First of all I can’t imagine any endo writing you a script without an in person visit to go over your labs. Also, don’t read too much into what the girls in the front office say. Sometimes they are way off the mark.
He’s probably right when he says clomid “wont resolve your (our) situation”. Sounds like you found a good endo and he’s researched a bit into PFS.
How are your FSH and LH? If they are high then whats the use of clomid? Your T is getting bound up by SHBG. I know clomid is the logical place to start but few of us improve while on it. For me personally I had zero resolution of any side effects while on clomid.
Here are some natural ways to lower SHBG -
Drink more water.
Lose weight - this decreases SHBG & losing abdominal fat reduces estrodiol levels…
Reduce excessive alcohol consumption.
Regular exercise.
Eat more cooked tomato which contains lycopene which markedly reduces prostate cancer risk.
Eat Cruciferous vegetables such as broccoli, cauliflower, cabbage, and brussel sprouts. These contain Indole 3 Carbinol which increases the conversion of estradiol to “weaker” (2OHE) estrogen. Broccoli also contains quercetin which is beneficial for chronic prostatitis.
Some herbs may help lower SHBG - Avena Sativa and/or Urtica Dioica are two.
If you’re still determined to get clomid you can buy it online. If your logic is to maximize your native T before you try other things I guess it makes sense. Low dose clomid over time will raise serum T but I’d procede pretty carefully and have labs done (esp checking e2 since you already said its high) before I started it and then after a few weeks into it.
ps- From what you say it sounds like your endo might subscribe to the androgen insensitivity theory. Seems most PFS docs do now. Read Awor’s thread on this and review the papers on that thread. Print it out and cite the papers for reference to present to your endo.