Sore Nipples. Not High E

I have just started TRT 6 weeks ago. The doc started me on a smaller dose (25mg 2 x week of cypionate SQ), along with 250IU of HCG twice a week. My labs came in and my T was the same as before TRT (remember, I started on a smaller dose) at 419 ng/dL, with a Free T of 22.8 pg/mL. My Estradiol, using the Roche ECLIA methodology, was a fairly low 20.7 pg/mL.

My doctor has now doubled the dose of cypionate to 50mg 2 x week. All fine and good.

The problem I have is that three weeks ago my nipples got ichy and very sensitive. This lasted for two weeks. Now they are only a little bit sensitive (thankfully), but still perpetually perky. What is causing this? I immediately assumed gyno from high Estradiol, but this doesn’t seem to be the same. Can anyone explain this?

–Me

EDIT: Had doubled my T cyp quantities because I’m spacing out today. Fixed. Forgot to divide total amounts by number of times taken.

200mg per week for TRT is not TRT. TRT is supposed to mimic natural testosterone levels, 419ng/dl is natural testosterone levels. Why are you on TRT to begin with if this was your testosterone reading before treatment? It’s average, where most males should be. Were you actually diagnosed with hypogonadism?

Personally I would just run clomiphene at 50mg per day for a few weeks with 20mg tamoxifen, drop the TRT and be done with it.

As for the itchy nipples. Are you only running the TRT and no other compounds? Have you had your prolactin checked?

The amount of T Cpyionate is less relevant than the blood serum levels of T (including Free T). Most men would do well in the 700 - 1100 ng/dL ranges. 419 ng/dL would be an acceptable average for a 77 year old. I’m 40. Before starting on the half dose of T cypionate, I was averaging around 350 - 375 ng/dL. Why would I run clomiphene and tamoxifen? Wut? My estradiol is 20.7…

Anyone else? Curious about nipple sensitivity when in low/normal ranges of E2.

–Me

You read all of those stickies?

Some guys, few, are T hypermetabolizers. Details not known, but typically need 300mg T per week to get where others are at 100mg/week. As the half-life is shorter too, injections should be EOD. So 300/7 * 2 every other day.

Try do always do labs half-way between injections to not be seeing lab timing artifacts.

Diabetic? Your TT:FT suggests low SHBG that diabetics have. So getting TT=900=1000 might not be appropriate for you. FT may be a better guide. This is based on an assumption that your FT range is ~<26

Starting TRT, there can be a transient period where nipples are hypersensitive to E2.

You are taking how much anastrozole?

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First of all, screwed up my numbers up top. Started with 25 units 2 x weekly, and am now going up to 50 units 2 x weekly. Heh. My bad, fighting a bit of a cold today and my head is in the clouds. Will edit above.

I am a type 1 diabetic, yes. And low SHBG. Glad to hear about a transient period where nipples get weirded out.

I am not on anastrazole. With an E2 of 20.7 I didn’t think it necessary. After looking at the bloodwork following my (this week) increase in T cyp dosage to 50 units 2 x weekly, I will or not depending on the lab results then.