estradiol issues

[atlien2488]

I'm 29 years old, taking 160 mg of test once per week (sometimes bump it up to 200) and 900-1000 iu of hcg per week. My doctor had me on 1 mg of anastrozole once per week (which is split up as much as possible) My last labs had my estradiol off the scale under 5.0 (range of 9-26 being normal) My doctor said take .75 of anastrozole instead of 1 mg per week. My problem is I have been having erectile issues. Before TRT, i was able to get rock hard erections and the last month they have been much softer. I feel like it is because I crashed my estradiol but I always thought soft erections that were still possible to get were a sign of high estrogen. I cut of the anastrozole about a week ago and things haven't seemed to have improved much. Do you think it is low estrogen regarding the ED issue? when can i expect my levels to return to normal? Should i supplement with DHEA or progesterone to help them return? Thanks.

 

[MarkM]

I'm sorry that your doctor has you on such a poor protocol. It is absolutely terrible. The once weekly injection of 160 mg of testosterone is not advisable unless you have very high SHBG. Do you know what your SHBG (Sex Hormone Binding Globulin) is? Why are you bumping the testosterone dose to 200 mg from 160 mg a week sometimes? That is another part of your problem. You need a protocol that is consistent.

What was your estradiol before you started TRT? It does appear you have crashed your estradiol if it is sitting at 5. Many of the symptoms of low estradiol and high estradiol can be the same. Your's is definitely low. I would not take any more anastrozole and it may take 10 to 14 days, maybe longer to work it out of your system. The half life of anastrozole is about 48 to 50 hours so 5 times the half life before it's gone altogether. You should start returning to normal. If you feel like you are starting to get high estradiol symptoms then take just a tiny bit like 1/4 of one pill (0.25 mg) and see what that does for you.

I wouldn't supplement with DHEA until you get back to normal and you need to see what your DHEA-s levels are. DHEA suppementation has a preponderance to turn into estradiol in men and you really need to see where your estradiol levels fall after stopping the anastrozole and what your DHEA levels aready are.

It is likely that you should increase the number of injections per week, which for most works well, but we need to know what your SHBG is before discussing that further.

Make sure to thank you doctor for screwing around with your well being. He/she really did not give you proper care.

 

[Blackhawk]

Hate to tell you but erection trouble is the least serious problem from crashed E2, just more noticeable in pretty much every man's mind. Get your E2 back over 20 pronto to avoid bone loss, cardiovascular risk and overall mortality risk. A temporary blip and most likely no big deal, but don;t keep going down that road.

So many doctors start patients on an AI from the get go with TRT and a huge percentage ignorantly crash their patient's E2. Happened to me too.

 

[atlien2488]

Yes, my estradiol was low to begin with at around 7 or 8. My SHBG is at 22. (17-56). I'll talk to him about doing 2 shots a week but he said do you really want to be taking 2 shots a week for the rest of your life since youre young? But yeah it might be necessary, I'll look into it. But do you think that was most likely the culprit for the ED issues? I've only been on TRT for 6 months or so and everything's good except that might be a deal breaker of staying on it. Also, I always thought softer erections were a sign of high estrogen not low estrogen but i guess they can be similar...

 

[MarkM]

Right now you are taking between 160 mg and 200 mg a week in one injection with low SHBG. This means that in essence you are passing a lot of your testosterone out in your urine because your weekly dose is way too high for your low SHBG. The only way most people with SHBG as low as your have success is with every other day (EOD) injections.

True, you are poking yourself more, and it is a lifelong commitment, but getting more benefit out of it...........and you probably won't need any AI when you go to multiple injections verse just one.

 

[Systemlord]

My estrogen got knocked down from above 40 pg/mL down to 12 pg/mL on only two .125mg spread across 3 days. I can only imagine what would happen if I took 1mg in one sitting.

 

[atlien2488]

it'll go >5 where labcorp can't even read how low is estrogen is which is what happened to me. I'm just hoping my hardware works okay soon im gettin a little worried I won't have rock hard erections again but I'm hoping once it raises a bit with more T injections and hcg. I'm just wondering if I should use prognenolone or DHEA to raise it faster...

 

[Blackhawk]

If it was my choice, I would drop the AI entirely until Estradiol comes back in range, then monitor symptoms and get E2 labs every 6-8 weeks. Then only take the AI if I go high and have high E2 symptoms.

And regarding DHEA, I'd get labs first.

 

[atlien2488]

yeah definitely not taking the AI for awhile. The highest my estradiol has ever been tested was 22 (7-46) which isn't that high at all. My other numbers had my estradiol below any sort of reading the last time and at about 6.8 the time before. I must not convert much to E2 which could turn out to be good in the long run I hope.