Help with Oestrogen Level Interpretation

Hi guys,

I am a 24 year old guy diagnosed recently with secondary hypogonadism. Specialist has put me on Testo Gel 50mg 5g gel sachet to be applied daily. I have now been taking for about three months. My total testosterone currently sits at 18mnol on a reference range that goes from 10-28mnol. When I began TRT my total testosterone was a mere 13.9mnol, so although not a significant increase, the gel is clearly working up to a point.

Unfortunately my oestrogen (E2) levels are troubling me somewhat. My most recent reading of oestrogen came back at 179pmol/L on a reference range that goes from 73-172pmol/L. Now, I have been told that the optimal oestrogen level for men on TRT is between 80 and 100pmol/L. In addition, I have physical symptoms suggestive of oestrogen dominance; bloating, random hot flushes, mild Gyno and mood swings.

Question to the guys on here is this: Could the elevated oestrogen levels be minimising the full benefits of the TRT gel? With numbers like these and symptoms, is it worth asking my specialist to consider low dose Aromatase Inhibitor? If so, what type and what dosage would you guys suggest?

Any guys on here in a similar position to me, please message back, including labs for your oestrogen and total and free testosterone. My SHBG was 46mnol on a chart that goes from 10-50mnol. Is this significant? Too high or too low?

Welcome your advice and your thoughts guys!

High estrogen inhibits testosterone’s effects on your receptors, high estrogen blocks T from entering receptor sites. I spent 3 month with high E2 (850+ ng/dL) and after a while it felt like I wasn’t on TRT anymore, so I lowered my dose and started feeling the way I did when my T was between 550-700 ng/dL. My doctor won’t prescribe an AI. You might be able to lower SHBG and better control E2 levels on injectables.


I spoke with my GP on Friday and he has prescribed for me an AI called Anastrazole (Arimidex). He has suggested that I take 0.5mg of a 1mg tablet two-three times per week, in conjunction with the 50mg 5g Testo Gel sachet.

Anyone on here used this sort of regime? I read that Anastrazole can actually raise sperm count and encourage a rise in testosterone. Could I potentially use the AI as a monotherapy and come off the TRT?

That AI dose seems a little high to me, I’m not sure how things are done with T cream only that it’s 1mg AI split on injection day per 100mg of T. Why shotgun things? This isn’t a race it’s a marathon.

Yes I have heard of guys on TRT taking up to 5mg of Anastrazole a week! The key here is balance: us guys need SOME oestrogen in our bodies for libido and bone density etc etc. However, with mine being so so high (180mnol on a reference chart that goes from 70-165mnol), I clearly have an oestrogen dominance issue.

I am experiencing symptoms that suggest oestrogen excess, like ED, bloating, Gyno getting thicker and mood swings. What dose of AI are you on, and which one do you take? I am on Anastrazole.

I’ve been messing around with my dosing for 8 months and would rather find the correct dose for me without an AI, and I think I found a dose that works without the need for an AI. I start converting excess E2 when I get near 800 ranges, but it makes no sense for a low SHBG guy to be that high in range because I simply don’t have enough SHBG to hold on to that much real estate. My SHBG can only hold on to a small fraction of all that T floating around in my blood.