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A small amount of gyno that resulted as a result of puberty can happen with some young men. Generally, it's not of concern in the long run. When you start with Defy you will have a full set of labs done including estrogen utilizing the sensitive assay. If you are in the normal range then...

Alll PDE5i's were designed for long term use. I have never read any clinical studies that indicate that there is a tolerance factor. I've used Cialis for years with great success.

This is exactly why a man can't use the standard default estrogen lab designed for women as it over estimates men's values. You were prescribed an AI when you probably never needed it. As noted, your estrogen is seriously suppressed. You need to stop the AI and let your E2 rebound....and this...

My Sensitive E2 lab just came back at 45 pg/ml with 35 being at the top of the reference range. I have no symptoms whatsoever and my libido is very strong...I have no need for an AI whatsoever.

HGH can be a very nice compliment to TRT. Keep in mind, HGH is not a neurohormone so you won't get that "keep good" that you get with Testosterone or HCG. It takes a while for HGH to see any effects but lose of body fat and gains in lean muscle mass will be the two you will notice the most...

I use 10 mg of Cialis daily and have used Trimix at the same time with no issues whatsoever.

Your response at those tiny dosage changes doesn't make sense. I suspect you're not injecting correctly.

Excellent observation.

When did you last run labs? Sounds like something is off as long as the quality of you HCG hasn't changed and you are reconstituting and dosing correctly.

You should read my "Gene's NO Stack" sticky in the supplement forum as it has over 286,000 views and has become epic as it has helped so many men: https://www.excelmale.com/forum/showthread.php?198-Gene-s-Nitric-Oxide-Stack

I've stayed away from it for just that reason; it can have PFS effect from my research as well.

OT: But I just got my labs back today. I totally forgot about not having sex for 48 hours prior to my pull. The day before my new girlfriend of 7 months and I had sex a few times the morning the day before my pull ... about 24 hour gap. PSA? 1.0 Go figure LOL:)

200 mg a week of Testosterone injected and 1500 iu a week of HCG would probably put most men a bit into the supraphysiological range. It's probably why E2 is a bit elevated as well. Lower these doses and go twice weekly on your testosterone injections and all will fall in line and so will E2...

What Vince said or unless you have a prostate infection like Prostatitis which would cause the same. Just get retested and talk to your Doctor...any serious pathology would take longer to get to those levels.

Your labs are not that bad at all. Dr. Saya will reduce your dosages for both Testosterone and HCG. 500 iu of HCG per injection is more then enough and 1500 iu a week will produce a nice level of endogenous testosterone as well. Don't do anything till Dr. Saya speaks to you ... this is very...

10 mg daily will help for sure. 2.5 mg is tiny dose. Remember, Tadalafil has about a 16 hour half life.

Cabergoline is a Dopamine agonist and can increase both libido and orgasm intensity. I use .25 mg twice weekly with fantastic results.

I have seen misinformation on Clomid (Clomiphene) too often - Men on TRT taking Clomid thinking that it will keep their testes producing testosterone (T) while on TRT. WRONG. Let me try to clear up this mess. Testosterone production is controlled by the hypothalamus-pituitary-testicular axis...

Just a little bit of searching the stickies on the Testosterone forum and you would have found this and other goodies! https://www.excelmale.com/forum/showthread.php?5040-Blood-Tests-Needed-Before-and-During-Testosterone-Replacement-Therapy

I don't like DIM...never had never will. In fact, there's a thread in here with a study that suggests in can even increase E2. And why an OTC vitamin can't be compounded with a drug makes no sense at all. Why are you on .5 mg of an AI? Do you have very elevated estrogen levels?

It's a possibility but all things being equal and factoring in the drug can't simply rule it out. Read here: http://www.medicinenet.com/metformin-oral/article.htm

Sounds like negative side effects due to the Metformin.

CW has it right; it is imperative that you learn the basics of TRT before you start any TRT protocol. There are a number of banners here where you can get books that are written by some of the top minds in TRT for men. Also this site and the forums has all that you need to learn as well...

Was this a once occurrence or does it happen all the time?

Adenoma's can be so small sometimes that they don't shop up well on an MRI; it happens. The high Prolactin combined with suppressed testosterone serum levels still point to a Adenoma in my opinion. She should have prescribed a low dose of Cabergoline to get your levels to mid range and see how...

Two good reads in case you didn't find them in the forums: https://www.excelmale.com/forum/showthread.php?6657-DHEA-Supplementation https://www.excelmale.com/forum/showthread.php?6658-Pregnenolone-%C2%96-By-Gene-Devine

Relax man! You're doing it right to see an ED Physician first. They will ask you a number of critical questions about your health, drugs you take, lifestyle and of course erection quality. These are very important to determine strength and dosages. Once the Doc has a good read on you he...

What are your Free T values? SHBG is one hormone that likes to find its own level in men and as long at Free Testosterone are in the physiological range it's really not worth worrying about as you can't do a lot to raise or lower levels. Vince is correct; when SHBG levels are low it's best to...

As for the alcohol consumption; I wouldn't be so concerned. I've been using Tadalafil (Cialis) for years and have gotten pretty buzzed a bunch of times and never ever had a problem. Like all things, keep an eye on it if you see any negative sides; but I think it a very low event to be honest.

Yes, AI's are very powerful antagonists in men and most on TRT doses simply don't need it. BTW, are you really prescribed 140 mg every other day? What's your total and free testosterone levels like?

Yes, that's fine. But why such a small does? Pregnenolone is not estrogenic.