As long as we are ceding control of estrogen management to aromatization I believe we are operating on a very slippery slope, one with many variables, some of which we may not be even aware. I believe this has been seen time and time again. It only takes a simple search on a forum to reveal numerous "my estrogen is too high/low" posts. Most of which reiterate my own experience. Certainly it is not the most concerning issue for the majority of trt patients, which is why I don't believe it's been given enough consideration, but for those of use who are on that teeter totter it is difficult to sit back and hope the AI/SERM is the correct choice, hope the dosage is correct, maintain testosterone dosage exactly, watch for interactions with other medications, supplements, and diet, not get any fatter or leaner (remember aromatase has a direct relationship with adipose tissue), etc....