How long should I use clomiphene?
The pregnancy rates with clomiphene use justify up to three months of treatment for women who normally ovulate on their own, or six months for women who do not usually ovulate without it. There may be exceptions on a case-by-case basis, however.

How is the medication given?
Clomiphene citrate comes in 50 mg tablets that are taken on the fifth through ninth day of the ovulatory cycle. The standard doses are one, two or three pills daily. There are legitimate variations on this dosing regimen, however.

Such as?
The medication can be given days 3-7, 4-8 or extended 3-9 or even longer. It is sometimes combined with injectable medications, such as HCG, human menopausal gonadotropins (Pergonal or Metrodin), or an oral steroid such as Dexamethasone. Occasionally we use higher doses than three pills daily.

What are the short-term side effects of clomiphene? Some women experience hot flashes, presumably because the action of estrogen is blocked at the level of the skin. Headaches are not uncommon (approximately 10% of women) and moodiness or depression are reported in approximately 5%. It is believed that the incidence of side effects does not change with higher or lower doses.

What about long-term side effects? Is clomiphene associated with ovarian cancer?
The relationship between clomiphene and ovarian cancer has long been a concern and the honest answer is that we still do not know for sure. No significant increase in ovarian cancer rates has been seen since the use of clomiphene became common, although one study published in 1993 implicated clomiphene use for greater than twelve months with a possible increase in cancer risk. For these reasons clomiphene should be used for a relatively short time only.