T Nation

How to Identify Estrogen Related Issues?

I am getting ready to start TRT and I’ve been doing a lot of research on this forum. I see a lot of guys stating they had a lot of trouble before they got their estrogen levels set.

My question is what were the symptoms that eventually turned out to be estrogen related? There’s lots of info out there about what happens when T is low, I’m just trying to get an idea of what to watch for should I encounter estrogen related issues.

(My T, FreeT, SHBG, and E are all low at this point)

Google “trt low e2” and “trt high e2”

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Having low SHBG means you may struggle on TRT do to excess Free T and more to the point Free E2 which is responsible for the symptoms you hear about, overly emotional, bloating/high blood pressure, low libido, soft erections etc.

Being overweight only worsens these symptoms as a high body fat percentage increases estrogen.

Low Estradiol Symptoms:

  • Fatigue along the lines of sleepiness
  • hypersomnia (sleeping too much and too often)
  • strong erections but limited sensitivity
  • loss of erections
  • osteoporosis and osteopenia
  • joint pain, clicking or popping joints
  • eye fatigue (eyes seem more tired despite adequate sleep, dark circles)
  • loss of libido (interest in sex)
  • difficulty retaining water (constant urination)
  • anxiety, depression, irritability

High Estradiol Symptoms:

  • Soft erections, inability to maintain an erection
  • water retention (less frequent urination), leading to excessive sweating, blood pressure spikes or high blood pressure (from the water retention)
  • insomnia
  • hot flushing (flushing around the ears or on the face)
  • night sweats (from estradiol lowering, causing loss of water retention)
  • bloating; brain fog (like your head’s in a bubble)
  • testicles seem smaller than usual
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For me its: slightly emotional (think tearing up a little bit when thinking about something sad), weaker erections (sometimes my libido is still high) itchy nipples is the red flag for me.

Did this signify high or low e2 for you?

Also, thank you for your answer.


Low e2 is:
Joint/Tendon/Ligament Pain
Dry Skin, Eyes
Low Libido
Low motivatin