Treating 5 week old testosterone replacement therapy induced gyno

[someguy01]

I'm a 36 year old male. Maybe around 15 pounds overweight but otherwise healthy and in good shape. I'm on doctor prescribed testosterone replacement - 100mg testosterone cypionate IM every 7 days, no aromatase inhibitor.

I've been on TRT for 8 weeks, had nipple symptoms for the past 5 weeks. It started with just puffy, pointy, sensitive nipples. Now it's progressed to also include some lumps underneath and my nipples look more pointy and cone shaped than they used to, especially when cold.

My doctor has been trying to avoid prescribing an AI but I think they're finally convinced. Once my new labs come back and confirm high e2 they'll prescribe an AI - probably arimidex or aromasin.

Basically, after 5 weeks of unchecked gyno symptoms I'd like to know:

1.  What are the chances of getting my pointy, cone shaped nipples and chest lumps back to normal using medication only, no surgery?

2. If it's reversible at this point, what medication protocol would you recommend? I'm not sure how knowledgeable my doctor is about this and I'd like to have some options and recommendations to show them at my appointment.

Thanks very much for any help you can provide.

[Litlriki]

Properly executed HRT should not lead to gynecomastia, and indeed, it should serve to prevent it from developing.  I would recommend that you follow your doctor's directions, and if you don't feel confident in his ability to manage your HRT, you should consider finding someone who can.  It's not a great idea to manipulate the variables on your own without laboratory follow up, since each drug you might use has it's own collection of possible side effects.  At this point, you need to determine if your estrogens are high, and if so, appropriate treatment should be instituted (and arimidex is probably a good option).  Such short term symptoms should resolve, but you should stay on top of it with follow up labs.

Rick Silverman

[someguy01]

Thank you. To be clear, I'm not considering treating myself. I'm just hoping to get a virtual second opinion on my doctor's treatment plan.

I'm currently waiting for lab results to confirm high estrogens and if confirmed my doctor will prescribe arimidex only.  I've read about treatment with a SERM in  conjunction with arimidex and was wondering if that would be recommended at this point. If so, I could ask my doctor to look into it and prescribe it.

If I'm understanding you correctly your opinion is that I should try treating with arimidex only for a while to see if that reverses the gynecomastia.  Is that correct?

[Litlriki]

I am not aware of other data that you've mentioned, but since I treat gynecomastia with surgery and not with medication, I don't know all of the medical literature.  It's certainly possible that other studies demonstrate more effective control of gynecomastia with medication.  Generally, however, the consensus in this forum has acknowledged a lack of efficacy for medical treatment of gynecomastia.  But for prevention during hormonal therapy, the steps you're taking are correct, and the Arimidex should be effective.

RS