T Nation

Insomnia Since Starting TRT


I had a shot this morning, next one due on Sunday.
Would you choose arimidex over anastrozole?


My test should arrive tomorrow, I could have the results by next Tuesday, would you wait or simply take the anastrozole now? I clearly have an E2 problem, it’s been high since starting TRT.
I am also going to see my doctor about potentially switching to Test E


Man honestly just Switch to scrotul cream application. Less e2 conversion. Switch to test e won’t make a huge difference. Studies show that e2 is not as big an issue. It also does not Process through the liver. This makes me think it’s a much better change in order to relieve your sides.

I’m Not sure which to take anastrazole kills new estrogen From being created. I think the other eats up what’s sitting in the reservoir. I’d say you’d want the latter if I am correct. I’m Not sure though.

@systemlord what should be suggested?


The scrotal cream isn’t available to me unfortunately. I am pretty sure systemlord will suggest smaller more frequent injections as he has mentioned in his previous replies to me, only I can’t wait for another protocol to take effect, that would mean another 6 to 8 weeks, the thought of that is depressing :frowning:


Right it takes time. Find someone who will
Prescribe the cream you don’t have to wait. You dose and it’s the highest it’ll ever be within hours. Next day you can change dose and see if higher or lower helps. Sure maybe takes a few days to get used to it but changes in dosing with the scrotul application is immediate.


I second the anastrazol. Take .25mg now and see what that does! From my experience low dose Ssri is definitely not as effective as a higher dose. What have been the problems with sertraline exactly? If it’s nausea get yourself Omeprazol/Pantoprazol. I would recommend you starting with 20mg fluoxetin. It has such a long half-life it needs weeks to get to a constant level in your body. If you start with 5mg now you have 5mg in your system in a few weeks where I doubt it will do anything. It’s weird for me you reacted so bad to sertraline… What about xanax/alprazolam - you tried it? I would shoot for 1mg in your case. You could also use quetiapine this will definitely put you to sleep. How many mg promethazine did you take? Are you eating enough?


It’s like he’s tried everything and I would jsut take the next step and take something stronger to let me sleep for a few days when it’s most needed. Otherwise insanity is at the doorstep.

I would ask for Xanax so I could sleep . Unfortunately your bad off and something like melatonin probably wouldn’t help at all.


I thought that current wisdom suggested that high e2, when accompanied by a proportionally high T, was optimal. You had insomnia before starting TRT so logic suggests that E2 generated from from your Test dose is unlikely to be the cause of your problems. You could take an AI to verify this.

I think your problems are psychological.

Don’t be discouraged by the ineffectiveness of sleep meds. None of the drugs you’ve tried worked reliably for me, either.


High, low E2 can cause insomnia, so going from one end of the spectrum to the other, insomnia before and post TRT.

High E2 amps me up.


From everything I have read neither cream nor injections are believed to be hepatoxic. They are absorbed into the blood stream therefore do not have to be processed by the liver. Oral steroids are what you have to worry about being hepatoxic as they have to go through the digestive process. If I’m wrong someone correct me.

On the less e2 conversion I am not sure I agree with that anymore. Or at least confused by it, too much conflicting info out there. I am also on a cream and have had to deal with high e2 (although I do have some excess weight so could be that). Dr.Crisler did state that cream though has a higher e2 conversion as he believed the skin caused higher aromatase. Had a link to show where he stated that but Chris said I couldn’t put it.

On a side note though creams to the nuts increase DHT conversion which in turn blocks the negatives of high e2 so does it really matter as much?


No you apply to the balls and it side steps the issues you get from applying to normal skin. Injections stored in fat/muscle do go through liver. Unless I’m going mad.

Look at the study I recently posted. It’s not just the study that verified this it’s my doc whose been using it himself and with all his clients.

Crissler wasn’t applying to the boys. He was doing leg arms stomach


Al you have to do to find a study is google and you’ll find a couple with legit feedback.


Was this study you posted in this thread? I’ve googled and the different ways I’m wording it I am not getting anything to come up with these studies. A fellow gym goer who also used scrotal cream,who is in phenomanal shape, doesn’t drink still had to be put on an AI. I’m not trying to argue with you but I am starting to have my doubts and what Crisler stated has some merit to me. Skin is skin just some is thinner and allows better absorption but still would have to pass through the same aromatization enzymes there in the skin layer.


Google excel male scrotul cream study.

Your mistaking the two. I haven’t heard crissler ever talk about scrotul. Only topical and injections.

Also just because someoens put on ai does not mean they need an ai. We have no clue if he’s on HCG and etc.

I know your not arguing but you need to look at the differences of fact. Your comparing crissler but he didn’t talk about scrotul. I haven’t seen that.Share if so.he also said use ai and then reversed his course.


This was a point of confusion for me as well, but I was told that the aromatase does not happen upon application or injection, or even during absorption. It happens AFTER the T has been absorbed into the bloodstream. Based on this, I don’t understand the argument that gels or creams aromatase more or less vs injections subQ, or IM.

It’s all going to eventually boil down to serum levels and aromatase enzymes.


That is what I had initially believed also so I figured doing everyday application of cream I should not have too much of an issue with e2. With the belief that smaller more frequent dosing would minimize it just as those on injections tend to see. Hearing that from Crisler who was thought to be an expert has me questioning that line of thought though regardless of application site.


What he wrote was about all modalities of administration and he lumped both cream and gels together in discussing them. You are right about him not specifically stating scrotal vs elsewhere. But he did state the same argument for increase in DHT conversion which is known for scrotal . That is why it would make sense to me for e2 conversion also. The article was about what he does for his TRT patients and stating gels/creams is what would be his first method he would prefer to use.


Scrotal skin is thin and has high steroid permeability, but the pharmacokinetics of testosterone via the scrotal skin route has not been studied in detail. The aim of this study was to define the pharmacokinetics of testosterone delivered via the scrotal skin route. The study was a single-center, three-phase cross-over pharmacokinetic study of three single doses (12.5, 25, 50 mg) of testosterone cream administered in random sequence on different days with at least 2 days between doses to healthy eugonadal volunteers with endogenous testosterone suppressed by administration of nandrolone decanoate. Serum testosterone, DHT and estradiol concentrations were measured by liquid chromatograpy, mass spectrometry in extracts of serum taken before and for 16 h after administration of each of the three doses of testosterone cream to the scrotal skin. Testosterone administration onto the scrotal skin produced a swift (peak 1.9-2.8 h), dose-dependent (p < 0.0001) increase in serum testosterone with the 25 mg dose maintaining physiological levels for 16 h. Serum DHT displayed a time- (p < 0.0001), but not dose-dependent, increase in concentration reaching a peak concentration of 1.2 ng/mL (4.1 nm) at 4.9 h which was delayed by 2 h after peak serum testosterone. There were no significant changes in serum estradiol over time after testosterone administration. We conclude that testosterone administration to scrotal skin is well tolerated and produces dose-dependent peak serum testosterone concentration with a much lower dose relative to the non-scrotal transdermal route.


Sorry for hijacking your thread @pilchard.

Yeah just got done looking at that and was actually responding when your post showed up, lol. The study was very limited in scope to me though as they were actually healthy eugonadal men not hypogonadal and were looking at absorption rate of application not longer term effects. The fact that they were only looking at peaks over 16hr time frames is not enough data for me to say “yeah it has lower e2 conversion” especially when they were spacing the dosing’s out by 2 days . Don’t get me wrong I love my cream and feel awesome just question the lower e2 conversion aspect.


They exactly the same Drug. Arimidex is the brand name. Anastrozole is the generic.