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- Estrogen Is Not The Enemy!
Happy Tuesday!
I just dropped a brand new podcast episode on Spotify where I go deep on the nature of estrogen in the context of testosterone therapy for men.
Today’s email is the written companion to that show.
I want you to stop being afraid of estrogen, understand what the science actually says, and make sure your TRT protocol is not quietly sabotaging your fat loss, bone density, libido, and mood.
Let’s dive in!
FYI, BioLongevity Labs just launched their Black Friday sale today! You can get 30% off storewide and an additional 15% off when you use code HUNTERW at checkout!
Mythical Origins
This whole thing was inspired by a wild bit of timing.
Recently, the FDA pulled the black box warning off estrogen therapy for women.
I don’t really follow mainstream news, but I saw that and thought, “Okay, we’re finally admitting estrogen is not this demonic hormone.”
Yet in the men’s world, especially around TRT, estrogen is still treated like an evil force that must be “managed” and suppressed the second a guy touches testosterone.
A lot of this came out of the bodybuilding world, where people are running a gram or more of testosterone per week and abusing drugs. Obviously a much different universe than the TRT/HRT world.
The problem is that this mindset leaked into mainstream TRT.
So now you have clinics where the standard of care is to start testosterone, then slap on an aromatase inhibitor with zero evidence of actual estrogen problems.
If your doctor’s first reflex is “Here’s your testosterone and here’s your AI,” I genuinely believe you should run in the other direction.
That tells me they are not reading the data nor thinking critically.
Estrogen’s Job Description
Let’s back up and look at what estradiol actually does in men.
Everyone hears “estrogen” and thinks “female hormone.”
It is that. But it is also a critical hormone for male physiology.
First. Bone density.
Estradiol is the primary hormone that keeps your bones strong. Not testosterone. Estrogen.
When estradiol is low, bone mineral density plummets, and you cannot fix that just by adding more testosterone.
If estrogen is crashed, your skeletal system is paying the price.
Second. Fat metabolism.
This blows people’s minds. Most guys think high estrogen = bloat, puffiness, fat.
The opposite is true. When estradiol is too low, men accumulate more fat, especially subcutaneous and abdominal fat.
The clinical trials clearly show that if you crash your estrogen, you get softer and fatter over time, not leaner.
Third. Libido, mood, and brain function.
Estradiol is involved in libido, erections, serotonin, and how your brain feels. Low estrogen men often report depression, anxiety, brain fog, and no sex drive.
The Clinical Data
In the Finkelstein New England Journal of Medicine trial, they shut down men’s natural hormones and then gave them testosterone with or without estradiol.
When estradiol was blocked, body fat shot up. Not a little. A lot.
In that study, low estrogen was the primary driver of fat gain.
And sexual function tanked faster when estradiol was suppressed. So when you hear “high estrogen is killing my libido,” understand the data says the opposite for most men.
Low E2 is often the culprit.
Bone density data are even scarier.
In follow-up work, when estradiol was suppressed, bone resorption markers skyrocketed and spinal bone density dropped.
One trial showed around a 15% loss of bone density in men with suppressed estrogen and zero improvement in quality of life.
Testosterone went up. Bone strength went down. Symptoms did not improve.
One more key point.
A study that compared testosterone therapy versus anastrozole (an AI) over a year found that the testosterone group gained bone density.
The AI group did not. Why?
Because aromatization to estradiol is required for the full benefit of TRT.
What Low Estrogen Feels Like
I have felt low estrogen before. Not from an AI, but from stacking too much of a DHT-derived compound with testosterone.
Same effect. Estrogen got pushed too low.
The first thing I noticed is that my bones and joints started to hurt.
This is the classic “dry, achy joints” you hear from bodybuilders overusing AIs.
It is the same thing oncologists see in women on aromatase inhibitors for breast cancer.
Massive rates of joint pain and accelerated bone loss.
Then comes the fatigue and mood issues.
Guys with estradiol in the single digits report overwhelming fatigue, lack of motivation, irritability, and flat, gray emotions.
They often feel worse on TRT plus AI than they do with low testosterone alone.
And of course, libido and erections.
Ironically, low libido is often blamed on high estrogen.
But the data in large TRT cohorts show that men with higher estradiol actually reported fewer libido complaints compared to men with lower estradiol.
In my coaching work, it is almost cliché.
“Hunter, my test is good, but my sex drive is gone.” My first question is always. “Are you on an AI?”
If the answer is yes, nine times out of ten, their E2 is being strangled.
Lab Ranges
On TRT, it is normal for estradiol to climb as testosterone climbs.
If your total testosterone is 900–1,200, it is completely normal for your estradiol to land in the 50–70 pg/mL range.
If you had a natural total testosterone of 2,000, your body would probably aromatize enough to give you an estradiol of 100 or more.
The problem is the lab range was built for untreated men with normal testosterone.
So your E2 of 60 on TRT gets flagged as “high,” and the knee-jerk reaction is “We need to block this.”
In a large real-world study from a big TRT clinic, about 20% of men on testosterone had estradiol above the lab cutoff.
Guess what. They had no negative impact. No tidal wave of estrogenic side effects.
Personally, I have run my estradiol as high as 134 with zero “high estrogen” symptoms.
No gyno. No bloat. No mood swings. And you know what was better?
My HDL, total cholesterol, and inflammation markers.
Everything looked more protective when estrogen was higher in the context of optimized testosterone.
Where Do We Go?
For 99% of men on a therapeutic TRT dose, the answer is not to “block estrogen.”
The answer is:
Fix body fat and insulin resistance.
Dial in the testosterone dose and injection frequency.
Address sleep, stress, and nutrition.
Most of what men think are “estrogen problems” are really insulin resistance and lifestyle problems.
When you normalize blood sugar, drop excess fat, and exercise regularly, your body naturally metabolizes testosterone into the right amount of estradiol for you.
Using an AI to feel “drier” while your bones thin, fat accumulates over time, and your mood craters is a terrible trade.
Final Thoughts
Balanced hormones, not “zero estrogen,” produce the best quality of life and the best long-term health outcomes.
Men thrive on the small amount of estrogen we produce.
High-normal estradiol in the context of high-normal testosterone is natural and, in many cases, protective.
If your E2 is 60 and you feel fantastic, do not let a scared clinician talk you into nuking it.
Fix insulin resistance. Fix lifestyle. Let your body convert testosterone into the estrogen it needs to protect your bones, brain, heart, and libido.
As always, I am insanely grateful for you being here, reading, watching, sharing, and doing the hard work on your own health.
This is what I love doing, and I could not do it without you!
Best,
Hunter Williams
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