MK1965 wrote:I am prostate Ca survivor and after prostate removal in 11/2016, whole year 2017 a was feeling crappy with low energy, low libido no power to exercise, pretty much just regular job and nothing else. Prior to prostate Ca , I was in excellent physical shape, exercised regularly 4-5 days a week with doing 2-3 soccer games on Saturdays, sleeping well and feeled recovered next day.
In January 2018, I was tested and my total Testosterone was 217. All other values were low. Doc started me on Clomiphene 50mg every other day, then changed it to 25 mg every other day. Now, I am on 25 mg every day. My most recent testosterone was 703 (March 2020). Since I had some tenderness in my brests, doc started me on Anastrozole once a week. Will see how it will go.
Definitely, feeling better and more energized.
MK
Clomiphene citrate is composed of two isomers, Enclomiphene and Zuclomiphene. It is the Zuclomiphene part of the mix that gives most men the undesirable side effects whilst taking these selective estrogen receptor modulators (SERMS).
Clomiphene will exert some estrogen like effects because of this as well as block some estrogen receptors. Your increase of T is substantial, but whether your body will hold that on its own after discontinuation of the SERM is the big question. For many this does not occur.
A long slow taper is one of the keys to helping this.
The estrogen like affects you are experiencing in your nipples is from some of the estrogen agonist stimulation that Zuclomiphene is most likely facilitating. Be very wary of Anastrozole (Arimidex). Aromatase inhibitors are very powerful medications, especially in the male.
They can easily plummet estrogen levels far too low and this will make you feel as bad if not worse than low T. Males do need a certain level of estrogen too! The bad thing about aromatase inhibitors is that they can upset the hormonal milieu in the body and it can take some time for estrogen levels to return
If they have been thwarted to much by these medications that have been designed to treat breast cancer in women who have much greater amounts of estrogen in their bodies.
The estrogen in your body being created by the aromatase enzyme from your natural Testosterone may be at the level it needs to be. The sensitivity in your nipples is most likely being caused by the Clomiphene. Anastrozole will not block the effect of the Clomiphene. This is not how it works. It interferes with the conversion of T into estrogen. Therefore you may be trying to counter the effect of the Clomiphene by compromising the needed estrogen level your body is trying to maintain via hormonal homeostasis.
You cannot test for estrogen levels if you are taking a SERM as well. The SERM will interfere with the test result. Many doctors are completely unaware of this. Therefore your doctor cannot assay your estrogen levels whilst you are on this “restart protocol” to determine if high estrogen is causing your nipple issues, in other words it’s just a guess.
I have been on T replacement for many years. I avoid aromatase inhibitors like the plague after using them some time ago and experiencing the deleterious effects of these drugs. I only took very small amounts.
Approximately 10 years ago a company called Repros therapuetics began their journey with a new drug for secondary hypogonadism called “Androxal”. This was the single isomer of Clomiphene citrate: Enclomiphene citrate. This essentially was the isomer that exerted all the positive effects, stimulating the pituitary to produce more LH and FSH. Thus giving our testes more stimulation to do what they do. It did not have the estrogen like effect the Clomiphene citrate causes, because Zuclomiphene is no longer in the mix. This new drug went through many trials and I was watching it closely as the years went by. It raised levels of T comparatively to T gel administration in males with secondary hypo and was very well tolerated. It seemed like it was going to be a brilliant alternative for exogenous T. It would also have had great potential for restart protocols, so as to avoid exactly the issue you have with nipple tenderness and or enlargement, plus many other side effect such as eye disturbances, mood swings, ED, no sex drive and depression that Clomiphene citrate can have. Men could stay on this drug if their T levels did not maintain after discontinuation, to keep the stimulation at the pituitary level as this was exactly what Repros were trying to get the drug approved for; and alternative hypogonadism treatment. Clomiphene citrate is not suitable for HRT, it generates for most males too many side effects, those side effects cancel out the benefits of the increase of T it can generate.
Zuclomiphene works an estrogen agonist in higher dosages and builds in the system as it has a much longer half-life than the other isomer Enclomiphene, which is a relatively pure selective estrogen antagonist.
After a short amount of time Zuclomiphene’s levels in the system can compound and high estrogen like side effects appear such as tender sore enlarged nipples!
Androxal did not get approved by the FDA.