question from a user
I continue to have issues with what appears to be estrogen. Pre TRT my estradiol was 88 nmol/l. Shortly after starting, I had very spicy nipples and general tingling in all of my pecs. My entire chest gets hot and tingly. My clinic started me on 0.25mg anastrozole twice a week. It's been 4 months now and my estradiol levels have gone down to 44 nmol/l. I try not to take the AI at all and usually end up taking 0.25mg once a week or sometimes once every 2 weeks. But I'm curious why even now at 44 nmol/l a level that is half of what it was pre TRT, why do I still get spicy nipples and a hot chest with tingling? I'm currently taking 45mg cypionate twice a week and the next thing I'm going to try is taking 30mg three times a week to see if that helps. Any other ideas or explanation?
AlphaMD's Answer
It sounds like you're sensitive to Estrogen transference & have a high Estrogen baseline.
It's likely that you're feeling the spike in Estrogen after injections, which isn't necessarily reflective of that 44. We have many men who on the days of injections, within hours, get very sensitive nipples if they don't take their AI.
We also have men who are on 3 times or more of your dose who don't take an AI at all and have no problems, to illustrate why I feel you're sensitive to it.
The things you can do to help naturally would be like you suggest, splitting your dose up further to reduce the spikes. You can also switch to subcutaneous injections if you haven't already, as the T is absorbed slower that way than IM.
In the end, if that doesn't help, the best thing would be to continue to take your AI on the days of injection & perhaps a higher dose. You may just be the kind of person who can feel the difference & subtle changes when your Estrogen spikes. If you ever go up in T dose you will very likely need to increase your AI as well if you're having such a reaction at a low dose of 90mg a week.
I hope that helps, trial and error seems the way on this one.
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