I’m a 35M new to trt. I have moderately low T at about 400.
4 days ago I started a protocol of 100mg/wk of test-C split in two 50mg doses.
I know this is a very conservative protocol, but on day 2 after my first dose I began experiencing tightness in my nipples. The tightness eventually became a light burning sensation, almost like a mild sunburn. I also noticed that I would feel a prickly feeling on random parts of my body every so often. Mostly on my chest, thighs, and shoulders.
Day 3, I woke up still experiencing symptoms. I also noticed my left breast was slightly larger than my right. I felt for hard lumps or nodules and feel nothing out of the ordinary. I took my second 50mg that morning, but that evening I decided to take .25mg of Anastrozole provided by my clinic.
Today, I woke up with noticeably less nipple tenderness. They’re still sensitive, but not as much as yesterday. I still feel slight pain and tightness in my breasts as well. They’re also both a bit enlarged and I feel like I’m retaining water elsewhere in my body too.
I totally get that my test dose is very low and conservative. I also understand that gyno takes some time to actually develop. Ive been told what I’m experiencing is impossible, but I’ve also been told this is completely normal for the first few weeks of trt and will go away as my body acclimates to the higher test and manages the estrogen levels. Is this indeed common and normal? Am I possibly extremely sensitive to trt and maybe should just not even bother with it? I’m genuinely concerned about what I’m experiencing and hoping to get some insight as to what might be happening.
I do have symptoms. Mostly exhaustion, low libido, and difficulty gaining muscle and losing fat. I’m a very active person in general. I workout 6 days/wk doing cardio and weight training, I have a physical career, I have kids and a wife who keep me very busy, but just live life in a fog. I get to the point where I don’t want to go out on walks with them or even participate in activities and I have little interest In sex.
My annual physicals have shown progressively decreasing T over the years. 650 two years ago, 500 last year, and 400 this year. I saw an endocrinologist who also ran bloodwork and found the same result. But they weren’t too interested in trt. They suggested I get more sleep, which was kind of insulting to be honest. I regularly get good sleep and have confirmed that by tracking with a Whoop band as well as having done sleep studies to rule out possible sleep apnea.
I found a clinic and thought I’d give it a try to see if it could help me overcome any of this. The clinic suggested 200mg/wk, but I chose to do 100mg as my T isn’t in the tank.
If I’m going to end up with large breasts for the rest of my life and if I’m going to harm myself, then no, it’s not worth it. I’d rather just go back to the fog and try to stay engaged the best I can. But if these are symptoms that will resolve, then I am hopeful that this is the solution to me feeling like I’m a part of life again.
Highly doubt this is gyno. When you take a shot of testC it needs quite a bit of time to reach full blood saturation. Below is the chart or your protocol. As you can see it would be close to the end of December when your bloods are stable.
After just one injection your body is getting used to the exogenous hormone you have introduced. Either your an super ultra converter or this is just gonna take a little time to settle. My bet is the latter.
Couple questions:
What is your bodyfat?
Whats was your estrogen pre TRT?
Is your BP normal? Was it prior?
Be careful with the arimidex. No more than .25 or .5mg 2x per week. You’ll feel really crappy if you tank your estrogen.
Can you get bloods now to see what’s going on? As it stands this is all guessing.
Do you have any Tamoxifen just in case gyno does start to develop?
Thank you for the detailed response. So is your chart saying that my body likely won’t be done adjusting to the hormone changes until the end of December? Am I understanding that correctly?
To answer your questions, my body fat is around 17%. My Estradiol was 23.2 prior to TRT. My BP is typically a bit elevated. Around 135 systolic. It’s currently in the 140’s, but I’ve also been drinking coffee and running around busy all day.
I have bloodwork scheduled with the clinic in 2 months and I’m not sure I can get it any sooner without spending a crap ton out of pocket.
And no, I don’t have Tamoxifen. Only Anastrozole.
So your guess is that it’s very likely my body is just adjusting to the increased hormones and trying to balance out?
The chart is saying it will take that long for the test to be fully saturated in your blood. At that point it will still take time for your body to reach homeostasis. I would say 3 months or so of the same protocol is where you will be stable and you’ll fully understand how you will feel long term at that dose.
Ok, nothing crazy. The 135 was pre TRT or that is normal but right now it’s a little higher?
I asked about your bodyfat as men with higher bodyfat are more likely to convert test to estrogen at a higher rate than a man who is leaner. Ideally i would work to get BF closer to 12%-15%
Like i mentioned prior, don’t go crazy here. Crashed estrogen is not fun and will take some time to rebound. You may want to get some Tamox just in case. If you did start to get gyno 40mg/day for as couple weeks should knock it out if you get it right away.
I think in this case you would be wise to get bloods to see what is going on.
Merak Health has a few levels of bloods to choose from.
This one would be more than adequate but they also have higher levels you can get which will also get you a consult with them to review you bloods and make suggestions to fix anything they see wrong.
Quest also has some basic panels you can get that are relatively inexpensive.
I would say yes but…You don’t know what you don’t know so i woul ssuggest bloodwork.
Man, thank you for taking the time to help me get sorted.
The 135 systolic BO is pre TRT. The 140’s is today, after 4 days of TRT. I’m definitely working to get my body fat dow. That’s been one of my struggles. I work out a ton (12-15 miles of running per week and a few days of heavy weightlifting) but see little progress. My diet isn’t perfect, but it’s not out of control either. That was one thing I was hoping TRT could help me with.
I’ll look into Tamoxifen. Gyno is really what scares me, so that would put me at ease a bit more.
And thank you for the bloodwork suggestion. I’ll do that. I guess it only makes sense. I’ll know for sure what is going on and how to address it.
If you start a training log myself and others will jump in to see where you could make some improvements.
Having higher test levels will def improve your body composition but it still takes diligence on your part with diet/training/cardio. It also takes time.
I’ll do that. I’m no bodybuilder or pro lifter, but I’d love some insight into what I could add and improve in my routine. Keep an eye out for it! And thank you again
it is VERY common to experience nipple sensivity shortly after beginning use of testosterone, even with conservative doses like yours. i began using moderately abusive doses around 18 months ago (i was 41, drug-free my whole life up to this point), around 250 mg/week with a shot every third day.
within days my nipples were VERY sensitive and uncomfortable. i has zero swelling, but i could feel them under my shirt. many guys can just wait this out, as our endocrine systems are going crazy with this exogenous introduction of synthetic testosterone. i was also around 400-ish during my pre-testosterone blood/hormone check. most guys’ nipple sentivity resolves itself with days/weeks.
i was more impatient at the time and began using nolvadex (maybe ~10 mg per tab?) in the morning, which immediately removed the sensitivity within hours. the next morning, sensitivity resumed, so i took a tab every morning until i no longer resensitized in the morning (about a week?). i then took a nolvadex tab only on mornings when i felt sensitivity upon waking, with the duration gradually extending: every two days, then every third day, etc. eventually i no longer needed nolvadex to address sensitivty even as i upped the weekly dose to around ~500 mg/week.
bottom line: it’s NOT abnormal to feel sensitivity (even at your conservative dose), and the VAST majority of guys will adjust to that dose in short order.
one reason why tamoxifen is the ideal choice (assuming you need any intervention, at all, which you probably don’t) is that it’s a pretty narrow and laser-focused SERM, as opposed to broad suppressor of estradiol like arimidex or aromasin. all nolvadex really does is occupy the estrogen receptors on your breast tissue, preventing your circulating estrogen from binding with these receptors and inducing the production/development of fatty breast tissue.
i made this choice deliberately because i wanted my body to have as much estrogen as it wanted. i trusted my endocrine system to aromatize as much testosterone into estrogen as it deemed necessary for balance, while only blocking one specific mechanism: one which induces gynocomastia.
i forget the details, but apparently certain metabolites of tamoxifen also have some hormonal effects over time. cheers.
I’m 1 week in right now, just took my third 50mg dose since starting, and my sensitivity has definitely subsided. My nipples are no longer burning, however, I do have diffuse aches throughout my breast tissue on occasion. Some slight enlargement as well, but nothing visibly noticeable. I just feel the difference. I don’t have any painful lumps under the nipples either, so I’m taking that as a positive. I’m assuming this ache I am feeling is likely due to some mild water retention in the chest.
With my second dose on 11/20 I took .25 of Anastrozole, so I’m not sure if my symptom relief was because of the AI or my body acclimating. I took a prophylactic .125 Anastrozole this morning with my third dose. I may not have needed it, but I figured it wouldn’t hurt.
I’m getting blood work on 11/27 and will not be taking any more Anastrozole before then.
I really appreciate the experience you provided. Some of this stuff can be difficult to navigate, so having someone share their experience can definitely bring confidence. Thank you
I was wondering if I could share this update on my symptoms with you and get your thoughts?
It’s been 9 days since I began trt and symptoms have improved quite a bit but not completely.
My right breast feels and looks completely normal.
My left breast is still slightly enlarged though. Not significantly, but slightly enlarged. I’m also noticing a small spot just outside my areola that is painful. There are a few hard spots in there and it feels like a bruise when I push on it hard enough. Is not directly under the nipple and the nipple looks completely normal. No puffiness and it’s not shiny. It’s concerning, but I’m still hopeful it’s from the swelling. I was overweight a lot of my life, so I’m hopeful the lumps I feel are old fatty deposits.
My bloodwork is tomorrow morning, so I’m going to take my 4th dose afterwards and follow it with another .125 anastrozole just in case. I’m hopeful my E2 is normal and I’m still adjusting. But in your opinion, do you think this might be gyno developing?
That’s great that things are starting to normalize. Seems like you are on the right track.
When did the enderness(bruising feeling) start? My gut tells me it’s prob due to you checking/prodding. Ths hard lumps are concerning but not under the nipple they might be something else. I’m sure everything is going to be fine. Your body is still adjusting to the hormones. This will take time. How do you feel otherwise? Achy, emotional, better than 2 weeks ago?
As a precaution I would get Tamoxifen just in case. It is a SERM that targets the breast tissue as @hueyOT mentioned in his post above. If it develops further you will have what you need to get rid of it.
Check back and let us know how your making out.
Things are going ok so far. The tenderness started sometime in the beginning of trt and has not gone away since. I’m 16 days in now. I’ve been pairing my test doses with anastrozole and that seems to be helping. I tried without and I think my left breast became even more enlarged, but it’s difficult to be sure. My right side is normal though.
I’m working on getting tamoxifen, but I haven’t been able to get ahold of TRT Nation yet. The pain and lumps are not under the nipple, but I’m going to take the tamoxifen to hopefully reduce the swelling and if the lumps are gyno, to take care of them. I’m pretty sure it’s hormone related water retention. The nipple isn’t puffy or shiny and I have no lumps directly under the nipple. The lumps are about 1cm outside the areola and the breast is slightly enlarged. I guess it could be gyno, but I feel like I’m missing most of the classic symptoms.
As for how I feel otherwise. Amazing. I have a lot more energy for my wife and kids, I am so much more productive, I have no brain fog, I’m getting stronger and working harder in the gym, I feel more competent at work, I’m sleeping better, and I’m actually interested in sex again. I’m so desperate to resolve the estrogen issues because everything else is so good. I’d hate to have to give this up because I’m starting to look like a woman.
Unfortunately, with the holiday, I still haven’t received my bloodwork results. Hopefully tomorrow. I’m sure it’ll show high estrogen though. I just want a simple trt protocol without having to take AI or SERMs just to get by.
I was in the exact same boat as you when I first started TRT. Painful, itchy, sometimes kinda swollen nipples for months on end. I was worried and frustrated because everything else seemed to be going so well for me. I then started experimenting using a little AI and also got some tamoxifen. They both helped. Then one day it just stopped. I guess my body finally got used to it and I haven’t needed to use any Gyno related meds since. I glad I used them when I did. Just be careful that you don’t overdo it. Best of luck and hang in there.
Thank you for the encouragement. It’s good to know that others experience similar symptoms with positive results. I’ll stay the course and hope for a similar outcome
