Early Gyno Concern: Exemestane Question

[MLX]

I suspect my estrogen levels might be elevated and I’m worried about early signs of gyno. My lab results won’t be back for about two weeks, and I know gynecomastia can develop fairly quickly. Until I get the bloodwork back, how should I approach temporarily preventing excessive aromatase activity with exemestane—without completely crashing estrogen?

 

[unimog]

Hey man. First you have to access if you really have the symptons of high estrogen like feeling bloated and having an elevated BP. If so you could either use anastrozole or exemestane. the difference is that exemestane really stops aromataze while anastrozole binds to aromataze enzyme leaving it de-activative but once you stop taking those "de-activated" enzymes will start working normally and converting to estrogen. so anastrozole is more forgiving when you take a dose that is too high that crashes your estrogen, you just have to reduce it to reactivate them and bring e2 higher. exemestane even if you stop taking it you have to wait for your body to produce new aromataze enzymes and that will take longer. Since you are going for bloodwork in two weeks, if i were you and i was just afraid of gyno and didnt have other screaming signs of high e2 i would probably just use tamoxifen while waiting for results. Tamoxifen doesnt stop aromatization it just blocks the receptor in the breast, therefore prevents gyno and even reverts early gyno. Just one last note, tamoxifen seems like a good friend and it is, it stops gyno and raises hdl and lowers ldl, but you should not run it permanently as we see in some protocols because it is pro-trombotic. Smart thing to do is to run it for pct or for cases likes this were you kinda suspect you might have early gyno but you are not too sure if your e2 is high or not.

 

[MLX]

how do i know if i have gyno when do o need to start taking Tamoxifen or exemstan and how much for how long

 

[dr. Doping]

Just one last note, tamoxifen seems like a good friend and it is, it stops gyno and raises hdl and lowers ldl, but you should not run it permanently as we see in some protocols because it is pro-trombotic. Smart thing to do is to run it for pct or for cases likes this were you kinda suspect you might have early gyno but you are not too sure if your e2 is high or not.

Another thing to consider is SERMs lowering your GH and IGF1, probably as a consequence of its anti-estrogenic properties/activity. I would really advise avoiding SERMs and AIs unless they're REALLY needed since they also affect mood.

how do i know if i have gyno when do o need to start taking Tamoxifen or exemstan and how much for how long

If you plan on using steroids for the long run (longer than the next few years), then it's pretty much inevitable. You will need to get surgery at some point, also because it's just easier to not have to worry about. The early sign of gyno is an inflammation around the nipple/gland. That's the "itchy nipples" people talk about. Thats the best sign, besides bloodwork (I've heard gyno start developing at around 100 pg/dl levels of e2). In any case, you will need to be taking exemestane or tamoxifen for the whole duration of the cycle to control your e2 levels.

 

[MLX]

Another thing to consider is SERMs lowering your GH and IGF1, probably as a consequence of its anti-estrogenic properties/activity. I would really advise avoiding SERMs and AIs unless they're REALLY needed since they also affect mood.


If you plan on using steroids for the long run (longer than the next few years), then it's pretty much inevitable. You will need to get surgery at some point, also because it's just easier to not have to worry about. The early sign of gyno is an inflammation around the nipple/gland. That's the "itchy nipples" people talk about. Thats the best sign, besides bloodwork (I've heard gyno start developing at around 100 pg/dl levels of e2). In any case, you will need to be taking exemestane or tamoxifen for the whole duration of the cycle to control your e2 levels.

am i not complelty crashing my E2 if i take exe 2 times a week for months?

 

[dr. Doping]

am i not complelty crashing my E2 if i take exe 2 times a week for months?

I don't think anyone here can answer that. Different AIs are effective to a different degree in different people. If I understood correctly, you already did your bloodwork and are waiting for the results. If you are truly experiencing high e2 symptoms then it *might* be ok to start the lowest dose of exemestane (I suggest you just use a normal timing interval like E3D or something similar, since 2x per week isn't exactly stable) and assess the effectivity.

If the symptoms improve, then you nailed your dose,
if the bloodwork shows normal/acceptable levels (I like my estradiol to be around 60), then drop exemestane,
if the symptoms do not improve and the bloodwork shows high levels, then up the dose for the lowest increment possible.

Keep in mind you are on cycle for the x amount of weeks and you will have to keep taking an AI if you don't adress high e2 problems in some other way (reducing test, adding/raising a non aromatisable injectable steroid while redusing test or ading/raising an injectable that acts as an AI (primo and EQ are the only widely available injectables to work in this way))

 

[MLX]

i come come on tuesday i hope its not to late to start exemastan

 

[unimog]

what is your protocol like? how much test? looks like 500mg a week for those e2 values. not saying that you have gyno but you look like you are in ranges for that (over 100). I tried to read your cycle post but couldnt find dosages. also you are running tamoxifen?

 

[MLX]

what is your protocol like? how much test? looks like 500mg a week for those e2 values. not saying that you have gyno but you look like you are in ranges for that (over 100). I tried to read your cycle post but couldnt find dosages. also you are running tamoxifen?

350mg weekly 50mg daily injections uff i fuckef up last time i copy pasted somethinf need to fix

 

[MLX]

@dr. Doping @unimog so just to clarify:

I’m running 350 mg/week testosterone enanthate (daily injections). At home I have tamoxifen, Anastrozole (Arimidyn), Exemestane (Aromalyn) and tamoxifen as well.

My own labs are fine (E2 ≈ 116,4 pg/mL, no gyno symptoms). I’ll use exemestane and re-check in 3–4 weeks.

A friend’s prolactin is 30 ng/mL (ref ~15–16). I suggested zinc, ashwagandha, and stress management to help dopamine.

Any additional evidence-based ideas for lowering prolactin?

Thanks!

 

[dr. Doping]

@dr. Doping @unimog so just to clarify:

I’m running 350 mg/week testosterone enanthate (daily injections). At home I have tamoxifen, Anastrozole (Arimidyn), Exemestane (Aromalyn) and tamoxifen as well.

My own labs are fine (E2 ≈ 116,4 pg/mL, no gyno symptoms). I’ll use exemestane and re-check in 3–4 weeks.

A friend’s prolactin is 30 ng/mL (ref ~15–16). I suggested zinc, ashwagandha, and stress management to help dopamine.

Any additional evidence-based ideas for lowering prolactin?

Thanks!

Ashwagandha is probably counterproductive in this context since ALL herbals are a bit progestinic/prolactinemic. Realistically, it would probably be the best to just start using caber or pramipexole (or amphetamine, but I don't support that idea, lol)

 

[dr. Doping]

My own labs are fine (E2 ≈ 116,4 pg/mL, no gyno symptoms). I’ll use exemestane and re-check in 3–4 weeks.

That is quite high, I had this much e2 on 440 test per week, but this is just me. I don't have experience with exemestane, but your estradiol was quite high at a low bf%, so keep that in mind. It's good you don't have symptoms and even though your e2 was high, you caught it fast and acted, so no need to be afraid. If your gyno grew, it is probably just swelling and not yet actual gland growth. Find your sweet spot dose of exemestane and you'll be fine. Down the road, when you learn estrogen managment, you can use nolvadex and raloxifene to shrink the gyno. I'll make a thread about this in the next week, since I'm getting my bloodwork done tomorrow and then I'll be running ralox and nolva to improve my gyno situation.

 

[MLX]

That is quite high, I had this much e2 on 440 test per week, but this is just me. I don't have experience with exemestane, but your estradiol was quite high at a low bf%, so keep that in mind. It's good you don't have symptoms and even though your e2 was high, you caught it fast and acted, so no need to be afraid. If your gyno grew, it is probably just swelling and not yet actual gland growth. Find your sweet spot dose of exemestane and you'll be fine. Down the road, when you learn estrogen managment, you can use nolvadex and raloxifene to shrink the gyno. I'll make a thread about this in the next week, since I'm getting my bloodwork done tomorrow and then I'll be running ralox and nolva to improve my gyno situation.

Yeah, but like I said I don’t feel anything no itching, no warmth, no lumps, no swelling. Libido is great, I wake up hard every morning. If I notice anything in my chest I’ll jump on it right away, but many doctors i watched say that everyone’s body is different and that E2 also protects you. As long as it’s under about 150–200 and ur body can handle it and there are no symptoms, it’s fine.