Effects of aromatase inhibition vs testosterone in older men with low testosterone: randomized-controlled trial

One short-term trial using AI in young eugonadal men showed an increase in triglyceride levels (Lapauw et al., 2009) while another short-term study in older men demonstrated no such effect (Dougherty et al., 2005). Additional blood and hormone levels are monitored to see how your body reacts to Testosterone Replacement Therapy. We can detect excessive estrogen production and act accordingly to counteract it.

In women, a number of studies suggest aromatase plays a role in the development of certain hormone-dependent cancers (breast, ovaries …), since oestrogens directly stimulate hormone-sensitive tumour cell receptors and contribute to their growth. Anti-aromatase drugs (letrozole, anastrozole, exemestane…) have, for several years, been showing promised in hormone therapy as an adjuvant treatment for breast cancer in post-menopausal women (6). The aromatase inhibitors anastrozole and letrozole are approved to be given to postmenopausal women as initial therapy for metastatic or locally advanced hormone-sensitive breast cancer (12, 13). Both of these drugs and the aromatase inhibitor exemestane are also approved to treat postmenopausal women with advanced breast cancer whose disease has worsened after treatment with tamoxifen (14).

When used alongside Testosterone Replacement Therapy, all men can reap TRT’s benefits without raising estrogen levels, regardless of their genetic makeup. Aromatase inhibitors (AI) have been used in the treatment of idiopathic short stature (ISS), constitutional delay of puberty (CDP) and precocious puberty in boys to increase adult height. Moreover, it has been used in the management of gynecomastia, oligospermia and male hypogonadism related to obesity and ageing.1,2,3 This retrospective study was carried out to assess the efficacy of letrozole, an AI, in varied conditions in Indian males. Of serious concern for prevention is the potential for increase in risk of bone fracture and cardiovascular disease related to long-term estrogen depletion with AIs. However, arthralgias, fatigue, dyspareunia, reduced libido and hot flushes may result in poor uptake and/or compliance.

Neoadjuvant therapy with aromatase inhibitors vs. tamoxifen

• Limitations to our study include the retrospective design, but all data were collected prospectively.
• The decision to use AI as initial endocrine therapy, as opposed to switching to an AI after 2–3 years of tamoxifen therapy, is likely to be guided by the tumour characteristics.
• Also, the less fat you have the more testosterone you’ll have due to less inhibitory feedback from estrogen.
• However, with the introduction of newer hormone therapies (i.e., the aromatase inhibitors), some of which have been compared with tamoxifen in clinical trials, additional approaches to hormone therapy have become common (5–7).

This retrospective study echoed the benefit of AI in Indian males in varied conditions. If you decide to take an estrogen blocker supplement, remember to be consistent and regularly monitor your testosterone and estradiol blood levels. Having objective measurements will reassure you that the estrogen blocker is working as expected (or not). Animal studies have demonstrated that supplemental calcium-d-glucarate reduces estradiol levels by as much as 25% 15. In the body, calcium D-glucarate serves as a slow-releasing reservoir of glucuronolactone, the latter of which appears to inhibit the actions of an enzyme called beta-glucuronidase. Elevated estrogen levels are common in men that take testosterone and those who are overweight.

Many women will turn to their internists for advice about whether to take these drugs, as well as help in preventing and managing adverse events. The purpose of this article is to provide primary care physicians with a basic understanding of AIs to help facilitate these interactions. Some doctors shy away from prescribing anastrozole because of the long-term risks if your estrogen drops too low, including loss of bone density. “If your estrogen levels dip below 20 pg/ml, your doctor may drop the dose to one milligram once a week, sometimes cycling it on and off for a couple of months,” Rambhatla says. Chrysin is a bioflavonoid compound extracted from a plant called Passiflora coerulea and also (found) in bee pollen.

Adjuvant therapy with aromatase inhibitors vs. tamoxifen

Additional end points included rates of endogenous glucose production and lipolysis, body fat, lipid profile, plasma adipocytokines, and mRNA transcript abundance in sc adipose tissue. Clinical trials have shown aromatase inhibitors were well tolerated, even at high doses.27 There is no established dose of aromatase inhibitors considered life-threatening. There is no specific treatment for the overdose of this class of medications. Standard treatment of care, such as frequent vital sign checks, induced emesis, and management of symptoms, is recommended. As an agent to induce ovulation, dosing is 2.5 mg to 5 mg daily for 5 days starting on day 3 of the menstrual cycle. In patients with cirrhosis of the liver, CHild-Pugh Class C, increase the dosing interval to every 48 hours.

It is still used to treat increased estradiol production for men on testosterone replacement therapy. However, as aromatase inhibitors have shown https://animprops.com/growth-hormone-before-and-after-understanding-the-2/ a higher efficacy than tamoxifen for women, aromatase inhibitors for men are also increasingly replacing tamoxifen as a supplementary treatment during TRT. In an earlier study a combination of spironolactone and testolactone proved effective 56, whereas in later studies the combination of bicalutamide and anastrozole was used 57-59.