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question from a user

With estradiol above 90 pg/ml at only 150mg test cyp split into MWF (test at 850). Is a long term AI generally safe on the body?

AlphaMD's Answer

Speaking generally, the fewer medications you can be on, the better. So adjusting the dose and/or frequency of testosterone should always be your first approach to managing estradiol while on TRT.

AI's get demonized, mainly because they are used entirely off label in TRT, and that the studies people quote regarding their side effects are from women who use much higher doses to treat hormone sensitive breast cancer.

At doses of 7 to 70mg a week, these poor women obviously get lipid problems and osteoporosis. The doses men use to control high E2 while on TRT (1mg/wk or less) have actually never been proven to cause problems with lipids or osteoporosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361692/

So are AIs safe long term? At the typical doses used to control E2 in TRT (<1mg/wk); yes.

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