Activity in my gland/breast due to high Estrogen

[problem man]

I always had some kind of activity going on in the breasts. Whenever i masturbate, the activity would increase. Otherwise, it would remain calm, but some breast increasing activity always took place in my breasts. So i had my Hormones checked. The results showed i had high Estrogen levels. My Endo prescribed me Tamoxifen 10mg for 3 months. For the first one month, i did not notice any change. But in the first 2 weeks of the second month, the activity in the breast had disappeared. i was very happy, i thought i could get the surgery done soon. But in the 3rd and 4th week, it again appeared back. Now i am in the 3rd month, but,  Tamoxifen 10mg is not available in any store near my area(they say its out of stock). I am not taking Tamoxifen for the past 1 week. Now, the activity in my breast has elevated to 4 times what it used to be. And, it gets worse whenever i masturbate.

Is there any permanent solution to reduce estrogen? In my case, the estrogen level has definitely increased after i stopped taking Tamoxifen.
Has anyone been successful in reducing estrogen permanently?

[Time_to_fix_it]

Hi,

It’s time to go back to your Endocrinologist and explain your situation.
   
Firstly you need to understand what Tamoxifen is and how it works.   Tamoxifen is an Anti Oestrogen, and to put it very simply it stops the oestrogen receptors in your breast tissue from taking up the oestrogen that is in your blood. There is no point in going into how it does this at this stage but it is all very clever.  Tamoxifen is often the first medication prescribed by doctors/endos when gynecomastia is diagnosed and/or breast tenderness/pain is present.  Dosage rates can be altered to suit individual patients and it might be that your Endo will increase yours.

There is one important thing to remember about an Anti-Oestrogen like Tamoxifen and that is it doesn’t lower the oestrogen (oestradiol actually which is the most potent form of oestrogen) levels in your blood, it just stops the breast tissue from taking up that oestradiol.  In effect the oestradiol levels in your blood will increase because it has nowhere to go.  So if you come off the anti-oestrogen, the oestrogen receptors in your breast tissue suddenly take up the increased amounts of oestradiol that are in your blood.  This would explain the greatly increased activity when you stopped taking it.  After a short period of time the levels will probably return to their previous levels which you say were high anyway.

Your Endo has a number of options and it’s not for me (a layman) to suggest what he should do.  It’s my guess he will consider increasing the dosage of the Tamoxifen.  Another guess would be to switch you onto a different sort of drug called an Aromatase Inhibitor which actually reduces or stops (depending on dosage) your body from producing most of its oestradiol in the first place.  Either way if I were you, I would want to know why my body has such high levels of oestradiol in the first place, so I would be pressing the Endo to carry out all sorts of tests on my thyroid, testicles, adrenal glands, liver, kidney and pituitary gland.  If he is a good Endo he will be thinking along these lines when you go back to him to tell him what has happen to you.

Is there any permanent solution to reduce estrogen? In my case, the estrogen level has definitely increased after i stopped taking Tamoxifen.
Has anyone been successful in reducing estrogen permanently?

The answer to both of these questions is yes, so go back to your Endo.  Good luck and keep us informed.

[problem man]

Hi, thanks for the wonderful reply. I did get the Scrotal ultrasound and Breast ultrasound tests done on my Endo's suggestion, the results said everythings normal. I will enquire about the other tests that you have mentioned.

But, strangely my Endo said that i could go ahead with the surgery even with the high estrogen. He said, if the gland is skillfully cut, the gyne won't return. I told him, some 5% of the gland will be left due to concavity problems and the gland might grow back if estrogen is not treated. He did not agree. Let me see what happens this time...  I will surely keep you guys informed in this thread.

I would be happy to know, if anyone in this forum have been successful in permanent estrogen reduction?

[15ineedhelp]

What kind of "activity" is happening?

[moobius]

you're having worse problems now than before b/c while you were taking the Tamoxifen, it was competeing for estrogen receptors in your body... your body was still producing Estrogen and your circulating levels probably went UP while on the Tamox...

once you dropped the Tamoxifen, your system got a mega dose of estrogen.

picture the tamoxifen as a dam with a river of estrogen building up behind it. stopping the tamoxifen was like blowing the dam


as for the masturbation aspect... that's in your head.

[Time_to_fix_it]

once you dropped the Tamoxifen, your system got a mega dose of estrogen.

picture the tamoxifen as a dam with a river of estrogen building up behind it. stopping the tamoxifen was like blowing the dam

An excellent analogy Moobius, it explains it perfectly.

Maybe there is a lesson here for us all about starting (and stopping) medication i.e. not to be done unless under medical supervision.  I would like to think that an Endo or doctor would explain this effect to any patient s/he was taking off an Anti-Oestrogen, but a cynic would only smile at that. 

[problem man]

What kind of "activity" is happening?

I don't know how to explain this, its like, there is some discomfort in the breast area. its definitely not pain related.

[problem man]

you're having worse problems now than before b/c while you were taking the Tamoxifen, it was competeing for estrogen receptors in your body... your body was still producing Estrogen and your circulating levels probably went UP while on the Tamox...

once you dropped the Tamoxifen, your system got a mega dose of estrogen.

picture the tamoxifen as a dam with a river of estrogen building up behind it. stopping the tamoxifen was like blowing the dam


as for the masturbation aspect... that's in your head.

I had posted about the Masturbation thing about 3 yrs ago in this forum. Couple of guys agreed with me, even they were facing similar problems. It is really happening to me. Maybe, mine is a unique case. I explained this to endo, even he said there is no relation between Gyne and Masturbation.
During the first two weeks of 2nd month of taking Tamoxifen, both this boobs/gland activity and masturbation thing had disappeared. It returned back during the 3rd and 4th week of the 2nd month.
Today, i managed to buy Tamoxifen 10mg from other part of my city. I will be taking it for another month and will see how it goes...

[problem man]

I finished the 3 months cycle of Tamoxifen. I did not benifit in anyway. The only thing it did was to soften my gland a little bit.

There is one important thing to remember about an Anti-Oestrogen like Tamoxifen and that is it doesn’t lower the oestrogen (oestradiol actually which is the most potent form of oestrogen) levels in your blood, it just stops the breast tissue from taking up that oestradiol.  In effect the oestradiol levels in your blood will increase because it has nowhere to go.  So if you come off the anti-oestrogen, the oestrogen receptors in your breast tissue suddenly take up the increased amounts of oestradiol that are in your blood.  This would explain the greatly increased activity when you stopped taking it.  After a short period of time the levels will probably return to their previous levels which you say were high anyway.

I spoke to my Endo about this, he says when Tamoxifen stops the breast tissue from taking up estrogen, the estrogen in blood won't increase, instead the estrogen is excreted through urine.
About the increased activity in my breast when i stopped taking Tamoxifen : he said it is not possible. i could not explain to him further about this problem.

Your Endo has a number of options and it’s not for me (a layman) to suggest what he should do.  It’s my guess he will consider increasing the dosage of the Tamoxifen.  Another guess would be to switch you onto a different sort of drug called an Aromatase Inhibitor which actually reduces or stops (depending on dosage) your body from producing most of its oestradiol in the first place. 

I asked him to prescribe Aromatase Inhibitor like Letrozole which stops the production of Estrogen. But, he said after i stop taking it the hormone levels will again return to the previous levels. He asked me to get surgery instead of wasting another 3 months on Letrozole.

I forgot to ask him why my body has high estrogen. Can anyone throw some light on this?

Will my Estrogen return back to previous levels after i stop taking Aromatase Inhibitor like Letrozole or anastrozole?

[Time_to_fix_it]

I finished the 3 months cycle of Tamoxifen. I did not benifit in anyway. The only thing it did was to soften my gland a little bit.

There is one important thing to remember about an Anti-Oestrogen like Tamoxifen and that is it doesn’t lower the oestrogen (oestradiol actually which is the most potent form of oestrogen) levels in your blood, it just stops the breast tissue from taking up that oestradiol.  In effect the oestradiol levels in your blood will increase because it has nowhere to go.  So if you come off the anti-oestrogen, the oestrogen receptors in your breast tissue suddenly take up the increased amounts of oestradiol that are in your blood.  This would explain the greatly increased activity when you stopped taking it.  After a short period of time the levels will probably return to their previous levels which you say were high anyway.

I spoke to my Endo about this, he says when Tamoxifen stops the breast tissue from taking up estrogen, the estrogen in blood won't increase, instead the estrogen is excreted through urine.
About the increased activity in my breast when i stopped taking Tamoxifen : he said it is not possible. i could not explain to him further about this problem.

I stand by what I said in my earlier post that when a patient is on Tamoxifen the oestrogen levels in the blood will rise because the oestrogen receptors in the breast aren’t taking it up.  I base that on what 2 Endocrinologists have told me in the past when it happened to me and I have the lab results to prove it.  Incidentally one was a Professor of Endocrinology.  If (as your Endo says) the oestrogen is excreted through the urine (which I am not qualified to doubt), then why isn’t it excreted through the urine when a patient isn’t on Tamoxifen?  If that was the case then surely any excess a patient had would always be excreted through the urine and we wouldn’t have elevated levels of it?

I asked him to prescribe Aromatase Inhibitor like Letrozole which stops the production of Estrogen. But, he said after i stop taking it the hormone levels will again return to the previous levels. He asked me to get surgery instead of wasting another 3 months on Letrozole.
 

What your Endo has said here surprises me.  If you have elevated levels of oestrogen which is causing your gyne then why isn’t he investigating the reason for those high levels?  Surgery will only work to get rid of your gyne if ALL of the gland is removed.  If the underlying cause of your high oestrogen levels aren’t addressed those high levels will act on any remaining gland giving it the potential to re-grow.  My understanding is that the gland is often mixed in with the adipose (fatty) tissue and it is very difficult for a Plastic Surgeon to remove all of it (short of a full mastectomy).  Some fat (and therefore gland) is always left in the chest to maintain a contour or we would be left with disfiguring hollows.  Dr Bermant on here often comments on sculpturing the fat in the chest to give a proper shape during gyne correction surgery.

I forgot to ask him why my body has high estrogen. Can anyone throw some light on this?

 

There are a number of reasons why a male can have high levels of oestrogen.  You might be interested in the following data.  The following causes of gynecomastia and percentages are taken from a medical paper .. The Endocrinology of Gynaecomastia by AAA Ismail and JH Barth (Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, England.)

Cause                              (%)
Idiopathic (unknown)          (25)
Puberty                             (25)
Drugs                             (10-20)
Cirrhosis or Malnutrition       (8 )
Primary Hypogonadism         (8 )
Testicular tumour                 (3)
Secondary Hypogonadism      (2)
Hyperthyroidism                   (2)
Renal Disease                       (1)
Others                                 (6)

Will my Estrogen return back to previous levels after i stop taking Aromatase Inhibitor like Letrozole or anastrozole?

Yes, if the underlying cause of your high levels isn’t addressed then when you come off the aromatase inhibitor your oestrogen levels will rise again giving the opportunity for your boobs to grow.

To sum up, if I were you I would want to know why my levels were so high and how they can be corrected.  If the Endo you saw can’t tell you this then I would be looking for another, one who specialises in the male reproductive system.

I have read several times on here of patients who's boobs have re-grown because the underlying reason for their high levels of oestrogen haven't been corrected or treated. 

[problem man]

Time to fix it, you have been more helpful than my endocrinologist man.

Right now, i am having a terrible activity in my left gland. I will meet my Endo again tomorrow and will ask him to investigate the reason for high level of estrogen.

So far i have tested all the important hormones like Testosterone, Prolactin, TSH, HCG-beta and ofcourse Estrogen. I have skipped LH, FSH and Progesterone. Now i want to get this tested too, but should i wait for a couple of weeks so that Tamoxifen exits my body? otherwise the test results might get messed up. what do u think?

I am guessing even you had high estrogen since you were taking Tamoxifen. Can you share with us how you managed to permanently reduce estrogen? and what was the cause for high estrogen in your body?

[Time_to_fix_it]

So far i have tested all the important hormones like Testosterone, Prolactin, TSH, HCG-beta and ofcourse Estrogen. I have skipped LH, FSH and Progesterone. Now i want to get this tested too, but should i wait for a couple of weeks so that Tamoxifen exits my body? otherwise the test results might get messed up. what do u think?
 

In my experience I was told to wait about a month to 6 weeks for the Tamoxifen to completely clear my system, because it will affect the levels of Testosterone, LH and of course oestradiol.

I am guessing even you had high estrogen since you were taking Tamoxifen. Can you share with us how you managed to permanently reduce estrogen? and what was the cause for high estrogen in your body?

When my gyne developed in my middle 40s I was tested and found to have high levels of oestradiol.  All other hormones were within the normal range albeit testosterone “low normal”.  I won’t bore you with all the tests, scans and medical investigations I underwent but suffice to say some of them were a little unpleasant.  Eventually the doctors drew a blank and my cause was classed as idiopathic (that is to say they didn’t know).

Like you I was eventually put on the anti oestrogen Tamoxifen for a couple of months, the sensitivity disappeared and the growth stopped.  However because the tests and investigations took place over a 2 year period (the UK National Health System (NHS) is painfully slow), the gland was set and didn’t dissipate.  I came off the Tamoxifen after a couple of months and because the sensitivity and growth did not return, the local Endo thought the problem (whatever it had been) had resolved itself.  The amount of growth wasn’t too bad and I elected to live with it.

A couple of years later the whole thing started up again for no apparent reason.  I was put back onto Tamoxifen but after an initial period of a month when it seemed to be working, the sensitivity and growth returned.  The dosage was increased to no effect.  There then followed another slow period of further referrals to a more experienced Endo and eventually a Professor.  Further scans were done of adrenals, testes etc, all of which took time during which the boobs grew to an unacceptable level as far as I was concerned.  The Professor eventually prescribed an Aromatase Inhibitor (AI) which my local GP and Primary Care Trust refused to fund so I eventually gave up on the NHS and saw a world leading Andrologist privately.  He immediately put me on an AI which as you will know reduces/stops the conversion of test to oestradiol, and all my hormones settled into place.  The oestradiol levels plummeted, testosterone increased and SHBG dropped.  The outward signs of growth and sensitivity disappeared making me feel confident that if I had surgery then the chances of re-growth would be very low indeed.  I had the surgery privately (because again the NHS wouldn’t fund it) about 8 months ago and I am still on the AI.

What the future holds for me is uncertain.  I understand that I will be taken off the AI from time to time to see if I continue to need it. There is something called Aromatase Excess Syndrome which it is possible I have if no other cause like liver, adrenal tumours etc materialise.

I would point out that I am on regular 6 month check ups with the Andrologist to monitor my Endocrinology, Biochemistry and Haematology.  These are necessary to monitor not just the hormone levels but also red and white blood cell counts, PSA, cholesterol, zinc, triglyceride etc levels (and about 30 other things).  All of which are necessary I’m told when using an AI.  A quick word of warning here to anyone thinking of self medicating not only an AI but also an Anti Oestrogen, they will affect more than your oestrogen levels and things can go horribly wrong if you don’t have an Endo checking you over on a regular basis .. end of rant and end of history lesson.

Apologies for all that .. but you did ask 

[problem man]

Then even i will hunt for a new Endo, since my present endo does'nt seem aggressive enough to investigate my high estrogen levels. He is also not accepting of my having activity/discomfort around gland/boob area.

Today one of my forum mate is getting surgery, even he is having high estradiol levels, he is getting 100% of his gland removed. If his gyne does'nt return, then i might get surgery done with the same surgen. Till then, i will see what can be done to set right my estrogen levels.

btw, reading about ur hormonal history was interesting and informative. Thanks again.

[iwannabefree]

dude i'm really curious wat u mean by activity, is it discomfort border line pain? cuz i kinda feel that from time to time.

[problem man]

dude i'm really curious wat u mean by activity, is it discomfort border line pain? cuz i kinda feel that from time to time.

I am not finding the right word to describe my problem. As i said before, i feel uncomfortable or discomfort in my boob/gland area, something is happening there all the time. It means the excess estrogen in my body is doing its job. High estrogen levels are increasing my gland size. From the last couple of days, i am having extreme activity in my left gland, it is as worse as pain but it is not pain.
A guy named Plato had earlier described this problem as tingling sensation in boobs. This happened to him after he stopped taking Tamoxifen after a month. But this problem of mine has started ever since i had gynecomastia and it looks like it is becoming worse now after i stopped tamoxifen.

I am curious to know if your hormones are normal or not, did you test them?