A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT

Juced

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10+ Year Member
A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read


SERMs and Aromatize inhibitors

Well today I would like to talk about something EVERYONE should know about before ever considering any sort of steroid use .
Now I feel steroids can be used fairly safely but there are some basics you need to know or you may end up with lifelong issues or a costly one.
Now that was not meant to seem as bad as it may sound, I am talking about Gynaecomastia mainly and why it is so important to understand. I also want to talk about the compounds that can help you avoid it, help it and possibly cure it.
Sadly once gyno has developed extensively and has been there for some time, there might not be any other option but to get your breast glands cut out if you wished to get rid of the gyno. There has been some help with high dosed AI use like Letro, but that is very unhealthy to the body as some estrogen is needed for functions.

Sounds like a bad idea not to know what an AI or SERM is now huh?

Thats why I want to talk about Selective estrogen receptor modulators (SERMs) and Aromatase inhibitors (AIs) today.
They are VERY easy tools to use that everyone should have on hand to keep any Gyno issues at bay. They also aid you in Post Cycle Therapy (PCT) possibly leading to a faster, fuller recovery after a steroid cycle .

If you are new to this all then here is a small definition of what Gyno is:
Gyno is the abnormal development of large mammary glands in men, resulting in breast enlargement.

Yah thats right you might just grow a pair of tits if you dont know what you're doing!
It really bothers me when I see so many posts like; how do I take away my gyno or is this gyno? or even I have gyno and I am taking an AI with my Tren and Test, so why is there gyno? (The last one was due to not knowing there is more than one type of gyno that is handled differently then with just estrogen related gyno)

These are things that should have been well researched before even considering the use of any sort of steroid.
There is more than one type of gyno, so make note of it!
Most of the Gyno issues you hear about are related to estrogen and seems to be the most common, thats where some might get into trouble when using other compounds that dont Aromatase but are progesterone/progestin based like Deca or Trenbolone .

Progestin seems to have a role in gyno development also and would warrant the use of not just an AI but also something to lower your progestin/prolactin levels like a prolactin antagonizer called Pramipexole while using compounds where things other than estrogen might be involved.
Prog-Gyno can even lead to leaky nipples! Yes like milk type thing!
I know trust me***8230; I was once young and new to all this myself.
Now I never had full blown gyno but I did get the wet nipples on a deca cycle early on in my Studies!
I found using an AI helped keep this away without a prolactin antagonizer, but that wont work for everyone, so gain HAVE IT ON HAND JUST IN CASE!

There seems to be a lower chance prog-Gyno issues when keeping estrogen levels low during cycles of say for e.g.; Deca and teste or tren and test, but I would not solely rely on an AI and would ALWAYS recommend having a prolactin antagonize like Prami (Pramipexole) on hand when using compounds like NPP, Deca or Trenbolone even if you do not plan to use it.

So what AI, SERM or Prolactin antagonizer should I take?

Well there are a few out there, along with some debate on which is better or what combo is better, but the basics are basics and any pick will do.



So what is a SERM?

SERM stands for "Selective estrogen receptor modulators".
SERMs are a class of compounds that have an effect on the estrogen receptor. SERMs effects on tissue vary, giving it the possibility to selectively inhibit or stimulate estrogen-like actions in various tissues. It also stimulates an increase of follicle-stimulating hormone and luteinizing hormone from the pituitary gland.[1]
What we care about its blocking of estrogen at the breast glands and the follicle-stimulating hormone and luteinizing hormone from the pituitary gland which is why we use it in Post Cycle Therapy (PCT).

At the end of a steroid cycle your own bodys natural hormonal production will most likely (if not every time) be suppressed/shut down and although stopping all steroids and waiting would eventually lead to recovery (if that was what was going to happen in your case). But the thing is it may take much longer to recover and that means a much greater chance of lost gains and emotional mood swings amongst other things.
That is why a SERM is highly recommended, SO much so that some even think if you DONT do a PCT that you wont recover!
Now although that is not true, it is true you SHOULD ALWAYS have a good PCT ready and on hand EVERY time you start a steroid cycle.
Doing so would aid the body in stimulation of the endocrine system and get things going in the direction you want quickly! (recovery).


What is an AI?
An AI stands for Aromatase inhibitor. (AI's) are a class of drugs originally developed for and used in the treatment of breast cancer and ovarian cancer. AIs also have the off-label use to treat or prevent Gynaecomastia in men. Aromatase is the enzyme which synthesizes estrogen in your body, sometimes even right from testosterone . AIs are usually taken to block the production of estrogen.
An AI should be on hand EVERY time a steroid cycle is started EVEN if you dont think you will need it and dont plan to use it, HAVE IT ON HAND!

Another good thing about keeping estrogen in check is Blood pressure, you might have some bloating and higher blood pressure if your estrogen levels are too high or unstable (fluctuations usually from miss-use of an AI and steroid or it would just be high all around in most cases).
That means using an AI will not only keep Gyno away but it may also lower your BP and help keep bloat/edema away!
Awesome stuff I think!


Cant I just use a SERM like Clomid for gyno and PCT?

NO! Well I mean you could, but it is not optimal and I strongly recommend against it.

This is why:
SERMS like Clomid, Tamox and others, only BLOCKS estrogen at some receptors like the breast glands. But it WILL NOT lower estrogen in your body!

If you have Gyno setting in and started up Clomid or Nolva sure you would block the gyno but your estrogen levels would still be building up and in my opinion that is NOT a good thing.
If you were not very smart, didnt think ahead and didnt have an AI on hand and only SERMs, then yes you could start a low dose while you wait for the AI to come, BUT USE THE AI for gyno control long term!
I ALWAYS tell people to use an AI for gyno/estrogen control; its just the most effective and healthy way to go about it.
Save the SERM for PCT use and IF NEEDED the onset of gyno while waiting for the AI to take full effect (if that ended up being the case).
Other than that I feel a SERM should not be used for gyno control and only as part of a PCT.

Some of the older guys may have used a SERMs for gyno control, but we know better now and its time to move with the times.

I am going to list the most used and well known of these compounds with a small description on each, then I will move into how you may want to implement its use and some standard ways of doing so that are generally accepted.




SERMs:

Clomiphene Citrate-
Increases production of gonadotropins by inhibiting negative feedback on the hypothalamus. It is also used in female infertility. Clomiphene has estrogenic and anti-estrogenic effects in the body. It also appears to stimulate the release of gonadotropins, follicle-stimulating hormone (FSH), and leuteinizing hormone (LH).[2] Dosing of 30-100mg daily seems the norm for PCT use.

Tamoxifen Citrate (Nolvadex )-
Tamoxifen is usually used as an endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in women. It is an antagonist of the estrogen receptor in the breast, while in other tissues it acts as an agonist sort of like how Clomid does.[3] Half-life is about 6 days, so ed to eod dosing is best for PCT use. 20-50mg daily seems the norm for this.

Toremifene Citrate (Torem/Fareston)-
Torem Is SERM similar to Tamoxifen (Nolva). Torem is also used to treat breast cancer and also does this by exerting estrogen antagonistic effects in certain tissues like breast tissue (anti-estrogen). It can act as an antagonist in the hypothalamus and pituitary, which could also increase testosterone production (why I recommend it as a PCT). Torem also seems to have a better ability to increase testosterone levels over Tamox because its andro to estro ratio is much greater than Tamox/Nolva. Half life is about 5 days. Dosing daily to eod is recommended for PCT use. Dosing of Torem for PCT at 20-100mg ed seems to be the norm.

Raloxifene (Ralox)-
Raloxifene is a second generation Selective Estrogen Receptor Modulator (SERM). Raloxifene is similar in its action to that of tamoxifene but with much less of an increase in testosterone levels when compared to Tamox or Torem. The half-life is only about 27hrs so daily dosing is optimal for use in PCT. Dosing of 30-100mg ed seems to be the norm for PCT use.




Prolactin Antagonizer (PA):

Prami (Pramipexole)-
Prami has actions similar to Cabergoline (another type of PA) but with a significantly more positive impact on libido and mood. Pramipexole acts as a dopamine agonist and one of dopamine's main function as a hormone is to inhibit the release of prolactin. Pramipexole plays an important role in the inhibition of prolactin secretion which is important to some using some types of steroids where prolactin build up may be an issue. Prami is also used for treating early-stage Parkinson's disease (PD) and restless legs syndrome (RLS).[4] Pramipexole has a half-life between 8-10 hours. Normal dosing is 0.25-0.5mg ED (pre-bedtime dosing is recommended as it make some feel a bit sleepy)




AI's:

Letrozole (Letro)-
Letro lowers estrogen production in the body by blocking the aromatase enzyme, the enzyme responsible for estrogen synthesization. Letro has a very high rate of estrogen suppression in the area of 90%+, so care should be given to dosing as over suppression could lead to side effects associated with low estrogen levels, like achy joints, low energy levels etc. This can be an issue with all AIs but Letro is very good at its job and that leads to helping prevent bloating and gyno which may be associated with the use of AAS.[6] Letro has a fairly long active life so dosing of every other day, to even 1-2 times a week is optimal at doses of 0.25mg - 1.3mg.

Anastrozole (aka LiquiDex/Dex)-
Dex lowers estrogen production in the body by blocking the aromatase enzyme, the enzyme responsible for estrogen synthesization. Dosing of 0.5 mg to 1 mg a day should reduce serum estradiol about 50% in men,[5] which leads to helping prevent bloating and gyno which may be associated with the use of AAS. Active life is fairly short so daily to eod dosing is optimal.

Exemestane (Stane/Aromasin )-
Exemestane lowers estrogen production in the body by blocking the aromatase enzyme, the enzyme responsible for estrogen synthesization. Exemestane has about an 85% rate of estrogen suppression and does this by selectively inhibiting aromatase activity in a time-dependent and irreversible way. That helps prevent bloating and gyno which may be associated with the use of steroids. Stane has a fairly short active life so daily to every other day dosing is optimal.




As you can see there is quite the selection of compounds and this I not all of them.
I think these are the most often used, safe and effective for our topic today.

How would I use this in a steroid cycle?

Do I take it as soon as I stop them?

Do I wait a few weeks?


Well I will give you a few examples of how you would properly incorporate these compounds into your cycle, but something you need to understand is the compounds you are using.
Steroids have differing release and clearance times!
Some might leave your system in hours, like with more orals if you were to stop them today you could start PCT tomorrow (I do not recommend oral only cycles BTW, this is just an example).
But if you were taking for example teste or testcyp, well if you stopped today you would wait 1-2 weeks before starting your PCT because their release times and active life are much longer then the orals.
But some injectables are also very short in active life like NPP or trenAce, with then you would wait 2-4 days and start pct. It is very important to understand EVERY compound you put in your body to be able to use them safely and effectively.

I will list a few examples of AAS cycles with an AI and PCT/SERM implemented:

1#
Wk1-12 500mg teste ew
Wk1-14 0.6mg e3d (2X a week) Letro
Wk13-17 PCT Clomid 50mg ed

2#
Wk1-14 500mg TestE ew
Wk1-12 300mg Deca ew
Wk4-15 0.25mg Prami ed (pre-bedtime)
Wk1-16 12.5mg ed Stane
Wk15-19 50mg Clomid and/or 20mg Nolvadex or 40mg Torem ed


3#
Wk1-10 50mg TrenAce eod
Wk1-12 100mg TestProp eod
Wk1-10 0.25mg Prami ed (pre bed)
Wk1-13 12.5mg Stane ed
Wk12-16 50mg Clomid ed


4#
Wk1-14 400mg TestE ew
Wk1-14 400mg MastE ew
Wk1-16 12.5mg Stane ed
Wk15-19 30-50mg Clomid ed or 20-30mg Nolvadex ed


You can see there are varying ways of doing things, and some may debate on what is best (in my op what I put is best lol) but the basics are there and should be followed regardless of your opinion.

I hope this helps someone out with their Gyno, AI or PCT questions!





ENJOY!










References

1) Riggs BL, Hartmann LC (2003). "Selective estrogen-receptor modulators -- mechanisms of action and application to clinical practice". N Engl J Med 618***8211;29. Selective estrogen-receptor modulators -- mecha... [N Engl J Med. 2003] - PubMed - NCBI
2) Endocr J. 2010;57(6):517-21. Epub 2010 Apr 6. Clomiphene citrate elicits estrogen agonistic/antagonistic effects differentially via estrogen receptors alpha and beta. Kurosawa T, Hiroi H, Momoeda M, Inoue S, Taketani Y. Clomiphene citrate elicits estrogen agonistic/antag... [Endocr J. 2010] - PubMed - NCBI
3) Br J Pharmacol. 2006 January; 147(S1): S269***8211;S276.Published online 2006 January 9 Tamoxifen (ICI46,474) as a targeted therapy to treat and prevent breast cancer Tamoxifen (ICI46,474) as a targeted therapy to treat and prevent breast cancer
4) Pramipexole (Sifrol and Sifrol ER) for Parkinson***8217;s diseaseMedicine Update August 2010: Date published: December 2009 Updated: August 2010 Pramipexole (Sifrol and Sifrol ER) for Parkinson
5) Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels. Benjamin Z. Leder, Jacqueline L. Rohrer, Stephen D. Rubin, Jose Gallo and Christopher Longcope Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels
6) Effects of Suppression of Estrogen Action by the P450 Aromatase Inhibitor Letrozole on Bone Mineral Density and Bone Turnover in Pubertal Boys Sanna Wickman, Eero Kajantie and Leo Dunkel Hospital for Children and Adolescents, University of Helsinki, Helsinki, FIN-00029 HUS, Finland Effects of Suppression of Estrogen Action by the P450 Aromatase Inhibitor Letrozole on Bone Mineral Density and Bone Turnover in Pubertal Boys
 
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Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

A compete and total FAIL. A FAIL at both HPTA restoration AND Gyno prevention. I did not get past the first example, which is a joke. I would NOT listen to this crap. Do you have any idea how long it will take TE 500 MG QW X 12 WK to clear before the HPTA is in a state for function/restoration? There are more problems ...

1#
Wk1-12 500mg teste ew
Wk1-14 0.6mg e3d (2X a week) Letro
Wk13-17 PCT Clomid 50mg ed
 
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Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

Looks like it took him a long time, to write..

Maybe, you could have said "Nice Try" then tore into it :)


Maybe, he should have given it some thought before documenting his ignorance.

I am an old man. I no longer have patience for BS when it comes to harming AAS users. Can you imagine the consequence of someone taking this seriously. Unfortunately, I have cared for 100s of men following this kind of BS.
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

This is not the best analogy, but it is the best I can come up with to dispel the myth that an AI is better than a SERM for gynecomastia. This is not to say an AI is not useful to treat gyno, but it is far from the first choice. As in any choice, clinical context is paramount.

Here is the analogy. Actually, there are studies that basically use this paradigm. Imagine there is a castle with 100 gates to enter. And, you have the job of protecting the castle against marauders. The marauders in this case is E2! There are two options: (1) Protect ALL of the gates (SERM); or (2) Protect NONE of the gates, but kill 50+% (even say 90%) of the marauders (AI). Which of these options will best protect the castle?
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

A compete and total FAIL. A FAIL at both HPTA restoration AND Gyno prevention. I did not get past the first example, which is a joke. I would NOT listen to this crap. Do you have any idea how long it will take TE 500 MG QW X 12 WK to clear before the HPTA is in a state for function/restoration? There are more problems ...

you are right I should update it to 2-3 weeks after last dose. if you think it should be more then that is fine and you can explain it . (yes it builds in system but after a couple weeks with that ester i feel its a good time to start PCT, if not then explain why...

I do not think there is that much wrong with it.
the SERM may help keep gyno at bay but using an AI is a better option.
not sure what you are referring to that was other mistake.

I dont think Im that off the ball if at all... studies come from both sides of the fence on alot of issues/oppinions and I do/did my best to form something out of to help.

if you want to enlighten me on some issues AND prove/explain why you "think" its off track them please do, I am willing to learn and dont know everything. but i sure as hell am not a dumbass so you don't need to come in swinging at me...
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

I should add i read alot of your stuff and like it and agree with "most" of it.

I have seen studies to prove more then one conclusion so at the end of the day its still opinions (and soem will agre while others wont) and what studys you have read. I am willing to learn (or hear your OP) if you think I missed something...
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

This is not the best analogy, but it is the best I can come up with to dispel the myth that an AI is better than a SERM for gynecomastia. This is not to say an AI is not useful to treat gyno, but it is far from the first choice. As in any choice, clinical context is paramount.

Here is the analogy. Actually, there are studies that basically use this paradigm. Imagine there is a castle with 100 gates to enter. And, you have the job of protecting the castle against marauders. The marauders in this case is E2! There are two options: (1) Protect ALL of the gates (SERM); or (2) Protect NONE of the gates, but kill 50+% (even say 90%) of the marauders (AI). Which of these options will best protect the castle?

when on cycle yes, when off cycle and still with gyno or estrogen issues... no.

this is one example I DO NOT agree with you on.

(cover up the issue with a bandaid or fix the issue estrogen)

you have a mob out side of castle that are hungry.. do you block all the gates to avoid the mob from getting in and cover up the issue thats going on? or do you feed them and keep only a few complainers around that would not cause an issue at the gates?


I do not agree with you on the SERMs over AI during cycle sorry man. I think thats why you are angry with me?
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

This is not the best analogy, but it is the best I can come up with to dispel the myth that an AI is better than a SERM for gynecomastia. This is not to say an AI is not useful to treat gyno, but it is far from the first choice. As in any choice, clinical context is paramount.

Here is the analogy. Actually, there are studies that basically use this paradigm. Imagine there is a castle with 100 gates to enter. And, you have the job of protecting the castle against marauders. The marauders in this case is E2! There are two options: (1) Protect ALL of the gates (SERM); or (2) Protect NONE of the gates, but kill 50+% (even say 90%) of the marauders (AI). Which of these options will best protect the castle?

also having high estrogen and getting gyno on cycle a SERM would block the gyno but not fix the high estrogen, or high BP and other possible issues from high estrogen due to aas..

you are old school i get that, but your opinion is not fact, it may be based on facts but not fact. same with mine.
AI for gyno SERM for PCT or if on cycle and waiting for AI to take effect...
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

I appreciate the contribution juced.

There are very few definitive answers in this area, its all theory, for the most part.

Very few things are accepted as universal truth.
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

you are right I should update it to 2-3 weeks after last dose. if you think it should be more then that is fine and you can explain it . (yes it builds in system but after a couple weeks with that ester i feel its a good time to start PCT, if not then explain why...

I do not think there is that much wrong with it.
the SERM may help keep gyno at bay but using an AI is a better option.
not sure what you are referring to that was other mistake.

I dont think Im that off the ball if at all... studies come from both sides of the fence on alot of issues/oppinions and I do/did my best to form something out of to help.

if you want to enlighten me on some issues AND prove/explain why you "think" its off track them please do, I am willing to learn and dont know everything. but i sure as hell am not a dumbass so you don't need to come in swinging at me...


Are you so sure of the 2-3 weeks? More importantly, your admission is evidence NOT to listen to any of the suggestions. Why the absence of hCG? This is inexcusable.

On the gyno, my analogy is an easy way to demonstrate an AI in many many cases is the wrong drug to reach for when treating gyno. Do you have studies showing an AI to be superior to a SERM? I would like to read them. There are a number of studies showing SERM as far superior to an AI. [Again, I am not saying an AI is not useful for gyno. They are good treatments under the right context.]
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

also having high estrogen and getting gyno on cycle a SERM would block the gyno but not fix the high estrogen, or high BP and other possible issues from high estrogen due to aas..

you are old school i get that, but your opinion is not fact, it may be based on facts but not fact. same with mine.
AI for gyno SERM for PCT or if on cycle and waiting for AI to take effect...


Are you reading what you write (rhetorical). So, you ADMIT to being wrong, but now wish to qualify the OP. What parts of the OP are legit. "Nice Try"

I am old school! LMAO You are NO school. I have treated over 1000 AAS users, direct clinical experience dealing with these very issues.
 
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Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

Are you so sure of the 2-3 weeks? More importantly, your admission is evidence NOT to listen to any of the suggestions. Why the absence of hCG? This is inexcusable.

On the gyno, my analogy is an easy way to demonstrate an AI in many many cases is the wrong drug to reach for when treating gyno.(I agree not ALL cases of gyno are for an AI but on cycle i DO) Do you have studies showing an AI to be superior to a SERM? I would like to read them. There are a number of studies showing SERM as far superior to an AI. [Again, I am not saying an AI is not useful for gyno. They are good treatments under the right context.]
sadly there are not many studies on bbers with Gyno (specially ON cycle) and AI or SERM use.
AI is mostly seen in cancer studies as is SERMS also but the thing I notice with SERMs is the further research done into Gyno where i dont see that much for AI's (probibly due to the fact hormones where not super high in non aas persons with gyno, so it would not make sense to many researchers to use an AI but somethign to block estrogen) but i do remember seeing some on AI and gyno over the years, ill try to find them but i dont feel that is the point of your post.

thing is i DO agree with you if you have pretty much normal hormone levels (off cycle) but have gyno or are getting it (due to possibly other factors such as genetics or diet or chemicals being taken in) since at this point crashing estrogen is not healthy. a SERM might help with the gyno and hopefully over time not to be of an issue when off the SERM.

ON steroids i feel it should be treated a bit different since high estrogen is something that should be kept in check for more reasons then just gyno.


I would never tell anyone to use a SERM an no AI. An AI AND a SERM if needed or just an AI.

there are differing ways of looking at it and I am happy you responded, thats how these threads become worth a shit ;-) by hearing more then just one opinion/view.
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

Are you reading what you write (rhetorical). So, you ADMIT to being wrong, but now wish to qualify the OP. What parts of the OP are legit. "Nice Try" i NEVER said a SERM would not block gyno on cycle.... but it IS NOT the HEALTHY way to go about gyno control... thats why i dont speak of it
, thats the old school way, we know better now.. or should

I am old school! LMAO You are NO school. I have treated over 1000 AAS users, direct clinical experience dealing with these very issues.

not sure what this rant is about I may be a bit off on starting pct soem say 1 week others 4.
I know you are old school, form Nandi days, i get that...
but habits of thought are hard to break and harder if you think you know everything and every situation...

You are wrong about gyno SERMs vs AI's thats MY opinion...
That doesn't need to hurt your EGO, you have taught me alot from your posts also over the years but dosnt mean i have to agree with everything nore does it mean you have been 100% right on everything you have ever said (if you truly do think that... then step back and think about how crazy that thought is).
I know I have not been right on everything i have ever learned and later on learned why to do something in a differing way or seeing somethign with a differing point of view... if you cant because you have your mind set thats fine.
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

Doesn't a SERM have benefits, that
an AI doesn't?..

Allowing the body, its needed estrogen?

Even stimulating some E receptors..
Acting as an agonist in some receptors
like Nolva does, in the liver?..

I allow estrogen to flow freely,
so I really wouldn't know..
Then again, I don't use aromatising gear
much, so... I really wouldn't know :p
 
Re: A HOW TO for: SERMs, Aromatize inhibitors, Gyno and PCT *A must read

I hate to say it but I agree with Juced on the idea of controlling the estrogen and avoiding the gyno... over using a SERM the whole cycle or waiting for gyno then using a SERM.
That is an old way of doing things in my opinion and we know better now.
I don't need to see a study on it to see the logic and the real world results with AI vs. SERM for gyno.
Also other issues come from having high estrogen levels so I see more reason to use an AI over a SERM for Gyno control ON CYCLE.

Off cycle I got no idea but a SERM seems to make more sense for gyno at that point since its too late to control the issue that brought on the gyno.
 

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