Changing nipple shape on Testosterone replacement therapy

[someguy01]

I'm a 36 year old male, in reasonably good shape.  6' tall and 200 pounds.  I'd estimate that I'm at around 18% body fat.  I'm on doctor prescribed testosterone replacement therapy.  I inject 100mg of testosterone cypionate every 7 days.  I've been on the therapy for around 45 days now.  Around 3 weeks into the therapy I started noticing the changes in my nipples that I'll outline below. 

My doctor says my estradiol levels are fine and not to worry about it.  She seems very opposed to prescribing an aromatase inhibitor.  I'd like an expert opinion to help me determine whether to push the issue with her or with another doctor.  I don't want to risk permanent breasts or surgery by waiting to long.

Terminology:  I'm using "areola" to refer to the differently colored circles on my chest that contain the nipples.  I'm using "nipple" to refer to the part in the center of each areola that protrudes out beyond the flat portion of the areola.  I'm not sure how technically correct these definitions are, but I'll use them this way unless someone corrects me.

-My areolas seem "puffy," but I think they were this way before the nipple changes as well.

-When my nipples get cold, they become much more erect than they used to.  "Cold" can even mean a room temperature room with my shirt off. 

-The nipples, when erect, now stick out further and are more "cone shaped" when erect.  The nipples are now much wider at the bottom and take up more of the area of the areola.

-When I'm outside in cold weather, they get so erect that they begin to get sore.

-I don't notice any lumps behind the areola, but I'm not exactly sure what I'm looking for.  When the nipples are not erect I can push in on the nipple/areola area and feel a sort of cone-shaped indention below it, approximately the same diameter as the areola.  I notice no lumps or hardness within this area.  Immediately outside of the areola I feel some bands and lumps, but I think they may just be muscle tissue.  I also have some fat around my chest so it's difficult to tell anything with certainty.

So, my main questions are:

-Should Ibe concerned about pronounced nipple size/shape changes with no areola changes and no noticeable lumps or tissue growth underneath (unless I'm looking for this in the wrong way).

-My labs after 30 days on testosterone (approximately 10 days after I noticed the nipple changes) were Total testosterone:  505, estradiol:  42 (reference range <63).  Could this level of estradiol be causing this?

-Assuming this is the start of gyno, how long do I have from the onset of symptoms to get my hormones corrected before it becomes permanent and only treatable with surgery?

Thanks for any help you can provide.  I'm kind of freaking out here!

[Tonyp1]

Trt caused my Gyno.  Same regiment as you ='d elevated estro for me.  If you're having nipple/breast issues after starting Trt, I'd assume your estro is high.  Just because you're levels are "fine" in her words, doesn't mean it isn't having an effect on your body.  I started a aromatase inhibiter a couple of weeks ago and feel much better already.  No more sore/burny/itchy feeling.  Boobs are still there, but I'm much less aware of them because I can't feel them all the time. I knew right away that my estro levels were high, but had doctors tell me it wasn't an issue for years.  Don't make the same mistake I did.  I'm looking into surgery to get them removed now that I finally got the cause under control.