T Nation

E2 Studies Needed


I am currently on HCG monotherapy for low T. Starting on 4/30, 500 iu 3x/wk has brought my TT from 141 to 640 on 6/5 (Quest: 241 - 827). I had another blood draw yesterday; should have results Tuesday.

Unfortunately, my E2 went from 1.5 pg/ml (3/29) to 3.9 (6/7), then to 4.9 (7/3). This is a saliva test with a range of 0 - 2.5 for males. I asked my doctor to test me again in early July as my libido had dropped, I was feeling very irritable and I seemed to be putting on some fat, especially in my chest (this is after marked improvement from the HCG for about 6 - 7 weeks of starting).

My doctor is a big believer in raising progesterone levels in men. He has had me applying a topical daily since the beginning. Those levels have increased significantly and he places great importance on one's E2/Pg ratio. He says Pg balances out the detriments of higher E2 (I understand this is controversial at best).

I am trying to (gently) convince him to prescribe an AI, although he is somewhat hesitant to do so.... however it is not off the table. He says that my irritability and lowered libido shouldn't be a function of the increased E if my T is where it is (hence the new test he sent me in for).

So I am trying to find some studies that show that elevated E2 can cause these symptoms even when T is normal. I am coming up empty so far and am hoping some here might know where I can find some.

I understand that the knee-jerk reaction is going to be "find a new doctor", however this one wasn't easy to find and is one of very few in my area. In addition, I have already shelled out over $1k in doctors visits and tests that insurance doesn't cover. I can't afford to re-do all of this.

I also understand that this sounds ridiculous considering my E2 is twice the high range (!!). He claims he has treated thousands that have had readings much higher than mine that enjoyed all of the benefits of higher T without the negatives. I am trying to tread lightly here with him as I don't want him to think I have an ulterior motive (which I don't) and he knows I lift. I just don't want to argue with him and have him shut down the discussion.

Any thoughts would be appreciated.


Clinical experience rules here. You will not find research papers talking about morning wood, mood and libido. Many guys are forced to self medicate.

250iu hCG EOD is a replacement dose for LH. Taking large amounts does force up E production in the testes.

You are injecting now. You could reduce hCG and inject T and not have such severe problems. If you were injecting and doing serum hormone levels, then specific dosing could be recommended.

High E2 from higher dose hCG is also quite resistant to adex. To get adex levels high enough to reduce T-->E2 aromatization in the testes which is driven by very high intratesticular testosterone levels [on high dose hCG], the amounts needed would severely block peripheral T-->E2 aromatization. Some of that is important for E2 produced in tissues for local use, such as in the brain and bones. Aside from the cost of high dose adex, if one were to achieve serum E2=22pg/ml, the result might be unhealthy and not result a proper sense of well-being.

I do not know that anyone knows a saliva equivalent to serum 22pg/ml. You can do your own serum E2 labs via LEF.org

Your doc is confident in his own ignorance.


Thanks for the response KSman. I figure that we will see a significant increase in T in my latest lab and will probably be reducing HCG accordingly. I should have guessed the saliva E2 tests weren't going to fly here, so I will order my own from LEF. If my doc doesn't come around with regard to adex, I guess I will consider taking care of it myself.

Also, do you have an opinion on the progesterone supplementation? From searching online, I see differing opinions: some think it's great, others think it's a recipe for gyno. Again, no studies I can find on the benefits of increased levels in males.


According to Dr. John Crisler (allthingsmale.com)...men should not take progesterone.