E2 can be elevated from meds, Rx and OTC, that interfere with liver clearance of E2, or a liver problem.
Inability to absorb transdermal T is a symptom of thyroid problems and thyroid function needs to be investigated. Thyroid levels may drive secondary hypogonadism.
T+AI+hCG is quite good at preserving the testes.
SERM cannot work with busted pituitary or primary hypogonadism.
See the HPTA restart link found here: About the T Replacement Category - #2 by KSman
which discussed dosing issues and clomid VS nolvadex