Awkward Gyno Question - Before TRT

Pharma TRT
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I visited a nurse practitioner yesterday for a checkup. Told her about my testosterone regimen. When she asked me if I have any side effects, I mentioned how every once in a while my nipples feel sensitive and harder, as well as some actual gyno - confirmed by an endo when he examined me. And I therefore take .25mg anastrozole twice a week to try and keep that at bay.

Anyway…she then asked me a weird question. “When you were going they puberty, did your chest area puff up and was it noticeable”. I’ve never been asked that before. I told her that when I was approx 15-16, I stopped going swimming because my chest area felt weird, almost sensitive and yes it was puffy as they were too full. And week to week it seemed like my chest area was more or less. It gave me a lot of anxiety for obvious reasons. She then said she wonders what my estrogen count was then and said I must be someone who aromatizes too much.

Of course she also said she’s weary of estrogen blockers and when I asked what she would have me do to prevent further gyno, she said then stop testosterone.

I told her that when I’m not on testosterone my drive is about a 2 out of 10 and I have 0 out of 10 sensitivity and whether I receive oral or attempt masturbation, it’s a dead piece of flop.

Her reply was at least you’d have your health. Aside from now feeling depressed somehow since my talk with her, was it normal for me to have noticeable signs of my chest area - nipples being puffy around 15-16 yrs old, enough that I avoided swimming and found it necessary to wear two T shirts plus a dam jacket wherever I went to avoid shit from my friends? Or was that experience actually indicative of something ???
Also, I do remember that during that age range my drive was about a 30 out of 10. Enough drive to distract me in school and almost any activity.

Was as honest as I could be here…. Normal or did my experience at that age reveal too much or too little of something happening hormonally. Interesting how I never noticed this with any friends of mine…and I was constantly in the locker room as I played sports.

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I don’t see how this is a relevant statement. Gynecomastia itself while being uncomfortable is not all together dangerous. So how is this applicable? I agree with her pubertal statement and opinion on AI but there’s always a surgical option if it gets bad.

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No, that is not normal. Not that it will make you feel better, but it is not unheard of either. When patients report that in the history I pretty much expect recurrence when we start increasing testosterone levels to teenage levels again.

You get to decide the extent that it bothers you and what levels you will go to in managing it.

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This is when guys coming off cycle get gyno flare ups, worst advice possible, androgen deprivation therapy degrading your quality of life while throwing your hormones into chaos.

There is tamoxifen which blocks E2 receptors in the breasts and gyno surgery to remove the glands.

This is classic sick care mentality, which is not to do anything.

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I had similar experience as a teenager myself. Not to the degree that they were painful but certainly I got made fun of at the pool for “titties” and have honestly been self conscience to take my shirt off my entire life. I’m 41 now. The nipples look much fuller when it’s hot, which of course any beach or pool day is going to be hot. Right after I get out of the water or if it’s cold they look normal. It’s been a struggle for sure. Which is why I was so insistent on an AI with my TRT but after hearing of the dangers and just not feeling great while on them so far I’ve decided to switch to Tamoxifen and hopefully that keeps it at bay.