Below is the apparent position of using an AI while on TRT, per Defy Medical.
Studies of this nature are needed. Furthermore, E2 levels in some men treated with aromatase inhibitors decreased below 40 pmol/L, considered the threshold at which there is increased risk of developing osteoporotic changes.
"We therefore find no evidence to support the contention that relative reductions in E2 via the use of aromatase inhibitors or other agents in conjunction with TRT offer benefits beyond that offered by TRT alone.
Anecdotally, in our practice, there have been rare cases of men who failed to experience symptomatic benefits from TRT and were found to have elevated E2 concentrations. Some of these men have responded to steps to lower E2 concentrations, either by reduction in T dosage or by addition of aromatase.
However, these cases are anecdotal, and even if treatment was beneficial, the rarity of such occurrences does not justify the routine use of aromatase inhibitors together with TRT. Moreover, aromatase inhibitors may reduce E2 levels below a crucial threshold for bone health, and dual-energy X-ray absorptiometry (DXA) monitoring should therefore be considered for individuals receiving such therapy".
Estrogens in Men:
Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency Ravi Kacker, MD,* Abdulmaged M. Traish, PhD,Ã¢?Â and Abraham Morgentaler, MD* *Beth Israel Deaconess Medical Center, Harvard Medical School, Urology, Boston, MA, USA; Ã¢?Â Laboratory for Sexual Medicine Research, Boston University, Boston, MA, USA International Society for Sexual Medicine