Confirmed Gyno - Efforts to Deal With It

[jeff7]

36yo male. On trt due to secondary hypo.

It was I found out I was secondary because I was developing gyno on my left side. Doctor did some labs and a mammogram and found the cause was low t.

After 4 years of HCG and clomid therapy I decided to begin TRT. Though out the entire 4 years of treatment (hcg and clomid) I still had gyno flare-ups which was why I decided to go to TRT.

Here is the issue. On TRT I am still having GYNO pain.
My labs on 3/17/17
testosterone 832 range 348-1197
free test 24.1 range 8.7-25.1
estradiol <6.0 range 7.6-42.6
igf-1 192 range 88-246
prolactin 6.1 range 4.0-15.2
shbg 19.9 range 16.5-55.9
dhea s 420.3 range 102.6-416.3

My estrogen was low and I still had Gyno pain on one side. This is glandular not just fat.
My doctor was concerned about the low estrogen and I 100% agree that it is way too low. He changed my AI dosage and my labs as of 4/26 show:

testosterone 799 range 348-1197
free test 24.7 range 8.7-25.1
estradiol 36 range 7.6-42.6
prolactin 8.8 range 4.0-15.2

Now I have gyno pain and glandular gyno on both sides. I feel my estrogen is a bit high so the doctor agreed to alter my AI once more and will get labs done in a month or so.

What else could it be? I had full blood work to check everything (liver kidneys etc.) and everything comes out fine.

Im not concerned with the visual appearance of the gyno but more so the pain.

Ive had low T and low E. Ive had high T and low E. Ive had High T and mid E but the problem seems to continue. Surgery is an option but I don't want to spend the $$$ just to have it resurface again.

Any suggestions would be greatly appreciated

 

[CoastWatcher]

36yo male. On trt due to secondary hypo.

It was I found out I was secondary because I was developing gyno on my left side. Doctor did some labs and a mammogram and found the cause was low t.

After 4 years of HCG and clomid therapy I decided to begin TRT. Though out the entire 4 years of treatment (hcg and clomid) I still had gyno flare-ups which was why I decided to go to TRT.

Here is the issue. On TRT I am still having GYNO pain.
My labs on 3/17/17
testosterone 832 range 348-1197
free test 24.1 range 8.7-25.1
estradiol <6.0 range 7.6-42.6
igf-1 192 range 88-246
prolactin 6.1 range 4.0-15.2
shbg 19.9 range 16.5-55.9
dhea s 420.3 range 102.6-416.3

My estrogen was low and I still had Gyno pain on one side. This is glandular not just fat.
My doctor was concerned about the low estrogen and I 100% agree that it is way too low. He changed my AI dosage and my labs as of 4/26 show:

testosterone 799 range 348-1197
free test 24.7 range 8.7-25.1
estradiol 36 range 7.6-42.6
prolactin 8.8 range 4.0-15.2

Now I have gyno pain and glandular gyno on both sides. I feel my estrogen is a bit high so the doctor agreed to alter my AI once more and will get labs done in a month or so.

What else could it be? I had full blood work to check everything (liver kidneys etc.) and everything comes out fine.

Im not concerned with the visual appearance of the gyno but more so the pain.

Ive had low T and low E. Ive had high T and low E. Ive had High T and mid E but the problem seems to continue. Surgery is an option but I don't want to spend the $$$ just to have it resurface again.

Any suggestions would be greatly appreciated

Can you explain what you mean when you wrote your secondary diagnosis was made on the basis of gynecomastia? I don't understand what that means. What are the details of your TRT protocol? Have you had surgical excision of tissue, or has your treatment been specifically medical? This is genuine pain you are dealing with, as well as the classic changes to the nipple/breast/chest area?

 

[jeff7]

The gyno caused the doctor to look for a reason and found I was secondary.
Trt is 180 mg split 3xs a week. HCG 500 iu 3 xs a week. .25mg anestrazole 3xs a week.

No surgery yet.

No change in the nipple. A very small lump under the nipple and that lump is very painful.

 

[Vince]

Is that the right estrogen test, you need Sensitive Estradiol Test for men.
https://www.excelmale.com/forum/sho...d-be-Tested-with-the-Sensitive-Estradiol-Test

 

[CoastWatcher]

This has been going on for four years? At a certain point, only surgery can eradicate gyno. I would schedule a surgical consultation.

 

[jeff7]

I spoke with a surgeon and understand that surgery is the only way to remove it. My concern is if I can not find the underlying cause then it will reappear after having the surgery.

 

[jeff7]

If it is not the sensitive test they are running then wouldn't my estrogen be even lower?

 

[CoastWatcher]

If it is not the sensitive test they are running then wouldn't my estrogen be even lower?

The standard test is unreliable. In most cases it over reports, but we have members who have had the opposite happen. Bottom line - the sensitive test is the only one that men should run.

 

[CoastWatcher]

I spoke with a surgeon and understand that surgery is the only way to remove it. My concern is if I can not find the underlying cause then it will reappear after having the surgery.

The underlying cause is important and should be identified if possible. However, if the entire gland is excised at the time of surgery there will be nothing left to spark a recurrence. Problems tend to arise when the procedure is inadequately done or, for sculpting and contouring purposes, a tiny bit of gland is left in place. In those situations a recurrence is possible.

 

[AbsoluteZ3R0]

I spoke with a surgeon and understand that surgery is the only way to remove it. My concern is if I can not find the underlying cause then it will reappear after having the surgery.

Like Coastwatcher said, if they remove the gland (which they should), it will be impossible to get gyno again even if your E2 is out of control.

 

[Vince Carter]

ALong with the great advice above ask if you can get your Progesterone tested. In the mean time there's some info if you google it about Male Progesterone and Gyno, some men reporting that Prog therapy (an OTC cream easily applied) has helped them combat gyno.