HcG and gyno exacerbation

[Rockslide]

Ok the TLDR main questions first . Then the full story

1. Anyone have issues with adding hcg exacerbating gyno on TRT that was previously stable. Had been off the hcg for around 6 weeks and recently added it back. Took 500 IU yesterday morning. Early and then out of absolute nowhere about 16 hours later suddenly noticed severe tenderness of previous gyno lump that had been stable for years . I have had some problems controlling estrogen on TRT but hadn’t had any issues with gyno because of it (full story below)

2. It appears that the area just above my nipple where the gyno and tenderness is is now slightly red. I have been pushing on it a little bit but not enough to make it red in itself . Has some redness of chest tissue outside of the nipple ever happened to anyone else with gyno. The concern with breast color changes is always male breast cancer but this was such sudden onset as well as extremely tender , neither of which should fit with that.

Ok the TLDR

I hopped on TRT several years ago. Was still interested in having one more kid so was put on enclomphene. Actually did pretty well on comid with levels ranging from 700 to 1200 and estrogen of around 50 to 60, After previously being around 300 with estrogen of zero before this. I did interrupt it for around eight weeks twice a year during those two years to run 11 KT, 3 ad, 1 and 4 ad . We finally got pregnant, so I decided to hop on real TRT given that there’s really no long-term safety data on Clomid in men. I’ve been relatively conservative with it only taking around 80 mg a week along with initially 250 of hCG three times a week but towards the end of the first cycle, I got lazy and started injecting 500 twice a week.

Right before I started TRT and after my last set of clomid labs while I was waiting on my appointment, I decided to run eight weeks of low-dose triumph and 4 ad. Around the last three weeks of that I had received my TRT script and started 80 mg of testosterone and the hCG. Finished up the triumph and continued on TRT for another nine weeks or so until my labs were due. I ran out of hCG about the time my labs were due. TRT labs showed testosterone of about 450. This was around two days after injecting 40 milligrams and around 500 units of hCG, although the hCG was about 10 weeks old at this point.

At that point on labs testosterone was around 450 two days after injecting and about a day and a half before my next injection of twice weekly testosterone and hCG. Estrogen was high at 122 and SHBG was low at like 6. This kind of puzzled the TRT provider with the SHBG being so low and definitely surprised me. I’m assuming that it was still low after running the oral although the oral had been out of my system for 9 weeks. They weren’t sure why the SHBG would be low but they concluded that the estrogen was so high because so much testosterone was aromatizing because SHBG was low. I somewhat agree with this, but I also think the hCG was playing a role in the high estrogen. They did not really seem to think the hCG was causing any estrogen problems which I disagree with. I had been taking 0.125 mg of anastrazole twice weekly although was prescribed 0.25 mg as preventative. Based on this, they increased the dose to 0.5 mg of estradiol three times a week. After these labs were done I also started some 11-KT at 200 mg per day TD trying to get a quick blast in for 8 weeks before my next set of labs.

I’ve continued the 80 mg a week for now although had planned on going up to around 120 a week soon when I finish up the 11 KT

HCG refill finally arrived in the mail and I injected 500 units of brand new hCG and then the gyno flared up 16 hours later out of absolute nowhere

Currently taking

200 mg 11-kt . I know that this is not causing it as I’ve run this numerous times.

80 mg a week of testosterone split twice weekly. I do not think this was causing it as it wasn’t causing problems before.

0.25 mg of Adex three times weekly which is an increase compare compared to what I was doing previously (0.125 twice weekly) based on that estrogen of over 100

Then started the hCG and this flared up. I have to assume it’s the hCG, causing massive swings of estrogen and the subsequent gyno as well as the estrogen control problems I was having before the gyno started.

Anyways, for the gyno, I basically last night as soon as it started, took 25 mg of Exemstane and started 60 mg of Ralox. Wondering how long I should wait for a response before I get a breast ultrasound , repeat labs, tell the clinic etc .

So basically if you have made it this far …..

1. Anyone else have major gyno problems strictly from hCG
2. Is the redness just outside the nipple relatively normal/ and assume it couldn’t be a cancer given that it flared up so dang quick after an hCG shot
3. Plan on doing 0.25 mg adex 3 times weekly, ralox 60 mg daily (pharm grade), and maybe 1-2 weeks of Exemstane 25 mg twice weekly as well as reducing the hCG to 250. Am I on the right track and how long before I slowly taper the serm ?

@Hyde @Smont figure both of yall have some experience here. I appreciate it if you stuck it out for the tldr

 

[Hyde]

So you added something that heavily converts to estrogen & don’t understand how it immediately pissed off old gyno?

Yes, that is the cause of the tenderness and redness. Don’t sweat cancer; generally the most obvious answer to a problem is the correct one. You added HCG, estrogen spikes, and the androgen/estrogen balance is thrown way off axis, causing gyno.

You’ve added Ralox to block the chest receptors & began AI to help further lower aromatization of your TRT (AIs don’t actually prevent HCG from converting because that’s intratesticular, but lowering your circulating test conversion still effectively reduces total net serum e2). This is sufficient to get the gyno under control if you also stop the HCG.

BUT if you keep the HCG in now that the gyno is flared up, you will still have that estrogen spike coming in that an AI can’t prevent, so you are entirely leaning on the Ralox and making it harder to do its job to starve the chest receptors entirely. Reversal of gyno usually is much easier when you also remove the offending substance.

I’d get it under control and then if you are determined to try HCG again, have Ralox in place ahead of time and preemptively raise the AI dose prior as well.

 

[Rockslide]

Thanks man. I understand the why of how it flared the gyno. I’m more just a little puzzled of why it flared this time and not the previous times I’ve have used hCG in the past. I’ve used it maybe 4-5 times in past 5 years including 3 months ago when I started TRT and it didn’t cause a problem . I’m sure my SHBG was in the tank then too because I was still on triumph at that time .

Maybe the 500 units vs 250 units is what did it. I’m also suprised it pissed it off in like a matter of less than 24 hours , must be a huge spike.

I may end up having to scrap it and deal with the shrinkage but I feel so good on HCG. Like tren level libido

Also yeah thanks for confirming that AIs don’t work on hCG estrogen . That’s what I thought … kind of frustrated that the trt clinic is so convinced that my high E2 was from low SHBG (some of it probably is) . I think it’s more the HCG.

So yeah I was going to drop it to 250 but maybe I just need to scrap it for a few weeks until the pain, redness, and swelling go down and then slowly add it back at 250.

 

[Rockslide]

Also thanks for confirming the redness. Never had that before and that is what freaked me out. I’ve also never had it this tender. Pretty sure my gyno happened years and years ago during PCT and when it’s had problems in the past it was usually mild sensitivity, tingling in pct

 

[Hyde]

Also thanks for confirming the redness. Never had that before and that is what freaked me out. I’ve also never had it this tender. Pretty sure my gyno happened years and years ago during PCT and when it’s had problems in the past it was usually mild sensitivity, tingling in pct

If it’s red, it’s bad - seriously, stop the HCG now. Consider that 500mcg HCG is 100% more dose than 250. The numbers are small, but for scale, it’s the difference between taking 1g test/wk vs 2.

Low SHBG = higher free test. More free test, more that can aromatize if you have sufficient aromatase enzymes available (and it sounds like you have a lot). It’s normal to have low SHBG after a blast of anabolics. It’s not a big deal, but it can lower libido some.

If you want more libido, something you can try in the interim is dosing 200-300mg P5P, twice per day (4-600 total) for a period, maybe a month. It helps a little by lowering prolactin, which can also elevate in the presence of higher estrogen. This will also only be a positive for helping control the gyno, in case there’s any influence coming from that axis.

 

[Rockslide]

If it’s red, it’s bad - seriously, stop the HCG now. Consider that 500mcg HCG is 100% more dose than 250. The numbers are small, but for scale, it’s the difference between taking 1g test/wk vs 2.

Low SHBG = higher free test. More free test, more that can aromatize if you have sufficient aromatase enzymes available (and it sounds like you have a lot). It’s normal to have low SHBG after a blast of anabolics. It’s not a big deal, but it can lower libido some.

If you want more libido, something you can try in the interim is dosing 200-300mg P5P, twice per day (4-600 total) for a period, maybe a month. It helps a little by lowering prolactin, which can also elevate in the presence of higher estrogen. This will also only be a positive for helping control the gyno, in case there’s any influence coming from that axis.

It’s stopped for now because it was only the first dose. Will hold it until things resolve and then try 250.

I’m wondering if the higher dose (although I have taken 500 units before but maybe fresh vial was more potent) combine with the fact estrogen was lower did it

I do think some of gyno is the fluctuation. I think increasing estrogen by like 10 a week is less likely to cause gyno than taking it from 40 to 200 in a day. Maybe what happened is that i have been off the Hcg 5 weeks, went up on my AI, had estrogen much lower then injected a big dose of fresh Hcg and it went from low to off the chart in hours.

It tracks. In a matter of hours libido went from normal to wild, testicle size up. I’m impressed but also frustrated by my body’s response to it

 

[Rockslide]

So everything has gone back to my normal chronic gyno. Literally shrunk with decreasing redness and pain by the dose of Ralox (twice daily dosed 30 in AM and 60 in pm) . Going to take the Ralox to 30 twice daily and add 125 IU of HCG twice weekly and see what happens . If that’s stable for a few weeks will go to Ralox 30 twice daily for a few weeks then 30 daily for a few weeks and then off . Hopefully doesn’t flare back up while tapering.

This has made me decide I’m going to eventually get surgery but not sure when that will fit good in the schedule yet, may wait a few years