[fnordpiglet]

That’s not my point. It’s not patentable so it’s not commercially viable to go through the clinical trials process for something that’s basically free to produce.

There is plenty of peer reviewed research, but not all doctors are aware of all research and testosterone replacement is widely marketed with very lucrative contracts to urologists.

Feel free to read the research yourself

https://www.ncbi.nlm.nih.gov/pmc/?term=Clomiphene+testostero...

[mattkrause]

That's not entirely true.

The FDA has a "new clinical investigation" program that is supposed to reward people running clinical trials. If you collect data showing efficacy of a new use of a previously-approved drug, you can "earn" the exclusive right to market it for that condition. Of course, someone has to actually do it...and the numbers don't always pan out.

[fnordpiglet]

I think a part of this is also the FDA has been really reluctant to touch testosterone producing substances - there was a company trying to get approval for a patented isomer of clomiphene and they took it through phase 3 and the fda indicated they wouldn’t approve it because they viewed the primary benefit of not being castrating as not compelling enough for a new treatment for low T. Their reasoning to my memory was mostly elderly men suffer from low T and they wanted to discourage what they viewed as a growing trend of lifestyle testosterone treatment. As a clomid user I bought the companies stock and followed it closely through the process and was terribly discouraged about the FDAs processes as a result (and my wallet too!). I’ve been trying to dig that stuff up but it appears the company died as a result and googles not finding the FDA communications. This was like almost 10 years ago.