question from a user
I (45yo, BMI 32 but dropping) recently started enclomiphene 12.5mg/daily, after multiple tests over 6 months had my testosterone steady at ~350. Estradiol was 30.6. My body feels great, but my sleep has gone to shit. I'm lucky to get 4-5 hours before I'm just in bed awake with insomnia. Is that normal, and how long do I give it to settle out before trying to change the dose? Is this an early sign of estrogen being out of whack? It's been 3 weeks.
AlphaMD's Answer
It’s hard to say without labs, but high estradiol is a very common cause for insomnia. Enclomiphene raises estradiol to a greater degree than TRT (it blocks the estrogen receptors in the hypothalamus and pituitary, making your body think you are low in E2, so it tries to ramp up your E2 production by releasing more LH).
High testosterone is also known to cause insomnia through alterations in serotonergic neurotransmission and higher nocturnal metabolic rate. It also inhibits melatonin release.
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