Sorry for the blog:
I have never had any TRT before, so I researched what would be the best for me.
The conclusion I came to was clomiphene citrate (or enclomiphene) which is not testosterone and does not have many of the side effects of testosterone gels etc…
TRT is associated with external, physical changes in men. Exogenous testosterone is known to cause an imbalance in the hypothalamic-pituitary axis. As such, testosterone can be converted to estrogen by aromatization. Excess estrogens may lead to gynecomastia and/or breast pain, both of which may be seen in 10-25% of men on TRT.
“Clomiphene citrate and the single isomer isolate enclomiphene are well-known selective estrogen receptor modulators which have been used alternatively to treat men with hypogonadism [13], [14], [15]. Clomiphene citrate stimulates endogenous testosterone production by inhibiting the negative feedback at the hypothalamus and pituitary, resulting in an increased gonadotropin-releasing hormone and luteinizing hormone (LH) release.”
“Testosterone/estradiol ratio was calculated to evaluate the potential benefit of clomiphene citrate in stimulating testosterone while causing minimal changes in estradiol levels.”
“Low dose clomiphene citrate is effective in elevating serum testosterone levels and improving the testosterone/estadiol ratio in men with hypogonadism. This therapy represents an alternative to testosterone therapy by stimulating the endogenous androgen production pathway.”
“The mean age was 39 years, and the mean pretreatment testosterone and estrogen levels were 247.6 ± 39.8 ng/dL and 32.3 ± 10.9, respectively. By the first follow–up visit (4–6 weeks), the mean testosterone level rose to 610.0 ± 178.6 ng/dL (P < 0.00001). Moreover, the T/E ratio improved from 8.7 to 14.2 (P < 0.001). There were no side effects reported by the patients.”
Can you cite any articles that indicate that enclomphene citrate raises estrogen levels in men? If so what percentage of men were affected?
At 6 months, TT levels were 545 ± 268 and 525 ± 256 pg/dL for groups receiving the gel and enclomiphene citrate, respectively. Only men in the enclomiphene citrate group demonstrated increased LH and FSH.
Low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) can be partly responsible for low sperm counts, which is the biggest cause of infertility in men. LH stimulates testosterone release by the Leydig cells of the testes.
“At follow‐up, only enclomiphene citrate treatment was associated with elevated sperm counts.”
TRT:
“In fact, In the 1990s the World Health Organization tested testosterone as a male birth control and found that it was close to 97 percent effective.”
Bottom line:
I conclude that TRT comes with more side effects and possible dangers to older men than TRT
I can find no compelling evidence that clomiphene citrate raises estradiol except in a small minority of cases.
I will take science over Reddit anecdotal cases. After all “Customers are more inclined to write negative reviews than positive reviews because of the heightened emotional response.”
Since I have a recent baseline for both T and estradiol levels I will be able to tell if it has any significant effect on T and estradiol levels.
TRT is more likely to raise estrogen levels (a minority side effect in both cases) than clomiphene citrate. I invite you to prove me wrong. I really do want to know.
https://www.sciencedirect.com/science/article/abs/pii/S1743609515312170?via%3Dihub