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What is testosterone replacement therapy? How does Estrogen effect my testosterone levels or how I feel?  What is Estradiol or E2 and what do I need to know about estradiol monitoring?  Why is it important to monitor estrogen level before getting TRT? What if my estrogen level is elevated, should I still be treated or not? What are the downsides of TRT? Is it dangerous?

These are some of the most common questions most men ask during testosterone replacement therapy. Read below to know more about this treatment.

What is Testosterone Replacement Therapy?

Testosterone Replacement therapy

Testosterone replacement therapy (TRT) is a medical treatment that aims to restore hormone levels back to a normal range without any significant side effects or safety concerns. More importantly, it should alleviate the symptoms associated with the hormone deficiency.

The ultimate goal of TRT is to regain and maintain the highest quality of life, compress major illnesses and reduce disability; and add life to years.

Estradiol Monitoring: Why is it important to monitor estrogen level before getting Testosterone Replacement Therapy?

As a Man’s testosterone level decreases, typically his estrogen levels are increasing.  Testosterone replacement therapy can also lead to elevations in estrogen level in some men who convert a portion of their testosterone supplementation to Estradiol. In some cases, the level could be above the normal range. While TRT is not about jacking up a man’s testosterone, it should also not be about suppressing his Estrogen or Estradiol/E2.

When the estrogen levels increase, a person may develop breast or nipple tenderness (gynecomastia), which may call for the use of aromatase inhibitors (AIs) – a potent estradiol-suppressor that is primarily used as an adjuvant treatment for breast cancer by lowering estrogen and thereby reducing the stimulation of estrogen receptors in such disease. 

Some doctors prefer stopping TRT first when symptoms of high estrogen levels are becoming apparent rather than managing it through AIs.  Many doctors, and Broscience websites, promote the absolute use of aromatase inhibitors during TRT despite the absence of symptoms or signs of increase estrogen or Estradiol. They believe that keeping a relatively low estrogen concentrations can boost the effectiveness of TRT and improve male health.  This approach, however, can cause other problems.

We at Hormone Therapeutics follows medical protocols and believe in treating the symptoms and the blood tests.  The Total Testosterone:Estradiol ratio needs to be kept below 5%.  We believe in monitoring and maintaining this level.

What if my estrogen level is elevated, should I still be treated or not?

Estrogen levels in some men administered with aromatase inhibitors have levels that sink below 40pmol/L, which may pose increased risk on bone health, energy and emotional health.

Perhaps the only study that can compare the use of TRT with and without anastrazole were in men diagnosed with hypogonadism, hyposexuality and epilepsy. The first trial revealed a positive effect on the sexual interest with the addition of testolactone therapy.

On the second trial that involves men reported an increase in libido among men treated with anastrazole and testosterone alone. However, this trial didn’t attain statistical significance because some men from the T-alone group also reported increase in sexual interest despite an increase in their estrogen.

However, these studies must be taken with caution because it isn’t clear how the group compares with the bigger group with low-T. This group were also treated with antiseizure drugs which increases SHBG (Sex hormone-binding globulin) – a glycoprotein that attaches to the two sex hormones, estrogen and androgen.

Therefore, there is no solid evidence to support the claim that the use of aromatase inhibitor in conjunction with TRT provides benefits more than that provided by TRT alone.

Do You Need Help?

Hormone Therapeutics is the leading national company assisting men who want to get their lives back through Hormone Replacement and Testosterone Replacement therapy. Our local physicians are ready to treat you anywhere in the entire country. Hormone Therapeutics is pioneering an easier, cost efficient and more private way for you to work with our clinical advisors and physicians from the privacy of your home or office after your local physical exam confirms you have one of the symptoms of Low T.

Contact us today and our clinical advisors will work with you on a hormone therapy program that may include prescribed hormones, exercise, nutrition and sleep programs to reclaim your vitality.

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