Patient's question:
Medical Description: (Mainly refers to 2007-present) The main symptoms now are:1. A slight pain from the urethral opening towards the scaphoid fossa, with several nerves near the urethra being particularly painful.
2. During arousal, only an erection occurs, without the former passion, and the desire is becoming less intense than before.
3. Premature ejaculation within 3-5 minutes, with a significantly reduced amount of semen compared to when I was 18 or 19—sometimes almost no semen is released.
4. In the first half of this year, I felt pain at the intersection point of the perineum and anus, likely due to nerves, as the nerves of the penis are connected to the perineum. This pain has been constant for days, and pressing the area with fingers feels very pronounced, with a sensation of tightness in the anus.
Doctor's answer:
Clomiphene (the preparation is citrate clomiphene) is a synthetic estrogen derivative that competes with androgen (or estrogen) receptors at the hypothalamic-pituitary level, promoting the secretion of gonadotropin-releasing hormone and gonadotropins from the hypothalamus and pituitary, thereby enhancing the spermatogenic function of the testes to facilitate sperm production.Currently, this medication is primarily used to treat patients with hypogonadism and some cases of idiopathic oligospermia, where multiple semen analyses show sperm density below 20 million/mL, testicular biopsy results are largely normal, and serum follicle-stimulating hormone levels are within the normal range. Dosage and administration should be conducted under the guidance of a physician, and it generally takes 3 months of treatment to determine its effectiveness. Reports indicate that with appropriate case selection, the rate of sperm count recovery after treatment is approximately 70% to 75%, and the pregnancy rate can reach 36% to 40%. This drug has relatively minor side effects, but excessive dosage may inhibit sperm production. In rare cases, it may cause side effects such as blurred vision or flashing lights before the eyes. It is one of the more widely used medications for treating oligospermia.