Update:
I decided to put the testosterone replacement therapy (TRT) on pause. Some of you guys who know where I am coming from and thus already know how hesitant I was beginning TRT/HRT. I jus' wanted to find the culprit if there was one before subjecting myself with a life-long treatment plan.
Well, I had another baseline test done the day before I began testosterone replacement therapy (TRT) to have an up-to-the-minute update on where I stood and to evaluate in a few weeks to tweak my protocol. I was about 10 days into my protocol when finally my results came in. My estradiol number was 62ng/dL. Luckily, I am enrolled at school and have an on-line database at my fingertips. One form of therapy that isn't well established is the use of an Aromatase inhibitor (AI) solely; Aromatase inhibitor (AI) monotherapy if you will. In subjects with high estradiol numbers and low testosterone values, an Aromatase inhibitor (AI) was given and evaluated after a certain period of time. Testosterone scores boosted to about 130%.
I want to give this a try since being overweight is a cause of hypogonadism because of the massive conversion of testosterone to estradiol. I am still taking the Aromatase inhibitor (AI), following a diet/exercise program and have lost 5 pounds in about 10 days.
Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism.
OBJECTIVE: Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E2) production and E2-mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process. This study evaluates whether letrozole once a week can normalize serum testosterone in severely obese men and maintain its long term effect. DESIGN: Open, uncontrolled 6-month pilot study in 12 severely obese men (body mass index>35.0 kg/m2) with obesity-related IHH and free testosterone levels <225 pmol/l, treated with 2.5 mg letrozole once a week for 6 months. RESULTS: Six weeks of treatment reduced total E2from 123±11 to 58±7 pmol/l (P<0.001, mean±S.E.M.), and increased serum LH from 4.4±0.6 to 11.1±1.5 U/l (P<0.001). Total testosterone rose from 5.9±0.5 to 19.6±1.4 nmol/l (P<0.001), and free testosterone from 163±13 to 604±50 pmol/l (P<0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men. The testosterone and E2levels were stable throughout the week and during the 6-month treatment period. CONCLUSION: Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is recommended.
Aromatase Inhibition for the Treatment of Idiopathic Hypogonadotropic Hypogonadism in Men with Premature Ejaculation.
Background: Idiopathic hypogonadotropic hypogonadism (IHH) has been observed to occur in men with premature ejaculation (PE). Common IHH therapies include testosterone replacement, which increases testosterone levels but suppresses gonadotropin release; and gonadotropin-releasing hormone supplementation, which restores gonadotropin levels but is impractical for chronic use. Hormonal imbalances associated with IHH/PE are thought to be related to hyperactivity of the cytochrome P-450 enzyme aromatase. Methods: Ten male patients with a diagnosis of IHH/PE were treated with the aromatase inhibitor anastrazole (1 mg/d orally). Levels of free and total testosterone, luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol were determined at baseline and after 2 weeks of therapy. Results: After 2 weeks of therapy with anastrazole, levels of testosterone, luteinizing hormone, and estradiol had returned to normal. No effect was noted on premature ejaculation. Conclusion: These results suggest that aromatase inhibition with anastrazole may provide a practical and efficacious alternative for the treatment of IHH but is not effective in preventing premature ejaculation.
