TRT + AI vs TRT Alone
Adding anastrozole to TRT lowers estradiol but is over-prescribed historically. Modern practice prefers TRT alone with careful dosing and cadence, reserving aromatase inhibitors for biomarker-confirmed symptomatic hyperestrogenemia.
TRT + AI is appropriate only when biomarker-confirmed symptomatic hyperestrogenemia persists despite cadence and dose optimization.
Explore pathwayTRT alone is the modern default. Most candidates do not require an aromatase inhibitor.
Explore pathwayEducational. Final pathway selection is provider-reviewed via synchronous video consultation against your biomarkers, history, and goals.
Frequently asked
Is anastrozole always needed on TRT?
No — most candidates do not require it.
What is the risk of crushing estradiol?
Bone, lipid, mood, and libido suffer when estradiol is suppressed too low.
Take the optimization assessment.
The adaptive assessment maps your symptoms, history, and goals to candidate pathways — and routes you into provider review.
Begin assessment