To my knowledge the ONLY drug class that has been studied for the treatment of male gynecomastia is SERMS! AI's should be reserved for those that fail SERM treatment which is unusual IF used in the correct doses, for an appropriate duration, AND with a LEGITIMATE drug.
(Dr Scally if you are aware of any literature to the contrary, the use of AI's as therapy for GYNECOMASTIA, please post it.)
What do I mean by the latter? Most if not all SERM failures are bc UGL SERMS were used, where quality control is usually an afterthought.
The cause of gynecomastia is NOT estrogen (if that was the case ALL males whether cycling or not would have it) BUT rather the presence of "hyperresponsive" E-2 dependent breast tissue itself. That's why BLOCKING the E-2 breast receptors with an SERM is considered FIRST LINE medical therapy for gynecomastia.
Finally all AI's elicit a similar decrease in total estrogen load (E-2, E-1, E-3) when administered in equipotent amounts.
Moreover since many mates do not NEED an AI or a SERM when TT is supplemented at roughly 500mg/wk, or less, why use ANY drug as prophylaxis when there is nothing to prophylax.
AFTER YOU OBTAIN BASELINE LABS, begin the TT at 200 mg/week to determine if your prone to gynecomastia and start SERM therapy if such is the case. OBVIOUSLY do not increase the TT dose as originally planned until the symptoms RESOLVE!
