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One of the things that is unique with scrotal skin and the use of testosterone being applied
to the *** is that within that skin there are some enzymes that can convert testosterone
into other hormones: principally oestrogen and also dihydrotestosterone. The conversion
of testosterone into oestrogen can happen in some men, and I emphasis some men, it's
not ... it's only a low percentage of men, maybe 2 or 3% of uses, who use testosterone
scrotally can get a conversion via an enzyme called aromatase from testosterone into oestrogen
and men's oestrogen levels can increase. Now, in general that isn't a problem and with correct
monitoring at again at one month and again at three months, if the blood levels show
that there's an increase in the levels of oestrogen in men, that can adequately be addressed
by either a dose reduction or the introduction of what's called an aromatase inhibitor which
blocks that conversion. But there's no point in using an aromatase inhibitor i ... as a
prevention because it may not happen in most men. So it's important that the follow up
blood tests at three months check not just testosterone levels but also oestrogen levels
as well.