Should Men Take Estrogen Blockers?
This article shares what the medical literature says about men who are taking estrogen blockers when on testosterone replacement therapy (TRT).
In my practice, I often see men who come in on testosterone who have also been prescribed Anastrozole or Arimidex to block the conversion of testosterone to estradiol. They have been mistakenly told they need to keep estradiol levels in the “normal range” because high estradiol levels are potentially dangerous to their heart.
The first thing you need to know is: this is a myth that continues to be propagated by doctors who are not current with the medical literature. It turns out that much of the benefit men receive by taking testosterone is the result of its conversion to estrogen. Estrogen has profound effects on the brain, heart and bones and rising levels are protective. When you block the conversion of testosterone to estradiol you actually block the beneficial effects of taking testosterone in the first place. So by taking the Arimidex, you are actually damaging your body. I have seen multiple men come into my office with estradiol levels of 10 who are taking 1mg of Arimidex weekly who have significant amounts of bone loss as a result of low estradiol levels. Many of them can’t understand why their libidos or erections haven’t improved, not realizing the estradiol is likely 50% responsible for a man’s sex drive.
So why did your doctor start you on it in the first place, and why the confusion?
It’s well known that what people learn first (physicians included) implants the deepest in their brain, and is retained. For many years, doctors were being taught that estradiol is bad and can increase prostate cancer risk in addition to risks of heart attacks or strokes. Some of the major medical academies, including the American Academy of Anti-Aging Medicine (A4M) still to this day teach doctors new to the field that high estradiol is harmful. They cite a study that looked at baseline levels of estradiol which showed that estradiol levels that were too low or too high were associated with an increased risk of heart disease. As a result, that taught that you want to keep levels right in the mid range.
However, what they fail to recognize is that having a high baseline level of estradiol is NOT the same as raising estradiol levels when you prescribe testosterone. When you give testosterone and raise estradiol, you get a reduction in the risk of heart attack and stroke. It turns out that men who are obese have higher levels of estrogen, because fat cells tend to convert testosterone to estradiol at a much higher rate. And, men who are obese are much more prone to having heart attacks. So they incorrectly assumed it was the estradiol increasing risk when in fact it was obesity, hypertension and insulin resistance causing the increased risk! Estradiol was simply an innocent bystander. This distinction is very important and completely overlooked by much of the medical community, and that is the reason men are being harmed on Arimidex or Anastrozole daily in the United States.
Now, I am not your doctor and can’t tell you what to do, but I never prescribe estrogen blockers to my patients. Furthermore, I want to see their estradiol levels rising when prescribing testosterone because of the health benefits. Dr. Neal Rouzier did an amazing podcast with Jay Cambell where he reviews the medical evidence to support NOT prescribing estrogen blockers to men. I would encourage you to watch this video HERE. Then, you should share that YouTube podcast with your doctor, and ask him or her to show you the medical literature that says you should be taking an estrogen blocker. I think what you will find is that they can’t produce any studies and unfortunately, they have just been doing what they were first taught.
If you would like me to personally help optimize your hormones, simply give us a call at 877-721-0047.