Estradiol

THIS IS THE SINGLE MOST IMPORTANT TEST YOU WILL EVER TAKE— this will be on ALL retests.

The monitoring and controlling of Estradiol is the only “SAFETY NET” that you have while on HRT to prevent adverse or even detrimental side effects in the short and long term.

• Your estradiol level needs to be in the “optimal range ALL the time”. This is done through compliant testing.

• You may report “feeling great” when starting your hormone treatment program, but then feel worse within 2 ½ – 4 weeks. This is due to the possible conversion of testosterone to estradiol.

• The risk of this conversion from testosterone to estrogen is increased if you are overweight. More specifically, if you carry weight in the stomach or back (the spare tire).

• Estrogen blockers will be used and are MANDATORY if needed. This will prevent the less conversion from testosterone. This is where most of the side effects will occur.

• The initial estradiol level will NOT predict what happens once you start to take Testosterone.

• If your testosterone levels are initially low, your estrogen level will most likely be low, given that there is very little testosterone to convert to estradiol. Most of the time this will happen at the 45 day re-test, or earlier through testing. This will determine the rate in which you convert testosterone to estradiol. This is only accurate when you are taking a consistent dose of testosterone. Our physicians, will always micromanage your estrogen level for safety and quality of your program.

Most of the so called “expert physicians” are unwilling to test for estradiol, even if you are presenting symptoms. If he does test for estrogen, he will most likely be unwilling to treat it with a true estrogen blocker. They may say things such as:

• “It is a female hormone which does NOT need testing.”

• “Don’t tell me how to treat you. I am the doctor.”

• “You don’t need to worry about that.”

• “Let’s just lower your testosterone dose and the unwarranted side effects will go away.”

Our physicians may preemptively prescribe an estrogen blocker for you after your initial baseline testing for reasons such as:

• History of “man boobs”.

• History of testosterone to estrogen conversion.

• Excessive Belly and back fat.

• Elevated estrogen level in relation to testosterone at baseline testing.

• Conversion from Testosterone to Estradiol is already occurring.

• Baseline estrogen elevated beyond the acceptable range.

Take Note: As you start to lose weight, your requirement for an estrogen blocker will usually cease altogether.

Classic symptoms of an unmanaged estrogen level (short and long term)

Short term: (when estrogen is too high)

• Increase in adipose tissue (MOSTLY ABDOMINAL OR BACK FAT)

• Man boobs

• Decrease in sex drive

• Water retention or edema

• Not able to achieve an erection

• Increase in prostate issues

• May increase “SHBG” (sex hormone binding globulin) which in turn decreased the free T / total T ratio

• Negates the positive effects of testosterone.

• Has a negative impact on the body’s natural production of testosterone

Long term:

• Increase risk of Prostate Cancer (when coupled with an elevated DHT)

• Continual issues with BPH (“enlargement of the prostate”)

• Continual increase in adipose fat

The Side Effects of a Low Estrogen Level

Short term:

• Decreased Libido

• ED

• Increased risk of prostate cancer

• Continual issues with BPH (“enlargement of the prostate”)

Long term:

• Decrease in bone density

• Decrease in Cardio Protectiveness

• Continual decrease in libido and ED