TRT and Gyno Question

[bjesplin]

I am 46 and I have had low normal testosterone and below normal free test for several years. I recently started using compounded testosterone cream at a dose of 50mg of test per day (5-7mg is probably absorbed). Doing this I get nipple/breast pain. My Dr. prescribed .25mg Arimidex every other day. This didn't work well so he upped my prescription so that I can use up to 1mg per day. I have been using .25mg every day and some days I do more if I notice pain. Before using the cream I had a test injection of 50mg test and after two days I got intense breast pain that lasted about a week even though I was taking .25mg Arimidex every other day.

My first question is whether the pain I have experienced is really gyno or something else? Is it possible to get breast/nipple pain on TRT without it being gyno? I have not noticed any swelling or enlargement. I am concerned about this because breast growth is the last thing I want. My second question is whether this much Arimidex would be too much/unsafe for the low dose of test I am on.

My doctor's attitude is that if I am having breast pain it has to be from estrogen and therefore I need to take as much Arimidex as I need to stop it.

I am not over weight and I only have breast pain if I am using testosterone or DHEA.

I would like to stay on the cream because I like how I am feeling with it, but if I can't keep the breast pain under control I don't know how I can keep using it.

As a side note, my doctor is Warren Willey who is a bodybuilder and has written many books and articles on bodybuilding and nutrition.

 

[Zyglamail]

My first question is whether the pain I have experienced is really gyno or something else? Is it possible to get breast/nipple pain on TRT without it being gyno? I have not noticed any swelling or enlargement. I am concerned about this because breast growth is the last thing I want. My second question is whether this much Arimidex would be too much/unsafe for the low dose of test I am on.

My doctor's attitude is that if I am having breast pain it has to be from estrogen and therefore I need to take as much Arimidex as I need to stop it.

Breast tenderness in some folks is just a side of changing hormones. Often times it will subside once a test dose levels out and things are holding steady. As for safety of adex its been proven to be pretty safe however, we do not want to eliminate E, just control it.

With all that being said, there is no reason for you, or you doc to be guessing. Get some lab work done to see what your various hormones are at and adjust adex accordingly.

 

[bjesplin]

The problem I have is that my doctor wants me to stay at a steady dose of test and Arimidex for six weeks before retesting, and keep going up and down on both to try to keep from having the pain symptoms. I wish I could test every week until I get the dose right.

 

[Zyglamail]

The problem I have is that my doctor wants me to stay at a steady dose of test and Arimidex for six weeks before retesting, and keep going up and down on both to try to keep from having the pain symptoms. I wish I could test every week until I get the dose right.

That dose of test is pretty low its very unlikely to cause gyno and I am sure thats what you doc is thinking as well. Fluctuating test levels can also cause sensitivity and you do need to be on a given dose for a good while to let things level out so you can get accurate blood work. Your just going to have to decide to trust him or get off TRT. Sorry but I dont think there is an easy answer for ya.

 

[bjesplin]

Thanks for your input.

What level of estradiol would it take to get gyno? Or is it more the ratio of test to E2? Could estrone or some other form of estrogen also cause gyno? I also read somewhere that DHT can cause gyno but I have not been able to confirm this.

I have had my estradiol tested about six times in the past three years. The first time, before I took Arimidex it was 41 in a range of 0-56. Since then it has always been in the range of 26-28 even if I was having pain. It doesn't seem like this should be the cause of breast pain.

With real gyno, what would the first symptoms be?

One of the causes of my low free testosterone is that I generally have high SHBG, around 70.

I have also done a few saliva tests to check hormones. The results seem to go along with the blood tests. What is your opinion of saliva hormone tests? They are a lot cheaper and I can do them on my own without a doctors prescription.

Again, thanks.

 

[Zyglamail]

The exact causes of gyno are largely still unknown. For me, the 2 most likely times to get gyno are at puberty when test levels starts ramping up and when andropause starts. By then also a lot of guys have let themselves go and androgen levels decline and E levels rise creating an unfavorable ratio. Aside from that however there is a whole slew of things that can cause or aggravate it. Gynecomastia Causes, Symptoms, Diagnosis, and Treatment by MedicineNet.com

 

[bjesplin]

Thanks again!

 

[jimp]

I've been on TRT for over a year. My clinic is pretty well known for TRT. I started with a compounded cream and every time the doc had me tested we pulled blood and Saliva test. He explain that transdermal deliver systems should always be gauged this way. Ultimately the creams raised my estrogen levels disproportionally to the rise they gave me in testosterone ( my bro had exactly the same reaction). I can remember a little nipple tenderness off and on while on the creams.

I switched to the injections, first once a week then to twice a week. Best thing I ever did. With the injections my test numbers went right to high/normal (1052) and estrogen fell into a normal range and no more tender nipples. no AI's needed yet and its been 6 months since switching to injections.

Good luck