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Any significant research into TRT will likely also discuss aromatase inhibitor and estrogen management.  You will definitely find this on the ‘Bro-Science’ bodybuilding sites focusing on bulking and supraphysiological dosages of testosterone and other anabolic-androgenic steroids that aromatize to estrogen and estradiol.  

What is an aromatase inhibitor  and what does it do?  

Aromatase is the enzyme complex that converts androgens like testosterone into estradiol in men.  Weight gain and aging increase the risk for testosterone conversion into estradiol.  Estradiol is the “bad estrogen”, responsible for issues including (often) prostate issues, gynocomastia and erectile/libido/hormonal problems. Men find aromotase in their fat cells and as they expand our estradiol will find itself increasing at the same time our testosterone levels dwindle.   

An aromatase inhibitors binds to aromatase, disabling it. 

Why take an aromatase inhibitor?

AIs will reduce Estradiol levels.  Symptoms of high estradiol include gynecomastia (male breast development and enlargement) and edema (fluid retention in the extremities).

Avoid or Reverse Gynecomastia – Estradiol plays a major role in gynocomastia and an AI like Arimidex (anastrozole) – occasionally letrozole is used – is quite effective in managing estradiol levels.  The most important thing is to blood test and measure the estradiol levels and look at is on it’s own and as a % of Total Testosterone levels.   if a man goes over a total testosterone of about 600 ng/dl, he will very likely need an aromatase inhibitor.  The symptoms for elevated estradiol can mimic those for low testosterone, including  mood issues, low libido, erectile dysfunction and other estrogenic side effects.

Did you really want to see a before pic?

Did you really want to see a before pic?

Clinical research has looked into the use of aromatase inhibitors as an option to testosterone replacement in older men, and to delay bone closure in adolescent boys who are short, to allow them to gain more height. 

 

Is Estradiol important?  Role in men of Estradiol:

Since Estradiol is known as a female hormone and elevated levels can cause gynecomastia or edema, many men believe they need to eliminate or suppress it.  This is not true, the body produces estrogens in men because we need it.

Estradiol is important in determining bone mineral density in men. Low levels may lead to bone loss and osteoporosis in elderly men.  Low estradiol levels increase fat and decrease sex drive and erectile function.

We do not know the optimal estreadiol range but do know that low levels are not good.  We also believe taking anastrozole without clinically diagnosed high estradiol levels and symptoms (gynecomastia and edema) can be counterproductive for men on testosterone therapy.  Get your advice from a trained HRT/TRT physician and not someone in the gym or a “Bro-science” website. 

Potential side effects of Aromatase inhibitors

Aromatase deficiency has been linked to increased insulin resistance, which is a precursor to type 2 diabetes. Animal studies have shown that an absence of aromatase in male rats increases insulin resistance as well as body fat, and “fatty liver” develops. When young, healthy men were given an aromatase inhibitor, they developed slightly increased body fat, particularly within the waist (i.e., intra-abdominal fat). This type of fat is associated with the development of metabolic syndrome, which includes insulin resistance.

Patients with low testosterone should be wary of automatically using aromatase inhibitors, due to a number of potential metabolic effects. For the AAS using bodybuilder, aromatase inhibitors can be necessary to combat aromatization from supraphysiologic testosterone and other AAS dosages.  The most important thing is to work under the guidance of a trained HRT/TRT physician and get tested regularly.

 

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Aromatase inhibitor benefits and side effects as part of Testosterone Therapy

Saleamp Design September 13th, 2016

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