Why are My Nipples Still Puffy?

Pharma / TRT Testosterone Replacement
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Let me start off by saying I know I’m a bit overweight which can complicate things a bit.

However, I started T about four months ago. 100mg every 3.5 days. About 10 weeks in and I started having really bad side effects of high estrogen and started doing more frequent pins, as well as started taking an AI. My blood pressure is down, a lot of the water weight has come off, and my chest and nipples are no longer burning.

Despite all of that, my nipples are still very puffy and at least one and a half times bigger than when I first started T. I really thought by now they would have settled down a bit.

Do you think that I could have given myself gyno over the course of 10 weeks prior to the AI? I honestly don’t know if I can feel anything or not. I feel all sorts of weird lumps, and stuff in my chest, but I’m not sure if I’m feeling lumps of fat tissue or glandular tissue. Nothing hurts.

Recent labs show now normal E2 in the mid 20s. Prolactin is 15.

Is it too late for a SERM? What will fix this?

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Likely not long standing gyno.

I don’t see any labs, but your dose at 200mg/wk is likely a lot higher than it needs to be. So your T is uber high, E2 climbs and then you need another medicine, AI, to combat what you did to yourself. Think about it. AI’s have their place, but this sounds like a case of too high dosage. Talk to your doc about lowering by 25% and removing the AI. Your nipple issues should resolve but it takes time.

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Thanks! E2 is steady now in the mid 20s. As of 11/11 labs. I can’t remember the exact off hand since I’m not home. But I imagine it’s only been that way for a few weeks now.

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If you are using the same labs as me (units and range), you certainly shouldn’t develop further gyno if E2 is in the 20s, unless it is from prolactin (this is unlikely if you are only on Testosterone).

I second what @blshaw said. 200 mg/wk is likely too high. I’ve done that dose, and was fine. I just started to think long term if it was healthy to be at that dose after being honest with myself about what actual averages are, and what my average (1350 ng/dL), not trough was. I was nearing 3X average TT levels.

Some say as long as labs look good that you should be fine. We don’t have a lot of long term data of good quality on this. Also in the last couple years have seen a few of my mother’s siblings end up in the hospital with heart issues, and my grandpa died in his 50s of heart issues. I’ve changed my outlook on what TRT should be for me (not everyone, but I am giving my perspective here). I am now going for top of the range for my average level.

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Thanks, prolactin is 15 so all good there. Hopefully it resolves itself. I’ll chat with my doc about lowering. I don’t want to be super, just average. I started at 175 so anything in the 500-600 range would make me happy.

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If you lose the weight, it can only help your situation. If you’re not exercising or going to the gym, these issues will likely continue into the foreseeable future.

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Could be prolactin, water, hormone changes (that are temporary)

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Wihtout know the units or ranges, this is out of range on my scale. I like mine around 6-8ng

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Been hitting the gym for 18 weeks, 3 times a week. Limited cardio so I’m starting to pick that up a bit.

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While this will help and I applaud you, most weight loss will occur at the kitchen table. Less food and in better macro ratios.

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For sure, which I’ve not been great at.

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Still measuring at trough?

I’ve had similair thoughts- I’m thinking of measuring at theoretical peak and making sure I’m not much over top of ref range.

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Last couple labs I’ve pulled, I’ve tried to get right in the middle. Seems more honest (with myself).

Readalot had equations to get peak, average and trough based on you levels and when you pulled them. I can’t seem to link him though?

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E2 levels are usually best in terms of a ratio of E2 to TT, but everyone is different…
If your ratio of E2 to TT is above 30 to 1 with E2 to TT with TT being 600 and E2 being 20 for example, most Men will feel good at this ratio and above.
My last blood test showed TT 1100, and E2 at 8, and I felt quite crappy will no spontaneous erections. I used T Cyp 2200mg per week and 1.0mg of Arimidex per week. I reduced my Adex to 1/2mg per week and I feel better, but I have not been able to get re-tested lately.