
klmcm80 said...

hi i have just stop my last pill on clomid!!!!!!!!!!!.whta can i say"i cant do this again".i have never been so ill,vomitting,hot flushes throat infection and genral pain and discomfort to anything that contained light or sound.if i had of been a surgeon ,i would have removed my own head it was that sore!!!.i really dont think i can do another month of this.

Jaime said...

Hi All

I started took clomid days 3-7 this cycle. day 3 for me was january 4th and now its february 2. i started having wicked hot flashes around day day 17, none before that date, and for the last week have been falling asleep at like 8pm at night exhausted. i also have cramping every once in awhile. oh yeah, and i have not gotten my period yet but it should have come january 30 but my pregnancy tests are negative.

my question i guess is this - how long do your hot flashes last? when do they start? i cannot believe i am still having them and its been weeks since i took the clomid. and i dont understand why i'm getting so tired now but didnt before! thank you for the help :)

The Town Criers said...

Jaime--

Is there any way your doctor can draw a beta hCG test? It's a blood test that measures the amount of hCG in your blood. Sometimes, there can be a low amount of hCG in your blood but it's not enough to tip a pee stick (which usually can't pick up levels under 25 mlU/ml depending on brand). The hot flashes definitely didn't continue that long for me. I had them randomly in the first part of the cycle, but usually, once I was post ovulation, the hot flashes were done too.

everyonesacritic said...

Hi, all. I'm on the first pill of my third round with clomid (I have PCOS). I have to say, I haven't had many side affects. The first time I took it, I had a bad headache but since then I've been just fine. Blood tests and ultrasound show it to be working well, but this month my Dr. is having me do IUI since I'm still not pregnant but he can't tell why. Maybe mucus issues.

Anyway, hang in there, everyone. This is such an emotionally trying issue and it's so difficult to focus on anything else. Thank goodness for blogs like this!!

maddie said...

I have just finished 2 cycles of clomid and about to start my 3rd cycle. I have hotflashes and insomnia but other than that i feel fine. I also have alot more energy which seems a little different. also, has anyone else have constipation, i've read that less than 1% get this symptom.

Anonymous said...

I took clomid day 5-9 and I think I ovulated on day 9, can that be??? I was not ready for that as I was told it would be 5-10 days AFTER the last pill.

Have you heard of super early ovulation on it? I am just taking 50 mg to stimulate a better O as I am 42, but I still ovulate and have suffecient hormones levels. I also have been bloated the last 2 days and feel like I am gaining weight for no reason. While taking the pills I actually felt great, like an energy and good mood high. My temps did not start going up until the day after the last pill. I will be bummed if it already made me ovulate.
Kristin

Anonymous said...

I have just finished my first cycle of clomid (okay, I finished a week ago...) and I was SO tired while taking it and for a few days after. I had absolutely no energy and an almost constant headache. Then, once I stopped the clomid, I developed severe diarreah with cramping. However, I did ovulate this month and had two good, viable folicles, so we're hopeful. It was a month of Hell and I don't know how much more I can stand, but for now, we'll keep trying!

Anonymous said...

I will soon start clomid. I have the pills (50 mg) sitting by my sink. The plan was about 3-4 cycles with clomid and if unsucessful then IUI. After my doctor prescribed the meds she called to say I needed to schedule a HSG. I decided to do the HSG first since that will tell me if I have any blockage. I am really bummed though because that means more waiting--no clomid aloud for the procedure since it could pose a risk of pregnancy. I have to get prescribed provera to start my cycles (I don't ovulate--found out after a month of blood work). You have to wait 40 days to call for provera and then provera can take up to two weeks to start your cycle. So, I am going to hold off of on the clomid until next cycle (which with my cycle would be more like 2 months). But, I have heard that an HSG can increase your chances of pregnancy for the next 3 months and with clomid too I may be off to a good start. I know there are lots of side effects from clomid and many of them scare me (multiple births, tubal pregnancy, weight gain, lack of energy, moodiness). However, this is my only way to ovulate so I don't really have a choice at this point. And, if it brings me and my husband a healthy baby then it is all worth it (just hope it doensn't effect my job too much-I am a teacher). So...I keep telling myself that I can do this. When the time is right it will happen. Take this experience as a journey. I am hoping that one day I can look back on this journey and think that it was worth it as I hold a healthy baby. In the meantime...my husband and I are anxious to actually start trying (since clomid will make me actually ovulate). Good luck to all and hang in there!

SAHW said...

I'm about to start Clomid for the first time tomorrow. I was supposed to be monitored with bloodwork and u/s on Days 14 and 24, but I'll be out of town, so my doctor said we'll only just do the Day 24 monitoring. I'm confused, b/c what is the point of monitoring then? I will have already ovulated by then, so it's not like they'll be able to see how many follicles I had or anything, right? If anyone has any insights for me, please contact me via my blog. I'm wondering should I just wait till the following month so I can be monitored properly??

Erin said...

finished second round of clomid last week 100mg days 3-7. i have been having hot flashes day and night, insomnia, and all i want to do is cry. today has been especially bad since i am now officially the only person i know that is not pregnant. we have been trying for a year and i dont know how much longer i can take people telling me we are trying too hard and it will happen. people may say they know how i feel but do they? thanks for all your posts they give me hope.

Anonymous said...

Hi there, I'm on my last month of Clomid and HCG injections, if I don't get pregnant this month (after 6 months on clomid), I have to go back in and get a laparocopy which I don't fancy. Here's hoping - its all way too much pressure and I;m sick of people saying it will happen when it happens - they just don't understand!!
Shellx Good luck to everyone!!

T said...

I finished my first course of Clomid on 4th July '08, and it was a rollercoaster. I was diagnosed with PCOS at 17 and I've been trying for the last couple of years.

I was on 50mg/day for 5 days on day 2 - 6. The first side-effects were mild headaches, they didn't cause any problems and I didn't feel I even needed paracetamol (Tylenol). I also had extreme mood-swings, going from incredibly happy (happier than I've ever been - it was bliss) to being very, very depressed. But nothing I couldn't handle, and I did not suffer from any angry mood-swings at all.

From day 4 onwards I noticed I was very bloated and I could definitely feel a strong "dragging" feeling, presumably a sign of my ovaries getting a kick from the Clomid. It was uncomfortable and unpleasant but it was bearable. I'm still having the odd hot-flush (at CD21), but usually only once a day.

In the UK, at least at my particular hospital, the monitoring is sparse and all I get is a CD21 serum progesterone blood-test (today), to see whether I ovulated or not. I get a very strong feeling that it hasn't worked, so I'll test at CD28 and again at CD38 (this seems to be my cycle length), though I'm not hopeful.

I have had sore nipples for the last 3 days, and I am wondering if this is due to PMS - though my cycles are so confused I don't have any idea whether it's possible to have PMS from CD17 onwards.

After cycle #2 at the same dosage (presuming I don't get pregnant this cycle), we're seriously thinking twice about upping the dosage and going for it again, not purely because of the side-effects (which I dread at higher dosages), but because of the stressing effect it has had.

Anonymous said...

I just finished my 2nd round of 50mg of clomid and no sign of ovulation on Day 13. I am also on estradiol and I am not sure which is making me feel "stoned" (good one!) I had extreme hot flashes this time and feel a little confused, sad and generally unmotivated. Last month my breats were so tender during PMS I swore I was pregnant! But no :(... Must admit having a hard time this month and cervical mucus seems to be sparse.

Dena said...

A little background...
i am 32, i do not have children, but i have been preg. before.
my husband and i had been trying for a year when we started the whole process of dr. visits and test after test. they can find no reason why we are not getting preg. so after what has now been an additional 6 mos. we tried clomid for the first time last month. the clomid itself i rather enjoyed. i felt great, had lots of energy, i even had positive thoughts about my body, (yes, i have same body image issues as most women in america - won't get into that can now), but then the 5 days were up, and i started coming down from the high!
the clomid worked i did grow two follicles, one on each side. i was given the shot to begin ovulation and was told what time i was to have sex. good - great! here's where it begins to take an ugly turn. i was told to insert these progesterone capsules twice a day, to help insure implantation, those sucked! now i was emotional, i was constipated, followed by lots of cramps, and my boobs were killing me. And the waiting, oh the waiting, to take the blood test to see if i was preg. it was very very intense. i am not. it didn't work. we are trying again this month, but we are going to do iui.
don't feel bad Erin, everyone i know is preg. or has just finished completing their little families.
it's hard to watch from the side lines.
one last thing, why do people feel it necessary to state the obvious. "it will happen when it happens" really? that's like saying when the sun goes down it's night - duh!
thanks for letting me vent ladies!
hang in there and good luck to all!

Anonymous said...

We've been trying for a little over 2 years. Just finished my first cycle of Clomid. I took it day 3-7 at 7am each day. I experianced a feeling of sluggishness ... almost like the feeling you would get from a nerve pill. Other than that, I had a few Hot Flashes. I went in for a Sonogram on Day 12. They measured my follies (I had 5 - but they didn't tell me the measurements) and figured that I would ovulate on Day 17. At that time they told me to take my trigger shot on day 15 and we would inseminate on day 17. Well ... it didn't quite work out that way. I ovulated naturaly on day 14. The office was closed for the holiday weekend so I couldn't get in touch with anyone. We had to cancel the insemination. I wonder if my infertility is due to small or immature eggs at ovulation. Has anyone ever heard of anything like that?

B. said...

Hi all. I just finished my first cycle on Clomid, taking it CD5-9. I didn't have much in the way of side-effects until CD10, the day after my last dose (100mg). I developed my first-ever case of hemorrhoids. Apparently, it was a mild case, and cleared up in about 6 days, but I have not found anything that mentions hemorrhoids as a potential side effect. I have nothing else to attribute it to, so I blame the Clomid. I had my first (of two per cycle) IUI today. I hope this works. Good luck all!!

Anonymous said...

This is for the ladies that are new to Provera and Clomid. I'm 29 and did two cycles with Provera and clomid a few years ago and had such a hard time with the side effects that we decided to hold off for awhile. This year we decided to try again. I'm now on my second cycle. Things are allot better this time around.Just a word of advice, each time will be different. You can't always count on it being good or bad when it comes to side effects. Good luck to all of you!

Anonymous said...

Hi... Need Help!
My Husband and I have been trying to get pregnant for close to 2 yrs. I had a huge endometriosis cyst removed from my ovary earlier this year (I have only one ovary left now and still have couple of uterine fibroids). After my surgery, we have been trying a lot more serious but no luck so far :(
My Doctor wants me to try Clomid + estradiol for couple of months. Tomorrow I am gonna start the first cycle of Clomid (Day 3-7) and estradiol (Day 8-12). I have still not done my HSG(its so difficult to find a slot!), so i dont know if my tubes are blocked. My question is, has anybody with endometriosis history tried this combo? Has it worked? or Has it worsened endometriosis/fibroids since these pills increase estrogen levels? I appreciate your help!

Anonymous said...

Hi! I'm 29 yrs old and have a 3 year old. My husband and I have been trying for nine months. We found out 3 months ago that I am not ovulating. My doc prescribed 50 mgs of clomid. I'm due to start tomorrow days 5-9. After reading all the side effects I'm not sure I want to begin. Does anyone have any suggestions on when to take clomid for best results? I'm a 7th grade teacher and not one for wanting to cry in front of my students!

Anonymous said...

i wanted to talk to the annonymous person from dec. 23rd...i'm not sure if you'll see this or not. i am 28 and my husband and i have a 4year old. i thought give or take a year we're kind of in the same boat. i am just finishing my first round with clomid(the whole prometrium calender thing) i was wondering how it has went for you so far. you must have started a month before me and i just wondered how it has worked.

Anonymous said...

I just finished my first round of clomid - 50mgs, given to help support my progesterone levels (I am 41 and ovulate on my own, but keep miscarrying). I did get pregnant on my first Clomid month, but unfortunately I miscarried at 5 weeks. I have just started cycle 2 of Clomid 50mgs, and I am hoping to get pregnant again this month. And stay pregnant ;-) As for side effects, I have had absolutely none so far. Nothing. Nada. Zilch. I was able to feel my ovulation happening for the first time ever, but it wasn't painful; I could just feel the eggs being released. Quite an interesting sensation. But yeah, no side effects at all for me.

Anonymous said...

Ugh - I am about to pop my 1st Clomid - am nervous but I suppose if it does the trick it doesn't matter. I will be 41 in June, have had 2 miscarriages and had an HSG about a month ago. I have pretty much been anti-fertility drugs so of course I am apprehensive about taking Clomid, especially now the first one. I'm sure it will all be fine.

Anonymous said...

I'm on my fourth and likely last month of clomid. I haven't see anyone else taking more than 50mg, but I'm taking 150mg. My dr. says that's the highest dose he can prescribe. I have had side effects like moodiness and the nightly hot flashes, but they are not any worse now than when I was taking just 50mg. I also have PCOS, but it's clear that clomid is not helping me ovulate. We're going to an infertility specialist next week. I really hope they can give some insight as to what's wrong.

Hang in there ladies.

Dena said...

I took 150mg of clomid for a couple of months, but it didn't work for me either. I had them do a saline sonogram to get a better idea of what was going on in there, since all of the other million tests they ran came back great. They found what may be a pollup or a fibroid, after another failed cycle, we are taking a couple months off so that they can do surgery to remove whatever is in there. I was feeling pretty hopeful, like finally I had an answer for why I was not getting pregnant, but when we met with the dr. she said that neither pollups or fibroids would keep me from getting pregnant, but it may keep the pregnancy from going to term, so I still don't have any answers. Oh, and these "growths" may be side effects of the hormones!
Ahhh!
Meanwhile EVERYONE around me is pregnant or has just had a baby!
Sorry for venting, but I find that after a year of dr. apts friends want to hear about it less and less.

Anonymous said...

I was referred to this blogspot by one of my friends and I'm sure glad she did! This is a great support for all of us. I'm 29 yrs old and my husband and I have been trying to get pregnant for 15 months. The first year I never got a period and never ovulated. Before my doc would prescribe Clomid, she had me do an HSG test. My test results came back just fine. So, my doc has presribed me Prevera (progesterone to get a period) and Clomid (to start on day 5 of bleeding). But my question is: Has anyone heard of getting pregnant after an HSG test? I've heard thru the grapevine that some "infertile" women were able to concieve shortly after that test.... Any words of advice will help me! Thx T.