Clomid for Infertility: 10 Side Effects You Should Know About

As one of the most affordable fertility medications, Clomid (clomiphene) is often a first-choice option to help you get pregnant. It increases the levels of certain hormones that tell the ovaries to develop and release a mature egg. You may take Clomid on its own or as part of an intrauterine insemination (IUI) procedure.

Clomid makes your body think you don’t have enough estrogen. This is helpful for fertility, but it can also cause unpleasant side effects for some people. Most Clomid side effects are mild and go away after you stop taking it. But it’s still helpful to know what to expect and when to seek medical care.

Clomid side effects at a glance

Below is a list of common and rare Clomid side effects reported in clinical studies. Keep in mind that this doesn’t include all possible side effects. So it’s best to talk to your healthcare team about any side effects you experience while taking Clomid, even if they aren’t listed here.

Common Clomid side effects:

• Hot flashes

• Bloating

• Nausea

• Breast tenderness

• Enlarged ovaries

• Headache

Less common Clomid side effects:

• Mood swings

• Vaginal bleeding or spotting

• Vaginal dryness

• Hair loss

• Dizziness

• Weight changes

• Insomnia (trouble sleeping)

• Vision changes

• Ovarian hyperstimulation syndrome (OHSS)

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Let’s take a closer look at 10 Clomid side effects to be aware of.

1. Hot flashes

Hot flashes — similar to those felt during menopause — are a common Clomid side effect. They were reported by about 10% of those taking Clomid during clinical trials.

Hot flashes can happen because Clomid blocks estrogen in the brain. This may cause feelings of hotness, flushing, and sweating. Although hot flashes may be bothersome, they’re not dangerous and should go away on their own once you stop taking Clomid.

It may help to wear loose clothing and drink plenty of water. You can also try sleeping with a fan on or turning the thermostat down at night. But check with your healthcare team before trying any over-the-counter (OTC) hot flash remedies. They might interfere with how Clomid works.

2. Bloating

Feelings of abdominal fullness or bloating may happen while taking Clomid. This is because the medication can cause your ovaries to become swollen and larger than usual. You may also have some tenderness in your belly or feel like you’re retaining water.

Bloating should go away a few weeks after you stop taking Clomid, once you’ve ovulated (released the mature egg from the ovary). In the meantime, stay hydrated — but avoid soda or sparkling drinks, since they can make bloating worse.

Good to know: Sometimes bloating can be an early sign of a more serious side effect known as OHSS (more on this later). If your bloating feels severe or is accompanied by pain or rapid weight gain, let your prescriber know right away.

3. Nausea

Clomid may cause nausea and vomiting for some people. You can take it with or without food, but taking Clomid with a meal or snack may help lessen this side effect. You can also ask your prescriber about other treatment options to help reduce your nausea if needed.

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If you vomit after taking Clomid, let your prescriber know. They may have you take another dose, depending on the timing.

If your nausea is severe, or you also have stomach pain and diarrhea along with it, contact your prescriber right away. These could be symptoms of OHSS (more on this later).

4. Breast tenderness

Sore or tender breasts are another possible Clomid side effect. This is a result of the hormone changes Clomid causes in your body. It should go away on its own once you stop taking it.

Like hot flashes, breast tenderness may be annoying or painful, but it’s nothing to be concerned about. Loose-fitting clothing may lessen discomfort, and a cold compress can also help. It’s best to avoid any OTC pain medications unless your healthcare team says it’s OK. They could interfere with your fertility treatment.

5. Mood swings

Since Clomid affects your hormone levels, mood swings are another possible side effect. You may feel depressed, anxious, or a combination of both. Keep in mind that the stress of fertility problems can also take a toll on your mood. So do your best to get enough sleep, exercise regularly, and practice deep breathing or mindfulness to help manage your stress levels.

You’ll typically only take Clomid for a few days, so any mood-related changes it causes should be short lived. But if your mood changes are severe or concerning, don’t hesitate to reach out to your prescriber. They can help determine the cause and suggest ways to manage them safely.

6. Insomnia

Insomnia is a less common Clomid side effect. But similar to mood swings, the hormone changes that happen while taking it may affect your sleep cycle. Hot flashes or night sweats caused by Clomid’s estrogen-blocking effect can also lead to trouble sleeping.

Practicing good sleep hygiene can help you sleep better. This includes:

• Keeping to a regular bedtime schedule

• Avoiding electronics within an hour of bedtime

• Getting regular exercise

• Keeping your bedroom cool and dark

• Limiting caffeine, especially later in the day

If insomnia becomes bothersome, talk with your healthcare team about safe treatment options you can take while trying to conceive.

7. Vaginal bleeding or spotting

Clomid can sometimes cause vaginal bleeding or spotting outside of your normal menstrual cycle. These aren’t common Clomid side effects, but can be alarming if they happen to you.

Report any light bleeding or spotting to your prescriber. They may want to see you to make sure everything’s OK, or they may just have you keep an eye on it at home. Any heavy bleeding or bleeding that doesn’t stop requires medical attention — especially if you also have abdominal pain, nausea, or other symptoms along with it.

8. Vaginal dryness

Although less common, vaginal dryness is a possible Clomid side effect. It’s likely due to Clomid’s estrogen-blocking effects. Vaginal dryness can be uncomfortable — especially when you’re trying to conceive.

OTC moisturizers and lubricants can help with uncomfortable dryness. But some may negatively affect sperm, so look for products labeled “fertility friendly” or something similar. You can also ask your prescriber or pharmacist for a recommendation.

9. Vision problems

Although rare, Clomid can cause vision problems for some people taking it. You may notice blurred vision, spots, or flashes. These vision changes usually go away once you stop taking Clomid. But they may persist in some cases.

Contact your healthcare team right away if you notice vision changes. You’ll likely need to stop taking Clomid and get an eye exam to make sure there’s nothing more serious going on. Keep in mind that vision problems can make it dangerous to drive a car or operate heavy machinery. Use caution when performing these activities until your vision problems have resolved.

10. Ovarian hyperstimulation syndrome

In rare cases, Clomid can cause a serious side effect known as ovarian hyperstimulation syndrome (OHSS). OHSS happens if the ovaries are overstimulated and become too large. OHSS can be dangerous if it isn’t treated quickly, so it’s best to seek medical care right away at the first signs of an issue.

The risk of OHSS goes up with larger doses of Clomid or when Clomid is taken with other fertility medications. Having polycystic ovary syndrome (PCOS) and being under 35 years old also increase your risk of this side effect.

OHSS can go from mild to severe quickly, in as little as 24 hours. So it’s best to let your prescriber know right away if any of the following signs and symptoms of OHSS appear:

• Stomach pain and swelling

• Nausea and vomiting

• Diarrhea

• Rapid weight gain (e.g., more than 10 lbs in 3 to 5 days)

• Shortness of breath

If your symptoms are mild, your prescriber may just keep an eye on you. Be sure to drink plenty of fluids, and try resting with your legs raised to help reduce swelling. If your symptoms are severe, you’ll likely need to stop taking Clomid. In rare cases, you may need emergency medical care.

How to save on Clomid

There are ways to save on Clomid, which is available as a brand-name medication as well as generic clomiphene. GoodRx can help you navigate between GoodRx coupons, copay savings cards, and patient assistance programs to save money on your prescription.

• Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase 30 tablets of Clomid at an exclusive cash price of $156.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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