I have been on TRT for 3 years. I tried unsuccessfully to go off trt sometimes because of high estradiol and testicular shrinking, but for the last 8 month I seem to have found my way to control both issues, and no use of any AI.
I even tried every day testosterone Injections but the very stable normal level of testosterone didn't work for me and I think it is due to accumulative effect, and the body needs some circadian rhythm to clear and level off things. With a dose of 100 mg per week (divided into ED doses) after 3 months I was having high estradiol, top normal Hematocrit, bloating, High BP...
Then, the last thing I tried (And is still working pretty good) was:
1.- Establish the minimum dose of HCG which keeps my testicles normal size: It is about 250 IU twice a week. That helps to control estradiol cause the more HCG, the more Estradiol Tescticles produce.
2.- Establish the maximum dose of testosterone I could use long term keeping pretty stable blood levels, without developing high estradiol levels and symptoms: It was about 78 mg per week: Undecanoate testosterone (Reandron, -Nebido in USA-) 200 mg every 18 days (that dose make me feel physically and mentally well, but no strong libido and erections)
3.- With the above mentioned "basal treatment" I added a weekly (once a week) dose of cypionate testosterone of 25 mg wich completes a total weekly amount of 100 mg testosterone which makes me feel amazing...
Those 25 mg make a small roller coaster that I consider key to control estradiol. Some times, during the week I feel a day like high estradiol symptoms are about to happen, but much before the next 25 mg cypionate dose y feel again pretty good and libido through the roof... Also, this way my mood is very stable along the week without swinging, I get to be always the same optimistic and proactive person, depressive mood don't happen.
If somebody finds this interesting, please, don't ask me for my recent labs, I quited persecuting my numbers, what counts for me is the way I feel (just better than ever). Once I feel dealt in with trt, I would take Lab tests only once a year.