High Estrogen in Men After Injectable Testosterone Therapy The Low T Experience

[Gene Devine]

The take away here is that elevated E2 had much less impact on lower libido as compared to suppressed levels of E2. Good abstract.

High Estrogen in Men After Injectable Testosterone Therapy

The Low T Experience

Robert S. Tan,
Low T Institute, Southlake, TX, USA
Robert S. Tan, 3311 Richmond #205, Houston, TX 77098, USA.

Abstract

Testosterone replacement improves quality of life and is aromatized in men in adipose tissues to estrogen. Hyperestrogenism is believed to be harmful to male sexuality. This is a description of our experience of screening 34,016 men in the Low T Centers, of which approximately 50% were converted to treatment. Men were treated with injectable testosterone, and we have available data from 2009 to 2014. The data were extracted from our electronic health record (AdvancedMD) of 35 Low T Centers across the United States. In all, 7,215 (20.2%) out of the 34,016 patients had high estradiol levels defined as &#8805;42.6 pg/ml. Estradiol was measured using electro-chemiluminescence immunoassay. Of the patients who had high estradiol levels, the age distribution was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years; 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years. The difference between extreme age groups (<25 and &#8805;65) was statistically significant using a chi-square test (p = .013). The correlation coefficient of serum estradiol to age was .53,SD = 8.21. It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription. Our finding was that high estradiol levels were not associated with higher rates of low libido but established higher rates of documented low libido with those with normal or lower estradiol levels. The difference was statistically significant (p < .05).

 

[James]

Seems estrogen is really misunderstood with many guys. It's primarily a chick hormone, so I can understand why many guys (who haven't studied the importance or this hormone on men), would want to keep their levels super low. My levels are as high today as they have ever been and I feel good, but I did have a period where I think my body was adjusting that I didn't feel so good.

Regular Estradiol 37.6 pg/ml (7.6 - 42.6 )
Sensitive Estradiol 17 pg/ml (3 - 70)

This from 160 mg weekly cypionate (I'm now taking 140 mg), and never had an AI.

 

[Gene Devine]

Seems estrogen is really misunderstood with many guys. It's primarily a chick hormone, so I can understand why many guys (who haven't studied the importance or this hormone on men), would want to keep their levels super low. My levels are as high today as they have ever been and I feel good, but I did have a period where I think my body was adjusting that I didn't feel so good.

Regular Estradiol 37.6 pg/ml (7.6 - 42.6 )
Sensitive Estradiol 17 pg/ml (3 - 70)

This from 160 mg weekly cypionate (I'm now taking 140 mg), and never had an AI.

You look great and maybe perhaps a bit low (Sensitive assay) LOL.

 

[Nelson Vergel]

There is also this study :

High Estradiol Boosts Libido in Men on Testosterone Therapy

I have been warning men and clinics not to be so aggressive treating estradiol in men with the overuse of anastrozole. Here is a recent study done in Houston.


Elevated serum estradiol is associated with increased libido in men receiving testosterone replacement therapy (TRT), according to researchers.

In a study of 423 men on TRT, Ranjith Ramasamy, MD, working with Larry Lipshultz, MD, at the Baylor College of Medicine in Houston, measured subjects' testosterone and estradiol levels and asked the men to rate the quality of their libido using a five-point Likert scale (1= terrible, 5 = excellent). The researchers categorized the men as having low or high testosterone (below or above 300 ng/dL, respectively) and low or high estradiol (below 5 and above 5 ng/dL (50 pg/mL), respectively).

Men with high serum testosterone levels reported significantly greater libido than men with low level and those with high serum estradiol levels had significantly greater libido than subjects with low levels. In all, 60.4% of men with both high testosterone and estradiol levels reported very good or excellent libido (score as 4 or 5) compared with 31.3% of participants with both low testosterone and estradiol levels, the researchers reported in European Urology (published online ahead of print). These results are expected to be presented at the American Urological Association annual meeting in Orlando this May.

http://www.renalandurologynews.com/h...rticle/335894/

 

[DHM]

It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription= Bad HRT management?

 

[Nelson Vergel]

The first study posted (chart review from Low T Centers) used the old estradiol test that has been shown not to be good for men. The second one used mass spectrometry but not the ultrasensitive type. The Low T Center review shows that all men are given anastrozole with testosterone irrespective of their baseline estradiol blood levels. So, yes DHM....I agree with you about the fact that is poor management of men on TRT.

Look at this paper comparing the two estradiol tests used in men:

Comparisons of Immunoassay and Mass Spectrometry Measurements of Serum Estradiol Levels and Their Influence on Clinical Association Studies in Men



"In conclusion, our findings suggest interference in the standard immunoassay-based E2 analyses, possibly by CRP or a CRP-associated factor. Although this interference does not seem to affect association studies between immunoassay E2 levels and skeletal parameters, we propose a reevaluation of previous association studies between immunoassay-based E2 levels and inflammation-related outcomes. In addition, MS-based assays are to be preferred for the quantification of E2 levels in men."