Info about Gyno

[Pianoman]

am posting this thread to help answer all of the questions regarding gyno prevention and reversal, the use of letrozole and other anti-e’s. I will go over everything in very simple easy to understand language. Also we are talking about estrogen gyno here, not progesterone (but using letro will stop progesterone related problems as well since it inhibits all estrogen anyways). Progesterone gyno will be enlargement of your nipple area, the actual aereola, not a lump under it.

Let me make this first point very clear, as I state in my signature this is from my personal experience, so whether you agree with it or not is your own issue. I have helped many people with gyno and it has worked just fine for them as well.

To first understand why you are doing what you are doing I am going to go over a few things and a few definitions:

SERM – Selective estrogen receptor modulator. These drugs work by binding to the estrogen receptors and flooding them in a sense, making it difficult (but not impossible by any means) for estrogen to bind to the receptors and thus prevent the onset of estrogen related side effects.
Most common forms: Tamoxifen (Nolvadex), Clomiphene (Clomid)
AI – Aromatise Inhibitor. These drugs work by inhibiting the aromatization of estrogen. This means that in effect AI’s prevent androgens from converting to estrogen, again, making it difficult (but not impossible) for estrogen to reach receptor sites.
Most common forms: Anastrozole (l-dex, a-dex), Exemestane (aromasin), Femera (letrozole). For our purpose of reversing gyno we are interested in Letro.

Letro and your sex drive:
Letrozole will suppress your sex drive. This is another reason why it is so important to act on preventing gyno as soon as possible. Since we all know that Test should be run in every cycle this will cancel out the effect of sex drive suppression.

Running letro to prevent gyno:
If you decide to run estrogen protection while on cycle (and I suggest you do unless you are aware that you do not require it), you can run either a SERM or an AI. Letro will be the most powerful AI you can use, it will inhibit 98+% of estrogen using a dose as low as .25mg and even lower. This is why I suggest you do not use a dose higher than .50mg while on cycle just trying to prevent estrogen related side effects.

You will want to start running the letro approximately 2 weeks before you begin your cycle to allow it to fully stabilize in your blood. I have often heard the argument that letro takes up to 60 days to stabilize, I don’t know if I buy into this for the reason that I have reversed gyno after using letro for only 1 week. Still to be safe I recommend starting it before your cycle as stated above.

If you do decide to run letro there is absolutely no need to run another AI or SERM. Do not make the mistake of thinking more is better. Think of it this way; if letro is preventing the conversion of androgens to estrogen than there is no estrogen, what would the purpose of a SERM be when there is no estrogen to bind to the receptors? Nolva will only take away from the effectiveness of letro.

This brings me to my next point. Do not listen to anyone who tells you to bump up your nolvadex to 60+mg ED if you get gyno. I have no idea where this idea started but I have seen it suggest far too many times recently. Nolvadex will do nothing to reverse your gyno…let me make that clear IT WILL DO NOTHING FOR GYNO. If you are running nolva as your anti-e and start to develop gyno than sure you can bump the dosage a small amount to try to prevent it from progressing further, but letrozole must begin ASAP.

It is very important that you begin taking letrozole immediately, the longer your wait the more risk you take in not being able to reverse it.

How do I know if I have gyno?
If you have developed gyno you will have a lump behind your nipple. It will be fairly hard, and it will be tender to touch.

Running letro to reverse gyno:
I am going to go over the three different scenarios which people could fit into. Remember regardless of what scenario you are in it is important that you begin taking the letro ASAP.

1. Already using an anti-e aside from letro.
2. Already using letro @ a dose of .25mg or .50mg ED.
3. Not running any estrogen protection.

1.
Day 1: .25mg Letro + anti-e*
Day 2: .50mg Letro
Day 3: 1.0mg Letro
Day 4: 1.5mg Letro
Day 5: 2.0mg Letro
Day 6: 2.5mg Letro **

2.
Day 1: .50mg Letro
Day 2: 1.0mg Letro
Day 3: 1.5mg Letro
Day 4: 2.0mg Letro
Day 5: 2.5mg Letro **

3.
Day 1: .50mg Letro
Day 2: 1.0mg Letro
Day 3: 1.5mg Letro
Day 4: 2.0mg Letro
Day 5: 2.5mg Letro **

*Regardless of the anti-e you are using it is important to still use it for the first day you begin letro as the letro will not have taken any effect and you by no means want your body to be without any protection when gyno is already prevalent.

** You will remain at this dose until gyno symptoms subside. Once you believe your gyno is gone it is important to stay at this dose for another 4-7 days to ensure all traces are gone. I recommend people with a bf% over 15 stay on for a week as it may be harder to judge completely whether the lump is completely gone. Once this period is over it will be important to taper letro down slowly rather than coming off it completely. Regardless of which manner you tapered up your dose you will all taper down in the same fashion.

Day 1: 2.0mg
Day 2: 1.5mg
Day 3: 1.0mg
Day 4: .50mg***
Day 5: .25mg
***You can remain at this dose or go down further to .25mg. It is really up to you at this point. They are both very common maintenance doses as an anti-e while on cycle. Personally I have stayed with .25mg and never had a problem.

Letro and the estrogen rebound:
With your estrogen being completely inhibited there is a definite estrogen rebound as your body tries to re-stabilize the testosterone:estrogen balance. We can prevent this rebound effect by supplementing further with another AI or SERM. So, I suggest that when you are coming to the end of your cycle you will more than likely be using Nolva in your PCT so just make sure that you begin taking nolva the last day you are going to take your letro and then continue on as you would with regular PCT.

This now leads us into the question of reversing gyno while not on cycle. There are a few things to remember here. You have already waited longer than you should have, and your sex drive will be shot. You can use tribulus or another natural test booster to help you in this scenario but I can’t guarantee the effectiveness. Just follow gyno reversal protocols 2 or 3. When coming off again you must taper and begin using nolvadex to prevent any rebound effect that may occur.

How much nolvadex should you use if you are not going into PCT and running this off cycle? I suggest starting at 20mg ED for a week and then lowering it to 10mg for another week and then coming off completely.

[access]

I have seen this post around the boards now for some time and for the most part is reasonably good information but this statement is just plainly false and wrong:

This brings me to my next point. Do not listen to anyone who tells you to bump up your nolvadex to 60+mg ED if you get gyno. I have no idea where this idea started but I have seen it suggest far too many times recently. Nolvadex will do nothing to reverse your gyno…let me make that clear IT WILL DO NOTHING FOR GYNO.

Nolvadex will reverse gyno and there are clinical studies and trials backing this up so completely ignore that part of the advice.

This also leads to why all of us should be doing our own research and not listening to self proclaimed gurus on internet boards as you could well be given the wrong advice. Just a word of warning.

[access]

Here are three studies which show Nolvadex is effective in treatment of gyno:

1)
Prevention and management of bicalutamide-induced gynecomastia and breast pain: randomized endocrinologic and clinical studies with tamoxifen and anastrozole.
Saltzstein D, Sieber P, Morris T, Gallo J.
Urology San Antonio Research PA, Pasteur Medical Plaza, San Antonio, Texas, USA.

A randomized, double-blind, placebo-controlled multicenter trial involving 107 men receiving bicalutamide ('Casodex') 150 mg/day therapy following radical therapy for prostate cancer assessed tamoxifen ('Nolvadex') 20 mg/day and anastrozole ('Arimidex') 1 mg/day for the prophylaxis and treatment of gynecomastia/breast pain. Tamoxifen, but not anastrozole, significantly reduced the incidence of gynecomastia/breast pain when used prophylactically and therapeutically. Serum testosterone levels increased with tamoxifen relative to placebo but prostate-specific antigen levels declined in all treatment groups. Further studies are needed to define the optimum tamoxifen dose and to assess any impact on cancer control. The use of tamoxifen in this setting remains to be investigated



2)
1: J Pediatr. 2004 Jul;145(1):71-6. Related Articles, Links

Comment in:

* J Pediatr. 2005 Apr;146(4):576; author reply 576-7.
* J Pediatr. 2005 Apr;146(4):576; author reply 576-7.

Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia.
Lawrence SE, Faught KA, Vethamuthu J, Lawson ML.
Department of Pediatrics, University of Ottawa, Ontario, Canada.

slawrence@cheo.on.ca

OBJECTIVES: To assess the efficacy of the anti-estrogens tamoxifen and raloxifene in the medical management of persistent pubertal gynecomastia.

STUDY DESIGN: Retrospective chart review of 38 consecutive patients with persistent pubertal gynecomastia who presented to a pediatric endocrinology clinic. Patients received reassurance alone or a 3- to 9-month course of an estrogen receptor modifier (tamoxifen or raloxifene).

RESULTS: Mean (SD) age of treated subjects was 14.6 (1.5) years with gynecomastia duration of 28.3 (16.4) months. Mean reduction in breast nodule diameter was 2.1 cm (95% CI 1.7, 2.7, P <.0001) after treatment with tamoxifen and 2.5 cm (95% CI 1.7, 3.3, P <.0001) with raloxifene. Some improvement was seen in 86% of patients receiving tamoxifen and in 91% receiving raloxifene, but a greater proportion had a significant decrease (>50%) with raloxifene (86%) than tamoxifen (41%). No side effects were seen in any patients.

CONCLUSION: 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. Further study is required to determine that this is truly a treatment effect.

PMID: 15238910 [PubMed - indexed for MEDLINE]

3)
Management of physiological gynaecomastia with tamoxifen.
Khan HN, Rampaul R, Blamey RW.
Professorial Unit of Surgery, Department of Surgery, Nottingham City Hospital, Nottingham NG5 1PB, UK.

AIMS: We aimed to confirm suggestions that tamoxifen therapy alone may resolve physiological gynaecomastia. METHODS: A prospective audit of the outcome of tamoxifen routinely given to men with physiological gynaecomastia was carried out at Nottingham. Men referred with gynaecomastia had clinical signs recorded, e.g., type (diffuse 'fatty' or retro-areolar 'lump'), size and possible aetiology. They were offered oral tamoxifen 20mg once daily for 6-12 weeks. On follow-up patients were assessed for complete resolution (CR), partial resolution where patient is satisfied with outcome (PR) or no resolution (NR). Success was either CR or PR. RESULTS: Thirty-six men accepted tamoxifen for physiological gynaecomastia. Median age was 31 (range 18-64). Tenderness was present in 25 (71%) cases. Sixteen men (45%) had 'fatty' gynaecomastia and 20 had 'lump' gynaecomastia. Tamoxifen resolved the mass in 30 patients (83.3%; CR=22, PR=8) and tenderness in 21 cases (84%; CR=0, PR=0). Lump gynaecomastia was more responsive to tamoxifen than the fatty type (100% vs. 62.5%; P=0.0041). CONCLUSIONS: Oral tamoxifen is an effective treatment for physiological gynaecomastia, especially for the lump type.

[fcpcjc]

I'm walking, living, breathing proof that Nolvadex will reverse gyno.

[babybull34]

Used Nolva myself on two separate occasions

[h4x0l2]

This brings me to my next point. Do not listen to anyone who tells you to bump up your nolvadex to 60+mg ED if you get gyno. I have no idea where this idea started but I have seen it suggest far too many times recently. Nolvadex will do nothing to reverse your gyno…let me make that clear IT WILL DO NOTHING FOR GYNO.


I hear deca + nolva won't reduce gyno, is that where the context of that statement was access?

[Pianoman]

Agreed Access. A better choice for wordage would be " Increasing intake of Nolvadex to higher amounts (60mgs) would not have a more profound effect than a standard dosage of 20mgs. I have always thought of Nolvadex as more of a preventative measure, taken always at the end of cycle during PCT. Or at the very onset of soreness of nips to prevent further problems. And other methods that are more suited at tackling a more serious situation. Good articles, to correct the statement in the post. Also in the studies in those articles..the subjects in the 2nd article were taking nolvadex for 3-9 months at 20mgs a day...and in the third study they took it for a month and a half-3 months. That seems like a very long time period. Thanks access! give some more feed back...

[New Blood]

So is it okay to run nolvadex throughout the entire cycle?

[h4x0l2]

Originally Posted by New Blood

So is it okay to run nolvadex throughout the entire cycle?

no, its best to just use nolva for pct. use arimidex/dostinex for gyno prevention during a cycle.

[young gunz]

im taking an all d -bol cycle for 3 weeks its my cycle ever when do i take my clomid? i dont want gyno or any of that other shit. should i take it throughout my whole cycle? thank.