Can High Estrogen Make You Tired on TRT?

Can High Estrogen Make You Tired on TRT?

If you haven’t already caught on, you’re likely learning how much of a problem estrogen can be while on TRT.  I created a post a while back outlining common estrogen symptoms (high vs low) With that said, it’s important to note these are general guidelines and every person reacts differently. For example unlike the most common symptoms listed below, when my estrogen is high I get extremly lethargic. The complete opposite of the most popular symptoms. Let’s look at the most common symptoms then, I’ll provide a little input of my own from personal experience:

Low Estradiol Symptoms: 

  • Fatigue along the lines of sleepiness
  • hypersomnia (sleeping too much and too often)
  • strong erections but limited sensitivity
  • loss of erections
  • osteoporosis and osteopenia
  • joint pain, clicking or popping joints
  • eye fatigue (eyes seem more tired despite adequate sleep, dark circles)
  • loss of libido (interest in sex)
  • difficulty retaining water (constant urination)
  • anxiety, depression, irritability

High Estradiol Symptoms: 

  • Soft erections, inability to maintain an erection
  • water retention (less frequent urination), leading to excessive sweating, blood pressure spikes or high blood pressure (from the water retention)
  • insomnia
  • hot flushing (flushing around the ears or on the face)
  • night sweats (from estradiol lowering, causing loss of water retention)
  • bloating; brain fog (like your head’s in a bubble)
  • testicles seem smaller than usual

Note that nowhere in the “high estrogen symptoms” does it mention being tired. This really threw me for a loop when I first started out on AI medication. Listen to your body. I’ve actually gotten to the point now I can tell without a blood test when my E2 levels are high or low. For example, when my estrogen starts creeping up the first symptom is an intense craving for sugar. I don’t eat sweets and rarely drink soda but the moment my E2 levels start rising (which isn’t often these days) I get a heavy craving for soda. We’re talking cigarette like cravings. (I quit years ago) the second symptom to start rearing it’s head is lack of libido and fatigue. Even after 8 hours of what I consider restful sleep, after 4 hours of being awake, I feel tired again. Not only do I feel tired but I can nap for a solid 2 hours! At this point I’ll usually take .25mg of Arimidex and within 4-6 hours I’m back to normal.

One quick point I’d like to make before ending this post is your weight. Your high estrogen is converted through fat, the less you have, the less likely you are to have issues. I had horrible problems with estrogen when I first started out on TRT. Depression, sleepiness, you name it, I had it. The past three months I’ve dropped a solid 20 pounds through diet changes. I take Arimidex these days at most once a month, if that. My weight loss really has made that big of a difference.

In the meantime, if you find the usual information online isn’t helping and you suspect your estrogen is creeping up, start with a low AI dosage, wait and see how you feel. Everyone is different and we all eventually settle into our particular regimens. If possible get a blood test done. (No insurance? See the post I wrote about affordable cash based blood testing) Hang in there and don’t feel down, this is fixable!



  • Nathan Evans Posted May 26, 2016 4:04 pm

    I have found that most doctors are not willing to consider an off label prescription to control estradiol. Their idea of controlling it is to lower the dose of testosterone which puts me back where I started.

    My urologist started me on testosterone and I was on as much as 400 mg every 2 weeks but needless to say that spiked my estrogen. I felt great except for the water retention. I now take 200mg testosterone cypionate every week which is vastly better; however, I still have some measure of water retention and still have a lot of fat retention. My bf is roughly 30% and despite eating well, crossfit and powerlifting I can’t seem to get to where testosterone does its thing and helps lower this. I would assume that this is likely due to high estradiol. My tests have always showed me to be at the higher end.

    I went to an endocrinologist who also balked at the idea of an AI for controlling estradiol and said he needed documentation and research of some type to consider it.

    What are my options? I don’t want to doctor shop or anything. I’m finally at a great dose that works but can’t drop my estrogen.

    • James Posted May 26, 2016 6:01 pm

      Your dosage schedule sounds very similar to how mine was once upon a time. I use quite a bit less now (it works for me personally) but if you want to lower your estrogen with no access to an AI then split up your dosage. I read this over and over again but really didn’t want to try it. Finally, I gave in and figured I’ve got nothing else to lose. What a difference it has made! Though I have access to AI, I generally don’t need anymore. I take my shot every 4 days. (Use a reminder app to help you) So if you’re doing 200mg a week, split it into 100mg twice a week. (every 4 days is the magic number for me) The idea here is to prevent a spike from happening in the first place (as this is when the conversion from T to E happens). Try to imagine a roller coaster track with lifts and dips. We’re trying to straighten out that track. Taking the shot twice a week sucks, but the benefits far outway the inconvenience for me.

  • Jeffrey Quiros Posted August 8, 2016 5:18 pm

    On 100mg twice a week I’m having a lot of trouble controlling estrogen. I’m very sensitive to e2 and to arimidex.

    .25mg twice a week is way too much but .135mg twice a week is not enough.

    I hate liquidex.

    What should I do?

    • James Posted August 8, 2016 7:05 pm

      I can’t really comment without knowing your numbers or how much T you’re on. But Arimidex is a pretty strong drug. I used to take .25 a couple times a week and it tanked me. Depression, loss of just about everything, mood swings you name it. (Thing is, I didn’t even realize I was low until after I finally managed to control things. Looking back now I don’t know how I made it through to be honest) These days I take 1/8th a cut from a 1mg pill perhaps every two weeks. But what made a big difference for me (and I was really resistant to trying this) was splitting my dose and taking it twice a week. (So if you’re on 1ml a week do .5ml every 3-4 days) I know it seems like it wouldn’t help much, but it does. The idea behind this is that your T levels never spike high enough to convert over to Estrogen. I highly suggest it. Since doing so, I rarely have to take Arimidex to correct my estrogen levels. It took about 2 weeks but my drive, energy, thought process everything is what I would consider back to normal if not better than pre TRT.

  • James o Posted October 5, 2016 1:37 pm

    Jeffrey, why not try .25 e4d?

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