Mike, great info and as always great advice.
OP, the following text is by a guy named Glycomann. I previously cut & pasted this to Steroidology on another thread. It has more info on the linkage between 19-nors, progesterone, prolactin, and the nasty things that can happen if you don't control them. Probably way more than you are after, but a good read.
The upshot to all this is keep your E2 clamped down via using AI on cycle, and also use caber to minimize prolactin. Not listed here but I would add drop your deca or tren several weeks before ending test, the more weeks the better, to allow them to bleed down in concentration and to clear more of their metabolites well before you finish up and PCT.
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With use of 19-nor-testosterone compounds, such as trenbolone and nandrolone esters, there is a considerably high percentage of individuals who suffer from gynecomastia with galactorrhea (lactation from the nipple) and often times prolonged erectile dysfunction (ED). These are probably the most disturbing acute side effects experienced by the AAS user and bodybuilding enthusiast. The ED often lasts for over a year with little relief for the uniformed, although there are some drugs to combat these problems. There is still some mystery surrounding the exact cause of these side effects noted by users of the 19-nor compounds. In this article I will discuss what I think are the most likely mechanisms that lead to the above problems associated with these compounds and the best remedies for the side effects as well as strategies to avoid, minimize or mitigate them with use of these compounds.
19-nor compound Effects
Trenbolone and nandrolone, while classified as androgens, closely resemble the progestins as they have in common the absence of the 19 methyl present on the common precursor cholestane, which is the precursor of all steroid molecules in humans. Progestins are a group of synthetic compounds related to progesterone and are used therapeutically and in scientific research in the areas of fertility and cancer research. In estrogen primed tissue progestins are known to mediate breast development. Progesterone levels are known to correlate with prolactin secretion and progesterone receptor signaling is tied in with a signal transduction loop leading to the production of prolactin, an important protein hormone involved in gestational development of the breast as well as sexual function in both men and women. Due to the interaction of progesterone and prolactin with the tissues of the body the gestating woman takes on some necessary characteristics. Her breasts enlarge but do not secrete milk. The ovaries are altered and no longer secrete as much estrogen and switch primarily to progesterone secretion. Upon birth progesterone levels decline as the endometrium and sustaining tissues of the uterus are no longer needed. Once progesterone levels diminish lactation ensues under the direction of prolactin. Through the mechanoreceptors of the breast prolactin secretion is maintained and mother reaches a level of sexual satiation from prolactin***8217;s effects on sexual functions. A series of sex hormones including progesterone are maintained at a level that reduces FSH and LH resulting in continued suppression of ovulation.
Interestingly, there is a neuroendorcine link between dopamine secretion, progestins and prolactin secretion in the brain. In the arcuate nucleus of the hypothalamus there is a group of dopaminonergic neurons that are responsive to progesterones. Progenstins bind to neurons in this region and reduces dopamine secretion locally leading to increased prolactin secretion and decreased secretion of GnRH (and thus LH and FSH) into the hypophysial portal blood. This series of physiologic responses may explain the loss of sexual function in nandrolone and trenbolone users.
Bodybuilding and the Progesterone - Prolactin link
As stated above, progesterone signaling is correlated with increased levels of prolactin secretion from the anterior pituitary gland. Progesterone and progestins are strong suppressors of GnRH and therefore LH and FSH. Therefore, the presence of progestins like nandrolone or trenbolone could be expected to be strong HPTA suppressors in the male user. Prolactin is negatively regulated by dopamine and positively regulated by thyrotropin-releasing factor and other neuropeptides. The first compound and drugs that mimic it are important for mitigating the undesired side effects seen with use of the 19-nor androgens and these will be discussed later.
In some sense the male bodybuilder who uses 19-nor androgens has feminized his body to a similar state as that of a gestating or breast feeding woman. Much like the gestating woman his breasts begin to enlarge and may secrete a small amount of fliud. His gonads are atrophied and his LH and FSH are greatly diminished. Sexual activity is blunted as erections are far less frequent and he feels strangely satisfied as if he has achieved an orgasm recently but has not. These are the effects potentiated by the progestin like qualities of the 19-nor compound(s). How can this state be treated and, better yet, can this state be avoided while using 19-nor testosterone derivatives?
Many 19-nor androstane compounds, especially nandrolone, and their active metabolites are long lived and can go on causing problems far beyond the period of their use. So the effects of these progestin-like compounds can go on for many months. Although it is suspected that for instance nandrolone could bind to the progesterone receptor like its progestin cousins this is not known for sure. In fact it may induce progestogenic and estrogenic effects through interaction with the androgen receptor, although this mechanism is not understood. However, the overwhelming evidence as far as clinical presentation and response to therapy would indicate that prolactin is the end culprit in at least the sexual dysfunction side effects. As discussed previously, dopamine negatively regulates prolactin secretion. There are two effective medications that can mimic dopamine that have been used successfully and safely to control 19-nor associated side effects. These are bromocriptine and cabergoline. Both of these are ergot derivatives and potent D2 dopamine receptor agonists. These compounds will significantly reduce prolactin secretion. A dose of 2.5 mg/day for the former and 0.5 mg 2-3 times a week for the later seems to be effective doses. Another important observation is that breast tissue must be estrogen sensitized for progesterone / prolactin induced development and lactation to occur. Therefore it may be useful to include a mild dose of aromatase inhibitor when using these compounds.
Post Cycle Therapy for 19-nor Compounds
The bottom line is that after a drug regimen that includes these compounds the user will likely be severely HPTA suppressed. Unlike other compounds the 19-nor compounds have the added nuisance of long lived metabolites that appear to be active toward GnRH suppression and prolactin secretion. Therefore, the goal in a 19-nor androstane PCT will be aggressive in starting the HPTA with the added problem of suppression of prolactin secretion. The HPTA should be attacked on two fronts to include the testes and the hypothalamus. HCG will be used to mimic LH and FSH and a SERM such as tamoxifen and or clomiphene will be used. In addition, to control prolactin secretion, either bromocriptine or cabergoline will be added. A PCT to treat 19-nor compound use might look like the strategy outlined below.
Week
Minus 2-0 HCG 500 U EOD
0-6 Clomid 50 mg
3-8 Nolvadex 20 mg
Throughout Cabergoline 0.5 mg EOD
Other comments
Cabergoline should be used throughout the cycle at 2 x per week at 0.5 mg to mitigate prolactin effects during 19-nor compound use. HCG can also be used at 250-500 U 2x a week intermittently throughout the cycle as well.
An aromatase inhibitor should also be used during 19-nor use and dose adjusted to the androgens used.
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