Long Term SERM Use and Coming Off

About two years back when coming off test, i started developing Gyno. Being a student at the time I couldn’t afford surgery and tried to use several AIs and SERMs to reverse Gyno…which ended up harming my HPTA in the process.

Have been attempting to Restart a few times using Toremifene but would crash a month or so after coming off. I decided to give Clomid a shot…which I have never used and have been on it for about 2 weeks @ 50mg day. My sex drive both on clomid and when I was on torem is pretty damn good…but I feel like I am unable to come off. What’s my next step? should I try and taper down off clomid…or just stop and if it doesn’t take come off again?

Short answer: Taper off slowly and land on 0.5 mg anastrozole and cruise on that. Do the same anastrozole while on the PCT/restart.

SERMs increase estrogens. If you stop suddenly, your hypothalamus suddenly can see the estrogens and you shutdown. The taper protects from that and the anastrozole lowers estrogens and increases the possibility of success.

Read the advice for new guys sticky.

Time to get and post lab work. Meanwhile, you can evaluate your iodine intake and check body temperatures now to see if your thyroid is a player.

Should I be doing bloodwork while on clomid now that I have already started? Or at this point just after?

The anastrozole won’t have an effect on hpta suppression or cause a rebound when coming off, similar to what you are taking about as far as SERMs?

I was thinking of running the clomid at 50 for the month, then 25 for 2 months, then 12.5 for 3?

Anastrozole will keep E levels lower and prevent estrogen rebound = shutdown.

You could test LH/FSH, TT and FT. If LH/FSH is not showing well, you are cooked, otherwise the top end of the HPTA is performing well and if that and T levels are good, the testes are working well. Then if you finish PCT properly, you may be good to go.

If LH/FSH are strong on SERM, then the resulting T levels can be expected to be an upper limit or bound for your recovery.

If LH/FSH are high on SERM, this might not be a good idea and dose should be reduced. Not wanting to fatigue the LH receptors.

If you feel good on SERM, then LH/FSH and T must be in good shape and knowing that is as good as looking at numbers on a piece of paper.

SERM taper, work some EOD into your dosing at the end.

When you say EOD dosing are you referring to the clomid or the anastrozole?

also, would anastrozole be a better choice then something like exemestane (which I have already?) just curious for my own learning?

Exemestane/Aromasin works well for those were it works. You can take 10mg/day or 20 EOD for 70-140mg/week or you can take 1mg anastrozole per week. Anastrozole is usually more cost effective. Most can use anastrozole. The anastrozole over-responders will need to reduce dose to 1/4mg per week. A few can’t seem to find a balance with anastrozole or find that it does not agree with them. We have had some reports of exemestane working well when anastrozole does not. But a by far, most do well with anastrozole.

If the half life of a drug is good for EOD dosing, no need to take every day. For those injecting T and hCG EOD, doing the orals at the same time makes things easy.

When tapering off of a SERM that you are taking ever day, part of the taper at the end can be to take the lower dose EOD at a further step in tapering off.

So I have worked my way down to 12.5 mg of clomid every other day and am feeling decent. I’m not completely where I want to be, but I’m having sex around 2-3 times a week and feel pretty good.

I’m a little confused about how the physiology behind using an AI. Will I not have a similar estrogen rebound to coming off an AI as I would anything else? I have anastrozole but haven’t started implementing it yet.

I also have a few questions about my future plans. As of right now my plan is to taper off all drugs and so I can figure out how my bloodwork looks at baseline.

  1. will my body continue to recover hpta function without any outside intervention after I have come off?

  2. I have some concerns that although I am feeling pretty good and do have a sex drive that I do have some testicular atrophy. I’m planning on doing bloodwork before I make any decisions, but I am curious how I should approach this. Is it likely that as a 27 yo male I could convince a doctor to prescribe hcg? Should that even be my next route at all? thanks

Sorry I know this is a lot of different things to address all at once.

Update:

I ended up landing some HCG and have a few questions.

  1. I am still in the process of tapering off a serm, should I wait until I finish before I start?

  2. What would be the ideal protocol and dose for running a serm along side?

3)How long would it keep in the fridge if I waited.

I am down to 12.5 clomid ED right now and was planning on tapering down from there over the next 2 months.


So I got bloodwork done while on 20mg of nolva a day and 1mg of arimidex a week. I was pretty satisfied with the results. I am now on 1mg a week of arimidex split into two doses. Hoping to slowly taper off.


Sorry. Wrong page


My bad. Wrong page.

Serms plus hcg is wrong and makes zero sense…

I think once mixed hcg is good for a month.

Do not do hcg and a serm together taper off the serm and land on an AI

Do not use a SERM and hcg together, you will overstimulate the Leydigs in the testes. Personally, I would wait and come off everything and get a good baseline before adding anything else into the mix. Give your body a month to six weeks once clean and get more bloodwork done.

"Serms plus hcg is wrong and makes zero sense…

I think once mixed hcg is good for a month.

Do not do hcg and a serm together taper off the serm and land on an AI"

“Do not use a SERM and hcg together, you will overstimulate the Leydigs in the testes. Personally, I would wait and come off everything and get a good baseline before adding anything else into the mix. Give your body a month to six weeks once clean and get more bloodwork done.”

I’m not sure why you guys are saying that combining a SERM and HCG does not make sense and should be avoided. KSMan has said that they can be used together in low doses. For a guy who has limited success in raising T levels with a SERM, it makes sense that a small dose of HCG can increase his T levels. The negative HPTA feedback from the HCG is reduced by the SERM. I’ve used both Clomid, AI and HCG together for treating secondary in doses of…

37.5 mg ED Clomid ( Too high of a dose for long term use)
.25 mg EOD Anastrozole
125 IU HCG EOD

30 years ago at the age of 24 I had TT measured at 670. Last year I was at 263. I began 25 mg of Clomid ED in November but the progress was fairly slow. Adding the AI helped boost the level from 491 in March to 554 by April. Adding the HCG increased my T levels by 40 points. It’s a small increase but got it got me to 593 TT. Those 40 points made a huge difference in how I felt. My LH and FSH labs decreased from the HCG by 1 point each but are still 3.5 and 5.6. I’m planning on increasing HCG to 125 IU per day and lowering the Clomid to a more sustainable dose of 25 mg per day. I’m hoping Enclomiphene gets approved soon for long term use.

Ksman has never said that that I have heard… Ever… Number one hcg acts like lh and stimulates the testies to produce T also in turn would lower lh… Then you take a serm and ad it in and try to stimulate lh and fsh production… Both of these drugs are going to raise E2 inside the testies and your totally confusing the Hpta…

I guarantee you ksman has said many many times.

“NEVER use a serm and hcg together”

Do a search and you will see…

It’s your world man kick it around I could care less what you do and was trying to help…

Thanks for getting back to me. I was referring to the first KSMan post on this page…

He’s not a fan of HCG plus a SERM but he says that if they are combined, both should be a low dose to avoid high IT E2. I’ve tried to be careful to avoid overloading the LH receptors. I’m trying to find a sustainable protocol to stay within median ranges. Even though my urologist prescribed the 37.5 mg of Clomid per day, I’m looking for a way to reduce that. My Labcorp labs right before the HCG were…

554 TT
4.6 LH
6.7 FSH
38 E2 ( dropped to 26 after 4 weeks on HCG)

It looked like the nuts were putting out a fairly normal amount of T for the LH and FSH levels. I was hoping that a small HCG boost would not overload the LH receptors. The 593 level seems to be right about a median level for a guy over 50. Do you know if there is a lab test or any other way to monitor E2 levels in the testes ?

It dropped from 38 to 26 when adding hcg to a serm? Or when switching?

No man I don’t know how to measure E2 in the testies :frowning: sorry

It dropped from 38 to 26 when adding hcg to a serm? Or when switching?

No man I don’t know how to measure E2 in the testies :frowning: sorry

You were on 37.5 mg a day of clomid and lh and fsh were that low??

I’m confused here?? Right?? Lol either I’m misunderstanding something or something is not right here

[quote]iw84aces wrote:
It dropped from 38 to 26 when adding hcg to a serm? Or when switching?

No man I don’t know how to measure E2 in the testies :frowning: sorry

You were on 37.5 mg a day of clomid and lh and fsh were that low??

I’m confused here?? Right?? Lol either I’m misunderstanding something or something is not right here[/quote]

This text should have been with the quote above.

One month before the 38 E2 it was at 29.4. It went up to 38 even after adding .5 mg of Anastrozole per week. It dropped from 38 to 26 after I added the HCG to the 37.5 mg Ed Clomid and also increased the Anastrozole from .5 mg per week to .875 mg per week. The most recent test came in at 19.4 so I’ve backed off to .75 per week. None of these tests were E2 sensitive so I’m not sure how accurate they are.

It seems that Clomid response is usually better with younger guys. I liked Clomid and was lucky enough to have no negative side effects from it, but the dose seemed high for long term use which is why I tried adding the HCG.

This month I’m taking a break from the Clomid and HCG. I’m trying 20 mg of Tamoxifen every day plus .75 mg of Anastrozole per week. I felt great for the first 10 days or so when the Clomid was still in my system. I’ll get new labs in 10 days to see if the Tamoxifen works as well as the Clomid.