Optimizing Post Cycle Therapy with Letrozole: Usage and Dosage Guidelines

Essential Concepts of Post Cycle Therapy (PCT)

PCT is the acronym for the term Post Cycle Therapy, which refers to a period of hormone treatment designed to help recover hormone production that has been suppressed both by some medications and by certain combinations of steroids. This refers to medications that contain androgens, or male sex hormones, usually used to treat conditions related to low levels of testosterone in the blood. These medications suppress the body's ability to produce testosterone naturally by increasing the level of these hormones in the blood. The body interprets this elevated level as a signal to shut down its testosterone production because it has the level of hormone for which it usually produces the highest amount that it needs. Generally, the shorter the treatment is, the greater the suppression of this production. That is, the body takes more time to realize that it can raise its testosterone level in a moment and then suppresses it less.

With the decline in the level of these drugs in the blood, testosterone production takes a little time to return to normal, resulting in a temporary drop in the levels of the hormone in the body. During this period, the user often faces a series of temporary adverse effects associated with low levels of testosterone in the body, such as exhaustion, loss of strength and muscle mass, decreased libido, erectile problems, and depression, among others. These unwanted effects are one of the main reasons why many quickly restart a new treatment without allowing the hormones to return to normal levels. However, it is important for the well-being and health of the individual to allow hormone levels to recover before reusing any medication that suppresses its natural production. The idea of PCT is to induce the body to restart hormone production faster, thus facilitating a faster return to the normal levels of these hormones and reducing or even avoiding these unwanted and temporary symptoms related to conditions of low testosterone in the blood.

2. Role of Letrozole in PCT

Aromatase inhibitors, also referred to as AIs, are the most commonly used drugs in the bodybuilding world for anti-estrogen purposes. They block the aromatase enzyme, reducing the body's estrogen levels and increasing the time before recovery is necessary. When estrogen levels drop too low, it is counterproductive. Estrogen is necessary for proper sexual functioning, aggression, libido, mood, and an overall healthy sense of well-being. Using too high of an AI dose can turn moods into depression or a lackluster attitude, among other symptoms. It's also common for joints to become dry or to stiffen up. Although AIs are the most effective tool, they should still be used with caution, especially for a bodybuilder in Post Cycle Therapy.

Letrozole is the most recent new class of AI to be developed. It's considered a more forceful and dangerous AI than the other two forms for a bodybuilder's use during PCT, but it is definitely the most effective of the three. It comes in pill form and should be handled with respect. Used in moderation, it will get the job done, and in some instances, will drop the estrogen levels to near zero. Many sportsmen have taken the drug and were impressed. The likelihood of uncovering it is greater in comparison with predominantly AIs, and it comes at a lower price. Look to use this over the previous antiestrogens; besides, you will more than likely be fully satisfied with the end result.

3. Optimal Dosage of Letrozole in PCT

Nothing good comes easy when it comes to using aromatase inhibitors during post cycle therapy. Actually, the approach of the medically inclined is to advise against the usage of aromatase inhibitors in PCT. Nonetheless, aromatase inhibitors can be extremely beneficial in comprehensive recovery from a cycle and Letrozole is at present second to none in this regard. The principle of minimizing Estrogen due to the fact that mass and strength levels can be very subnormal during the post cycle period means that use of a particular aromatase inhibitor should be minimized to the greatest extent possible while still being able to eliminate as much Estrogen as needed. The secret, is, hence to use the least dose possible. Since even 98% of Estrogen may not be enough to prevent aromatization, one has to understand that aromatase inhibitors might not work as effectively as is hoped. The fact is, the body is very willing to produce Estrogen no matter how much is used to try and stop it. Aiming for such high doses just isn't a good idea and may result in a harsh rebound effect. There is simply no ideal dose of aromatase inhibitors during post cycle therapy.

The ideology behind aromatase inhibitor usage is to use as little as possible, enough to lurch yourself through the cycle so that high levels of mass inducing and strength inducing compounds can be used. That being said, the minimum dose is sometimes not enough, while, on some occasions, even the maximum dose is not enough. In most cases, 2/3 of a milligram daily should be enough Estrogen elimination for the duration of post cycle therapy. Use of additional aromatase inhibitors should not be necessary but may be needed if increased heavy snoring develops. How aggressive Estrogen inhibiting of any form should be is a matter of personal preference, and may not even be necessary for your PCT for the most part.

4. Duration and Timing of Letrozole Use in PCT

In terms of duration, letrozole use should not begin until testosterone levels have fully dropped to normal (or better yet, to baseline) levels, or the assistance in lipid and cholesterol improving capabilities that Nolvadex provides may be negated. If the PCT protocol uses human chorionic gonadotropin, letrozole use can begin almost immediately. Once the HCG use begins to halt, letrozole can serve as the next step in the transition to a fully functioning HPTA. As with other AIs, letrozole should be used with caution in doses and cycle lengths in excess of what is necessary to assist in normal testosterone recovery, especially in cases where subnormal doses of AAS were used (or an AAS that does not aromatize). There are two reasons for this.

To start, letrozole is known for being very effective in increasing testosterone levels, but its negative impact on cholesterol values prevents its use for as long as other alternatives. Full dose letrozole cycles beyond PCT can reduce both HDL and LDL values by up to 20-25% each, all while increasing serum estradiol levels by 60%. Overtime, these effects can be hazardous when seen in men with normal cholesterol levels, let alone when among those who already possess problematic values (or are at risk of doing so).

5. Potential Side Effects and Monitoring during Letrozole Use

The use of Letrozole as the primary aromatase inhibitor in post cycle therapy is controversial, but there are some data to suggest that Letrozole might be useful in the setting of PCT. If Letrozole is used, it should not be used at too high of a dose or for too long of a duration in the setting of PCT. In general, excessive doses and durations of aromatase inhibitors during post cycle therapy should be avoided, as they are likely counterproductive. Finally, plasma concentrations of estrogen, high sensitivity C-reactive protein, and lipid profiles should be measured before, during, and after treatment with Letrozole, particularly in the setting of PCT.

Several side effects of low and high estrogen levels can cause significant morbidity. An excess of estrogen and the inability of the body to counteract this excess can result in negative feedback and a decrease in endogenous serum testosterone concentration during post cycle therapy. In other words, the more excess aromatization that occurs, the greater the probability of loss of gains during post cycle therapy. The use of aromatase inhibitors can not only prevent excess aromatization but quite possibly restore endogenous serum testosterone production. Carefully chosen, aromatase inhibitors can result in hormonal levels during post cycle therapy that are conducive to maintaining muscle mass and associated gains. On the other hand, excessive use of aromatase inhibitors that 'crash' serum estrogen below physiologic levels during post cycle therapy may decrease IGF levels, negatively affect HDL and LDL, elevate hs-CRP, and inhibit recovery of the endocrine system. However, it has not been shown that antidepressant therapy during PCT significantly reduces the risk of cardiovascular and cerebrovascular events.