Testosterone Replacement Therapy (TRT) helps restore healthy testosterone levels in men, but a small amount of testosterone naturally converts into estrogen. This is called aromatisation.
While some estrogen is important for male health—supporting mood, libido, and brain and cardiovascular function—excess estrogen can cause unwanted symptoms.
At Hormn, we reduce the risk of high estrogen by:
Starting with low doses
Using small, frequent injections to keep hormone levels stable
Adjusting based on symptoms and bloodwork, not automatically
Common Symptoms of Elevated Estrogen
Nipple sensitivity or puffiness
Water retention, bloating, or facial puffiness
Emotional changes—irritability, low mood, or anxiety
Reduced libido or erectile changes
Fatigue or brain fog
Common Causes of High Estrogen
Excess body fat (especially >16%)
Fat tissue increases aromatase activity, converting more testosterone to estrogen.Undiagnosed sleep apnea
Causes systemic stress, hormonal imbalance, and impaired clearance of estrogen.Insulin resistance
Increases aromatase activity and affects hormone metabolism.Alcohol consumption
Reduces liver function and increases estrogen production.Liver dysfunction
Estrogen is processed through the liver—poor liver health impairs clearance.Lack of cardiovascular exercise
Leads to poor metabolic function, reduced estrogen clearance, and body fat retention.
How We Manage Estrogen
Routine blood tests at 8 weeks and every 4 months
Symptom tracking via the portal and check-ins
Doctor-led decision-making—we do not prescribe estrogen blockers unless medically indicated
Estrogen blockers (like aromatase inhibitors) are rarely needed and can worsen your outcomes if used incorrectly—causing joint pain, low libido, fatigue, and poor cholesterol levels if used when not needed.
What You Can Do
Stick to your prescribed dose and schedule
Avoid increasing or skipping doses, which can destabilise hormone levels.Improve body composition
Aim to reduce body fat below 16% through resistance training, cardio, and diet.Avoid alcohol and manage sleep
These lifestyle factors have a direct effect on estrogen balance.Complete all scheduled blood tests and consults
Your doctor will assess estrogen with each test to catch issues early.
High estrogen is manageable and often preventable. With low, stable TRT dosing and regular monitoring, most patients do not experience issues.
When symptoms do occur, they are usually temporary and can be resolved by adjusting lifestyle factors and, in some cases, modifying the TRT protocol.
Always message your doctor if you notice symptoms or have questions.