The latest and greatest internet steroid gurus will often recommend anti-aromatase drugs such as Arimidex or Letrozole as the treatment of choice to prevent gynecomastia (‘gyno’) in bodybuilders who use aromatizable anabolic steroids. While this may work in most case, the advice is dangerous because it doesn’t always work.
There are other readily available drugs that could have been used to effectively prevent gyno in those unfortunate cases. And steroid-using bodybuilders, especially those prone to gyno, should always have these drugs on hand when starting a steroid cycle.
The drugs I am referring to are the class of drugs referred to as selective estrogen receptor modulators (SERMs). The most commonly recognized drugs in this class are Clomid (clomiphene citrate) and Nolvadex (tamoxifen citrate). These drugs are nothing new. They have been around for decades.
Old school bodybuilders always relied on antiestrogens like Clomid and Nolvadex from the late 1970s through the 1990s. They were very effective at preventing gyno and often a better choice than the anti-aromatases at preventing gyno.
The reason for this is that SERMs can block all the estrogen sensitive receptors in breast tissue. So no matter how much estradiol is circulating in the blood, gyno won’t happen because all of the receptors are blocked.
On the other hand, AIs work by an entirely different mechanism. Rather than acting as an estrogen blocker, AIs prevent the conversion of aromatizable steroids to estrogen by disabling the enzyme responsible for the conversion (i.e. aromatase).
Second and third-generation AIs like Arimidex and Letrozole only became available in the mid- to late-1990s. And even at that time, the cost was prohibitively expensive out of reach for all but the most affluent bodybuilders. This scarcity made it even a more desirable drug. These drugs only became widely available to the masses when they were introduced as “research chemicals” marketed as “not for human consumption” at a fraction of the price.
If SERMS like Clomid and Nolvadex worked so well, why were bodybuilders so excited by the arrival of anti-aromatase drugs? Well, gynecomastia is only one negative side effect of the elevated levels of estrogens caused by aromatizable steroids such as testosterone and Dianabol (methandienone). High estrogen levels can cause a host of other undesirable side effects, some less obvious than others. Elevated estrogen levels can contribute to extra fat buildup and visible water retention and bloating. It can contribute to elevated blood pressure. Some people suspect that it is elevated estrogen (and not elevate androgens) that actually contribute to prostate cancer.
There are many good reasons to keep one’s estrogen levels in check. And for this reason, the recommendation to use anti-aromatase drugs (AIs) like Arimidex and Letrozole during a steroid cycle represents sound advice. AIs can effectively reduce circulating estrogens by 60-90%. However, recommendations of AIs as the best or only drug necessary to prevent gyno is very poor advice.
You should ALWAYS have SERMs like Nolvadex, Clomid or Toremefine on hand any time you are using aromatizable steroids. You don’t need to use them from the outset (or ever) if not necessary. The use of Arimidex or Letrozole is the best choice at managing serum estrogen levels and this may be enough to prevent gynecomastia as well. But if it is not, the absolute best choice as a gynecomastia treatment are SERMs.