Hello, I take finasteride for BPH. After a year on it I think I’m developing gynecomastia. I don’t seen anything in the mirror but in discussions with others the first sign can be nipple sensitivity. Not in the pleasureable sense, more of irritation. I can feel shirt fabric rubbing against the nipples. A blood spot test showed Estradiol 27 (12-56) and testosterone 453 (400-1200). I’ve used DIM but don’t know whether it’s working. I’d like to try Femara, a relatively new aromatase inhibitor. Anyone have experience with this?
I know that Femera (letrozole) can be very tricky to dose, and is also very powerful, enough that you risk dropping your E2 to near zero, which will have sides of its own and not good for long-term health. Your best choice would be to stop the finasteride and use another means to control your BPH. If that is not possible, I suspect that you will need to use an AI if you are gyno prone. Arimidex (anastrozole) would be a better choice.
Talk to your doctor about alternate treatment options. Saw palmetto is known to provide some relief from symptoms.
Okay I lied about the Finasteride. My urologist prescribed it. I’ve donated blood regularly for 30 years. Finasteride is on the list of banned medications for anyone donating blood. I didn’t want to give up donating. I tried Saw Palmeto but didn’t see a response and quit. I kept seeing ads: Pee like a racehorse. They were ads for beta-sitosterol. So I’ve been using it for the past year. Just recently while lurking on MedLine I read abstracts that suggest beta-sitosterol is an alpha reductase inhibitor, same as finasteride. The problem was it worked. I was sleeping 7-8 hours a night without trips to the bathroom. My urologist hadn’t heard of Femara. My research suggested it was a better alternative to older aromatase inhibitors. I hadn’t expected that you guys would already have a ‘sticky’ on the stuff.
So I found a new urologist and am seeing her in two weeks. I looked up Dr Chrisler. I haven’t had the symptoms that he talked about on finasteride use.
Gyno with E2=27 does not look like something that should happen. Which raises the possibility of prolactin problems.
Lower E2 and that may improve the prostate situation. E2 is probably a bigger risk than T or DHT.
Femara has absolutely no advantages over Arimidex/anastrozole. In your situation, 0.5mg anastrozole per week would be a good first dose, then refine with labs. But needs to be dosed EOD and you really can’t do that with tablets. This is where liquid anastrozole products are needed for fine incremental dose control.