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Research trials, including those supporting NICE guidance, have demonstrated that these medications may lead to modest improvements in cholesterol levels, particularly reductions in total cholesterol, LDL cholesterol, and triglycerides
When estradiol levels rise due to fat-driven aromatization or conversion of excess external testosterone the brain senses enough sex hormone and slows down the axis: Less GnRH is released from the hypothalamus The pituitary releases less LH and FSH The testes produce less natural testosterone This negative feedback loop means men with obesity or on high-dose TRT may experience further suppression of their own testosterone production and long-term dependence on therapy
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