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This study finds not change in SHBG as a result from pellet hormones.

First, Testosterone pellets are not the way to go.  Historically, these will go the way of all the implantable contraceptive devices.  However, the conclusion of this study is good and confirms the benefit of anastrazole to inhibit aromatase activity and help to maintain Testosterone levels.

Study finds that Testosterone with or with the aromatase inhibitor anastrazole as a pellet reduced breast cancer risk.  This conclusion should be taken with caution.  It is well know that abnormal breast tissue, breast cancer, highly expresses aromatase activity which would increase Testosterone to estradiol production.  This would feed any growing tumor.  But, this study finds protection.  The failure of this study is the measurement of hormone levels.

Prospective study finds that elevated total and free Estradiol levels in the follicular phase and elevated total and free Testosterone levels in both the follicular and luteal phase are associated with increased breast cancer in women.  The risk is for pre menopause in this study.  This and several other studies point to serious questions about the massive dosing of Testosterone via pellets, injections, and topicals for libido.  We appear to be following the same patter as seen with premarin, provera, now Testosterone in men and this may be the next ball to drop.  Is the Testosterone therapy merely producing an environment that feeds breast cancer?

This study appears to fly in the face of the recent studies on the dangers of Testosterone therapy in those with comorbidities.  This study was a retrospective cohort.  The study found that men in the highest risk for MI, had a reduced MI risk with Testosterone therapy.  Men in the lower risk quartiles had no such benefit.  Of note, the frequency of injections suggests inadequate dosing i.e. 4.4 in first year and 8.2 in follow up.  Most injection regimens will require at least monthly injections, though Testosterone pellets were used.  Of special note, no mention of level testing of Testosterone prior to study and/or during study and follow up.

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Testosterone SQ pellets + AI letrozole associated with a reduction in breast cancer survival.

Testosterone is great when needed, not doped; but Testosterone is not without risks.  Population case-control study finds increased blood clot risk in first 6 months of Testosterone therapy.  To many variables left unanswered by this study.