Not wordy at all. Thanks for all the details. I have a better clue into what’s going on.
Let’s start point by point:
1. 1x injection frequency isn't ideal for anyone. Your levels will be constantly yo-yoing all over the place. Also, your AI has a half life of 30-60 hours while test Cyp has a half life of 5 days (120 hours). That means with your current injection frequency, you can’t maintain stable serum T or E2.
What is the highest injection frequency you can commit to long term? For me, I do daily IM injections with an insulin syringe because it’s easier for me to remember (part of my daily routine) and it’s painless. I would strongly you to do daily if you can stick with it. Otherwise, EOD or 3x per week would work good too.
I CANNOT STRESS THE NEXT POINT ENOUGH:
HIGH E2 HAS MORE SYMPTOMS THAN PUFFY/SORE NIPS. This is HIGHLY dependent on your individual genetics. As an example, I had 3100 ng/dL total T and 112 pg/mL E2. I had ZERO nipple sensitivity issues. I suspect this is because I had more than adequate DHT levels to counteract the effects of E2 at the mammary gland itself. For me, I could only tell that my E2 was high because I was struggling to maintain my erection without cialis (it was semi-hard).
I believe you have high e2 levels given your inability to get hard without cialis.
The p5p helping with your puffy ankles can be explained by the prolactin-estrogen relationship.
Prolactin and progesterone are two hormones which both INCREASE estrogen receptor density throughout the body. In a pregnant women, progesterone sensitizes the mammary gland to estradiol. Progesterone and estradiol grow the breast tissue and prolactin causes milk letdown.
When you knock down your prolactin, you reduce the number of estrogen receptors. This means you reduce the effect of estrogen on the body WITHOUT changing serum estrogen levels.
Try increasing your AI dose in small increments. Right now you’re on 0.5 mg arimidex 1x per week. Add in another 0.5 mg and time these 3.5 days (or 3 days, doesn’t really matter) apart. Very unlikely to crash E2. 1 mg of Arimidex has been shown to reduce E2 by up to 70% in breast cancer patients. With how elevated your E2 likely is, a 70% reduction wouldn’t leave you in dangerous (single digit) territory.