# STEROIDS FORUM > PCT (POST CYCLE THERAPY) >  Stop Using Aromatase Inhibitors to Reverse gynecomastia! SERM's Only!

## austinite

Letrozole is an aromatase inhibitor. One of the most powerful aromatase inhibitors available today. Far too many people are considering this method because many moons ago it was touted as a good tool for reversal. We've learned a lot since then and Selective Estrogen Receptor Modulators (SERM) studies on gynecomastia reversal are readily available for confirmation. 

I did a short experiment myself recently when my E2 came back at 46 pg/mL (Range < 29 for a sensitive E2 assay). I did not experience gynecomastia, but I wanted to bring that down back to range. The increase was likely due to switching my Testosterone Therapy administrations from subcutaneous (SubQ) to intramuscular (IM). IM injections have more of an impact on E2 due to faster absorption. This result came about on July 2nd. I had a Letrozole prescription laying around and figured I'd give it a go. It's been so long since I've used Letrozole. My prescription was for 100 microgram capsules. 

I administered 100 mcg. (Micrograms) daily. After the 10th day I felt miserable and so I discontinued use. One week _after_ I stopped, I tested E2 again and it came back 2 pg/mL. Remember, this is a full week after Letrozole was discontinued. So it had to be at zero, or "too low to count" for several days. I was bedridden for several days. Completely useless and couldn't find a reason to get up and about. If you've killed your E2 before, you know exactly what I mean. I don't wish this on anyone. Really amazes me that some folks are running this thing using milligram after milligram several times per week. And these "Gynecomastia Reversal" threads using these astronomical doses are just mind boggling. Pretty eye opening once again. Anyway, I waited a while and got back on DIM.

The entire letrozole for gynecomastia reversal came about in 2001 when a study was published. This study was done on mice, not humans. So don't be a mouse, be a man. PMID: 11850204 if you want to look it up. 

To give you an example of how low this drug is supposed to be dosed, it was studied in extremely obese hypogonadal men. Overweight men convert far more estrogen than non-overweight men. This is because they carry far more aromatase enzymes. Using Letrozole, these highly aromatizing men were treated with doses of 2mg to 2.5mg once per week. If we break that up, you're looking at about 285 micrograms per day. That's it. This powerful drug never, under any circumstances should be used in a milligram + basis on a daily administered protocol. It is simply outrageous. Reference here. 

_Let's look at some more recent studies:_




> Dated: 2011 - *Effects of aromatase inhibition on male breast
> 
> *Tamoxifen was much more effective, however, in the prevention of gynecomastia in these men. Due to these disappointing results, *aromatase inhibitors are not recommended as a first-line treatment for gynecomastia* in men.
> 
> ^ Click here for the source of the excerpt above.






> Dated: 2004 - *Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia*
> 
> Inhibition of estrogen receptor action in the breast appears to be safe and effective in reducing persistent pubertal gynecomastia, with a better response to raloxifene than to tamoxifen. *No side effects were seen in any patients*.
> 
> ^ Click here for the source of the excerpt above.






> Dated: 2004 - *Management of physiological gynaecomastia with tamoxifen*
> 
> Thirty-six men accepted tamoxifen for physiological gynaecomastia. They were offered oral tamoxifen 20mg once daily for 6-12 weeks. Oral *tamoxifen is an effective treatment for physiological gynaecomastia*, especially for the lump type.
> 
> ^ Click here for the source of the excerpt above.


So we've learned a couple things here. We know that an Aromatase Inhibitor is a poor choice, and we also learned that SERM's are more effective, safer and with no side effects. Lastly, we learned that while Tamoxifen is effective, it is superseded by the superior SERM; Raloxifene. 

Aromatase inhibitors are not selective and will demolish your estradiol levels with prolonged use, rendering you miserable and useless. In the case of Letrozole, you could deplete your E2 levels to nothing in no time. SERMs like Tamoxifen and Raloxifene are pure antagonist in the E receptor in breast tissue. This is what mainly makes a SERM the clinically preferred drug for gynecomastia reversal. 

*TO REVERSE GYNECOMASTIA WITH SERMS:*

*Raloxifene:* 60mg daily. You should see improvement in approx. 4 to 6 weeks. If not increase by 20 mg for every 3 weeks, never to exceed 100mg daily. 

*Tamoxifen:* 40mg daily for once week. Then 20mg daily until gynecomastia is reversed. 

Both protocols above will take time. This is not a 2 week process. Reversal will require patience. But it most certainly is effective, side-effect-free and cost incredibly effective when compared to surgery.

################################################## ##################

Below is information provided by **********.

I see it all over. I have gyno..how much letro should i take? Jumping on letro to "crush"estrogen to the point that gyno can not survive. The problem is estrogen plays an important role in so many things the idea of simply "crushing"it is far from a prudent one.

This is where serms come in. Serms bind to the estrogen receptor in breast tissue, making it impossible for estrogen to bind and illicit its effects on those receptors. If we are getting gyno, even if using an ai, our estrogen levels are too high. They need to be managed, however with gyno at the door a serm will stop it in its tracks.

I think gyno treatment should be 2 fold , treatment and then management. The treatment and management should occur at the same time using a serm and an AI. The SERM will IMMEDIATELY begin to prevent and treat gyno. The ai will manage estrogen levels lowering them to a proper level where serm therapy may be stopped. 

There is a lot of talk about tamoxifen and its effects on pogesterone or how it lowers blood levels of arimidex and letrozole . All that aside (i personally think its over hyped), one can use the serm Raloxifene which puts these fears to rest.

Gyno symptom? Lump etc. Start 60mg ralox/day and up ai dose as current dose was not adequately managing estrogen. When lump goes away cease serm use and continue on with elevated ai doages till end of cycle up to pct.

Thoughts?

_Thread source: http://forums.steroid.com/anabolic-s...etro-gyno.html_

----------


## austinite

oops.

----------


## Buster Brown

Agree with the Tamoxifen protocol. Just got the "opportunity" to try it for the first time. It took about three weeks to notice a difference and now there are no sighns of a lump. I was told to be patient with the the tamox. because it takes a while to kick in and not to get impatient. Nice write up, my brother went the route of Letro for gyno he developed on cycle and it totally wiped him out and more or less ruined an otherwise productive cycle.

----------


## jimmyinkedup

http://forums.steroid.com/anabolic-s...etro-gyno.html

----------


## austinite

^ Sorry jimmy. It was late I guess I forgot about that thread.

----------


## jimmyinkedup

> ^ Sorry jimmy. It was late I guess I forgot about that thread.


Naah I dont see it that way. The more people that say it, hopefully the more people will take heed and learn from it. The goal is to help people, the more doing it the better buddy.

----------


## Lemonada8

Sticky Quality! 

Great post!

----------


## kelkel

X2. Combine both Jimmy's and Austin's into one sticky.

----------


## Bio-Active

As usual awesome info from Austinite and Jimmy!!

----------


## austinite

Added jimmy's post/thread to support my post .

----------


## Iron Mind

Great read. Very helpful on what to do what developing gyno and what to do about it.

----------


## Java Man

Ok now go re-write all those old beginner cycle stickys  :Stick Out Tongue:

----------


## austinite

> Ok now go re-write all those old beginner cycle stickys


Done: http://forums.steroid.com/anabolic-s...rst-cycle.html

----------


## Java Man

Nice. Lol. Fast too!

----------


## lidding

Would using clomid in conjunction with aromasin reverse gyno?

----------


## austinite

No. Ralox and Nolva focus on breast tissue. Clomid works more in the brain. Aromasin is an AI, not a serm.

----------


## JackedJesse

So if I have low T because I didn't do a proper pct a few months ago and Im now getting puffy sensitive nipples, do I have gyno, or can I just go straight to an AI? Thanks

----------


## ppwc1985

Nice thread, yes to the sticky, now austinite if you could get those op with problems to actually read it instead of just starting threads that will be something  :Smilie:

----------


## Speedslayerr

Damn I wish I saw this thread earlier. I just bought liquid Letro and Liquid Ralox. I have some residual gyno from a botched cycle a few months ago, and I was researching here before I bought it, but it seems that I didnt research enough. So only the Ralox for the gyno? Just save the Letro?

----------


## mockery

From self testing i have found that high dosages of test with an ai and 60mg daily of The SERM still presented continue growth of the glands, 2 week after last injection the glands and growth have decreased in size at a rapid rate. Even a bigger fibrous growth has become soft and pliable with some size decrease.

----------


## devil-1986

ralox can do it the same as arimidex or letro for balancing estrogen level ? and can do it for lowering down estradiol or estrogen level to the safe range ?

----------


## Bio-Active

> ralox can do it the same as arimidex or letro for balancing estrogen level ? and can do it for lowering down estradiol or estrogen level to the safe range ?


^*^no

----------


## paxman1

What are the recommended dosages of Raloxifene for pubertal gyno? 60 mg ED or 30 mg ED?

----------


## Bio-Active

> What are the recommended dosages of Raloxifene for pubertal gyno? 60 mg ED or 30 mg ED?


How long have you had it. I believe if it has been there long enough you may not be able to reverse it once the tissue has matured

----------


## paxman1

I've had it for more than 5 years for sure, maybe even from childhood but I wasn't aware back then. Check my thread please (Letro and nolvadex didn't help for pubertal gyno).

----------


## Tank123

hey guys just a lil confused u say not to use ais on cycle yet all cycles and cycles writen before youv said to use adex .25mg eod or aromasin can someone please clear this up thank you  :Smilie:

----------


## Bio-Active

> hey guys just a lil confused u say not to use ais on cycle yet all cycles and cycles writen before youv said to use adex .25mg eod or aromasin can someone please clear this up thank you


I don't think anyone is saying not to use an ai on cycle. You use an ai on cycle and serms for pct

----------


## Tank123

ya make sense thanks bro

----------


## devil-1986

can tamoxifen increase e-2 levels ?

----------


## Bio-Active

> can tamoxifen increase e-2 levels ?


Tamox is a serm it doesn't lower circulating estrogen but competes with the receptor in the mammary glands fighting off gyno. I have never heard of tamox increasing estogen. Its probably just estrogen rebound if anything

----------


## devil-1986

> Tamox is a serm it doesn't lower circulating estrogen but competes with the receptor in the mammary glands fighting off gyno. I have never heard of tamox increasing estogen. Its probably just estrogen rebound if anything


then what should i do for e2 rebound ? what your suggestion for Prevention of e-2 rebound ?

----------


## redz

Letro works but definitely crushes estrogen I can see the benefit of using a serm instead. I've had success with both but felt way better without the letro.

----------


## Bio-Active

> then what should i do for e2 rebound ? what your suggestion for Prevention of e-2 rebound ?


as long as you are using the serms I wouldn't worry to much about the rebound as your mammary glands should be fine

----------


## Mrharoto

Austinite, what would be your take on using torem at 60mg ed do on reversing gyno?

----------


## devil-1986

if some one start the cycle with pre existing gyno then should he begin that cycle with both tamoxifen and ai ?

----------


## beetlejuice13

So, I have small pee sized lump under my left nipple. I am currently running Test p, and tren ace and masteron ! So I started cycle without any ai because it was late getting to me which I should have waited. anyway now I have been using the Letro gno reversal which ive found on few other sites! So my question is how do I get off the letro cant just stop right? Also, since I do not have Raloxifene on hand should I use adex till I get it?? Oh forgot to mention I am running caber, I dont think its prolactin related anyway since my chest looks fine it just the little bump!! Please help me out!!

----------


## oxfordbeta

I see that this thread is fairly old but i'll still give the question a shot. I have read that Ralox may be effective in reversing pubescent related gyno, as far as experimenting with it should I be concerned with some sort of "rebound" in any way when using it? Thanks in advance.

----------


## Pantelis1001

Hi Guys,

I have to understand somethings so pls help.

Lets say that someone is on cycle while he uses hcg and an A.I in the lowest doses. For example 250iu of hcg eod and 0.25 mg aromasin /day.
If he do his mid cycle blood work and sees some estrogens higher than they should be what is the next step?

He have to increase the dose of the A.I? And how much?
Or is it better to start a serm ? And that should be Raloxifen or Nolva?
After the last injection of the cycle should he do blood work again or he must wait 60 days?

Sry if i am speaking bullshit. I try to understand how things work.
Thxxx

----------


## numbere

> Hi Guys,
> 
> I have to understand somethings so pls help.
> 
> Lets say that someone is on cycle while he uses hcg and an A.I in the lowest doses. For example 250iu of hcg eod and 0.25 mg aromasin /day.
> If he do his mid cycle blood work and sees some estrogens higher than they should be what is the next step?
> 
> He have to increase the dose of the A.I? And how much?
> Or is it better to start a serm ? And that should be Raloxifen or Nolva?
> ...


This thread is about treating gyno with SERMs. This not the right place to be asking these questions. If you have cycle related questions then you should create your own thread in the Q&A section. 

Your hypothetical questions are difficult to answer because advise is tailored to each individuals unique situation. In short, yes the AI dose should be increased but without more information I have no idea how much. SERMs should not be used for keeping E2 within range. SERMs only regulate the amount of E2 that attaches to the receptor and do nothing to change serum levels.

----------


## Pantelis1001

> This thread is about treating gyno with SERMs. This not the right place to be asking these questions. If you have cycle related questions then you should create your own thread in the Q&A section. 
> 
> Your hypothetical questions are difficult to answer because advise is tailored to each individuals unique situation. In short, yes the AI dose should be increased but without more information I have no idea how much. SERMs should not be used for keeping E2 within range. SERMs only regulate the amount of E2 that attaches to the receptor and do nothing to change serum levels.


Ok Thx and i am sry.

I have one more question about the matter. Somewhere in the article Austin propose not to use A.I with Serms because E2 levels could rise. In the case of gyno reverse on cycle, where the proposals are nolva or raloxifene, what someone should do? Stop using the A.I?

----------


## numbere

> Ok Thx and i am sry.
> 
> I have one more question about the matter. Somewhere in the article Austin propose not to use A.I with Serms because E2 levels could rise. In the case of gyno reverse on cycle, where the proposals are nolva or raloxifene, what someone should do? Stop using the A.I?


You're mistaken austinite never makes those claims. You should read the thread again. The quote below is directly from the OP. 


> I think gyno treatment should be 2 fold , treatment and then management. The treatment and management should occur at the same time using a serm and an AI. The SERM will IMMEDIATELY begin to prevent and treat gyno. The ai will manage estrogen levels lowering them to a proper level where serm therapy may be stopped.

----------


## Deadren

I had some pretty bad gyno in the past. Tried everything, nothing shrunk it like letro, made me a depressed zombie tho, but after the lump i had that was the size of a grape shrunk entirely down to barely anything.

----------


## austinite

> I had some pretty bad gyno in the past. Tried everything, nothing shrunk it like letro, made me a depressed zombie tho, but after the lump i had that was the size of a grape shrunk entirely down to barely anything.


Letro does not reverse gynecomastia . Your chances of a re-occurrence are entirely high.

----------


## austinite

> I see that this thread is fairly old but i'll still give the question a shot. I have read that Ralox may be effective in reversing pubescent related gyno, as far as experimenting with it should I be concerned with some sort of "rebound" in any way when using it? Thanks in advance.


Yes, it has been proven to aid in pubertal scenarios. And no, there is no rebound effect.

----------


## TrevHoff

Yet another great thread here Austin.

Question... I had pubescent gyno that I had surgery on in my early 20's now 34. I have NEVER been happy with the surgery results as he needed to leave some of the lumps to keep the natural curvature of the breast. 

My nipples still puff out to this day and extremely self-conscious about it (although look great when hard and find myself constantly playing with them to make them hard even when alone), would this recommended approach be worth a shot (Tamoxifen : 40mg daily for once week. Then 20mg daily until gynecomastia is reversed) OR is surgery still my only option?

----------


## Lemonada8

^^ if they are puffy tamox/ralox wont do anything for them, they only work if theres a lump there. (speakin from experience and science  :Big Grin:  ) 

from what i found but yet to actually try, DHT gel looks promising for reversing the puffiness due to its actions at help removing excess fluids ( why DHT derivatives make ur muscles hard and not swollen)

----------


## kelkel

> from what i found but yet to actually try, DHT gel looks promising for reversing the puffiness due to its actions at help removing excess fluids ( why DHT derivatives make ur muscles hard and not swollen)


Several of my friends swear by andractim gel in combo with serms.

----------


## TrevHoff

> ^^ if they are puffy tamox/ralox wont do anything for them, they only work if theres a lump there. (speakin from experience and science  ) 
> 
> from what i found but yet to actually try, DHT gel looks promising for reversing the puffiness due to its actions at help removing excess fluids ( why DHT derivatives make ur muscles hard and not swollen)


Yes, I still have lumps that the surgeon had to leave behind to keep the natural curvature of the breast. It is the lumps that I believe are making the nipples puff out.

DHT Gel... Never even heard of it, to think I thought I had brushed up on my gyno knowledge.

----------


## Hydrophile

I'm 20 and have had pubescent gyno for 6 years (Lump type, a few areas of fatty tissue but the only visible part is the puffy nipple). I want to avoid surgery because of the cost and recovery time. Just stumbled on this thread and it this information is much more useful than any physician I've talked to regarding this issue. I haven't used steroids and don't plan to because my goal is only 200lbs (currently 180). That being said, I have a few questions.

* Is it a good idea to see an endocrinologist to check for low test before hand?
* Should you use an AI like DIM with raloxifene? (I'm assuming my estrogen levels are not right)
* Is this anything to be concerned about (Wikipedia):




> Adverse reactions
> 
> Common adverse events considered to be drug-related were hot flashes and leg cramps.[4]
> 
> Raloxifene may infrequently cause serious blood clots to form in the legs, lungs, or eyes. Other reactions experienced include leg swelling/pain, trouble breathing, chest pain, vision changes. Raloxifene is a teratogenic drug, i.e., can cause developmental abnormalities such as birth defects.
> 
> Black box warnings were added to the label of raloxifene in 2007 warning of increased risk of death due to stroke for postmenopausal women with documented coronary heart disease or at increased risk for major coronary events, as well as increased risks for deep vein thrombosis and pulmonary embolism.[4]
> 
> A report in September 2009 from Health and Human Services' Agency for Healthcare Research and Quality suggests that tamoxifen and raloxifene, used to treat breast cancer, significantly reduce invasive breast cancer in midlife and older women, but also increase the risk of adverse side effects.[5]

----------


## devil-1986

have winstrol any effect on gyno ?

----------


## numbere

> have winstrol any effect on gyno ?


Whinny may lower your e2/T+DHT ratio but it's not going to reverse gyno.

----------


## Men in Black

> ga


1 question
does this protocol help pubertal gyno in anyway?

----------


## Lemonada8

yes!

----------


## kelkel

Well look who showed up!

----------


## jimkuhn9

Resurrecting this thread on Halloween.

So should I be taking both the Raloxifene 60mg daily and Tamoxifen : 40mg daily for once week? 

Also I can't find tamoxifen anywhere is this the same as nolvadex ?

I am 26, tried to do a cycle 1.5 years ago, stopped a month in and took arimidex and nolva and still had very painful chest, the swelling went away and came back months later. I used all the arimidex and nova and ran out. Now chest has been painful for like 6 months and there are tons of small lumps ranging from dime to 1 inch long in my chest. I want to try this but do not know if they should be used together? Is nolva tamoxifen?

Nolva worked but always came back. From the side it looks like a girl boob

Thanks.

----------


## kelkel

Use one or the other, not both. They both basically do the same thing. If the lumps are hard and fibrous you need surgery.

----------


## jimkuhn9

> Use one or the other, not both. They both basically do the same thing. If the lumps are hard and fibrous you need surgery.


they bumps move sometimes feel like they go away if I push on them, some days it seems worse then other days. Only one nipple has a bump underneath . I am slightly overweight but my chest clearly sticks out way too much. The bumps run all the way up my outside peck and into my shoulder then disapear. Mainly the bumps are the side of my boob. not much directly underneath the nipple but they are puffy and cone shaped and point outwards. nipples never were sensitive or burning. i just more had a side soreness.

----------


## JaneDoe

Very good

----------


## JaneDoe

:ri muito:

----------


## JohnnyBreeze

I really wish this info had been around back in 2000. I was 21, researched for months, followed the popular advice to the letter. Convinced a doctor to give me a script for Arimidex , had Nolvadex , etc. I thought I was smart because I understood the articles about anti-estrogens, PCT, etc. But I was really stupid because I ignored the fact that I shouldn't have touched juice at that age. 

I did two cycles over the course of one year. I developed really bad gyro and lived with it for over a year. My self esteem was through the floor. I had to wear multiple shirts all the time. Wouldn't have sex with girls because I was ashamed of my chest. I thought I was lucky when I finally got insurance, but it refused to pay. I ended up making friends with a lawyer who wrote a letter for me and after, they cover it. Again I thought I was lucky.

I was so excited to have the surgery. Afterwords the doctor showed me how much tissue had to be removed by not just removing lumps, but liposuctioning my chest. The two piles of tissue were about 6 inches in diameter. When I finally got to look at my chest I knew it was off right away. The doctor told me I needed to wait for however long to let the swelling and everything heal and it would be okay. It wasn't. He took too much tissue off of my left chest so it was flat and pretty much no lower definition of the pec muscle. On my right side there was a little more tissue, but in the area just below my right nipple, the skin is pretty much stuck to my ribs.

I guess you could say it's better than the gyro was, but wearing thin shirts showed the disproportions. Now, 20 years later I'm in slightly better shape so it's not as bad, but I still can't wear thin shirts. Thanks for the info, I really hope it helps others avoid the mistakes I made.

----------


## JohnPatron

Hello i have been off steroids for 3 years and i'm just now getting gyno. mammogram confirmed very slight gyno. I got bloodwork and my test lvl was fine but estrogen is high. Should i follow this protocol that you posted or will i have to stay on it forever. I really just need advise.

----------


## CaptainJericho

Holy shit, no kidding.
I just started Aromasin as a precaution against gyno, and holy fuck every joint hurts like fucking crazy. I feel like I pulled my back in the middle of a 3 day stint of not working out at all (and even my "workouts" are at home with bands and whatnot, so not exactly like I'm tearing it up DLing, etc).
This has me really rethinking AIs in general.

----------

