Estradiol at 55.8 (range 8-35). What should I do?

Trust me, I was worried about infections, extrusion, and scarring. I even voiced my concern to my urologist even though I requested to be put on pellet therapy. He did not push me to use pellet therapy. I paid the compounding pharmacy who made the pellets that were not covered by insurance directly. The compounded pellets were reasonably priced compared to the Testopel pellets. The compounded pellets were shipped directly to me, so I had to take them to the appointment. My doc injected a small amount of local anesthetic, made a tiny incison, inserted a trocar, slid the pellets into place, and sealed the wound with one stitch. The procedure was very quick. My girlfriend holds a BSN and was a practicing nurse for years before moving into management. She was impressed by how tiny the incision was because she watched a YouTube video where a urologist was not so meticulous. The only problem I had was bruising and a tiny bit of soreness, which were to be expected.

With that said, I wounder if extrusion is more a function of how and where the pellets are placed. My doc placed the pellets on top of my right cheek where the most fat is on my buttocks. The pellet pile is about 1.5" from where the incision was made. I am guy who routinely throws dissolvable sutures, so I was worried that I was going to be an extruder.
 
I actually inject testosterone daily and HCG twice a week. For injecting both, I use an Easy Touch 29g 1/2 inch syringe. I can easily adjust my dose and get the right levels I need. Thankfully I've never had to add an AI. I'm surprised that you never consider injecting, even though you're dating former practicing nurse. I do though have a good friend that does not like injecting and he goes to his doctor for injections. The downside is he only gets his dose once every two weeks, he is happy with his protocol. Shows how different we all are.
 
One thing that I would like to add is that my urologist's practice is not a closed system like Nelson discussed. The only thing that his practice handles is ordering the Testopel pellets. I purchase the compounded pellets directly from the pharmacy and all of my blood work is performed by LabCorp.
 
I'm surprised that you never consider injecting, even though you're dating former practicing nurse.

For me, it is about convenience. Even though many injectables do not need to be refrigerated, they are not conducive to certain lifestyles. For example, I like to fly fish. One of the areas I fly fish requires me to camp primatively. I would hate to have to inject myself while camping primatively. I could do it, but it would be a pain the backside.
 
For me, it is about convenience. Even though many injectables do not need to be refrigerated, they are not conducive to certain lifestyles. For example, I like to fly fish. One of the areas I fly fish requires me to camp primatively. I would hate to have to inject myself while camping primatively. I could do it, but it would be a pain the backside.

You get very used to the injections. I camp in the backcountry very frequently, dirty as hell for extended periods of time, and have injected from inside a cramped tent more times than I can count. No big deal.
 
You get very used to the injections. I camp in the backcountry very frequently, dirty as hell for extended periods of time, and have injected from inside a cramped tent more times than I can count. No big deal.

Like I said, I could do it. I used to inject a diabetes drug when I was camping. It was a pain in the backside. I was never as happy as when I finally learned what worked for me diet and lifestyle-wise and was able to reduce my hbA1C to a point where I could just use metformin.
As long as I get the results that I desire from pellets, I see absolutely no reason to switch to injections. There is a lot of pro-injection bias on this site, which is largely from guys who have never used any other form of TRT. Yes, pellets do not work for some guys. However, to say that injections are better for all guys under all circumstances is to be divorced from reality. There are guys for whom topical testosterone works, but it became a nightmare for me. The major reason not to do pellet therapy is the cost, not the results. Pellet therapy is expensive, but so is AndroGel. Injections are relatively cheap because we are using a commoditized technology to deliver a commoditized compound. My insurance covers the procedure and six Testopel pellets. I paid $20.00 a piece for the the other four 87.5mg compounded pellets. My total out of pocket cost was $30.00 for the visit plus $80.00 for the pellets not covered by my insurance. I will pay $110.00 to $150.00 (if I have to go to 12 pellets) per quarter to avoid to having to apply a topical daily or inject myself at least one time per week. I would suspect that I would have to do EOD injections because I am a low SHBG guy.
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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