I did not know where to start on AI, but then this review popped up in my head. It is as good a place as any to start a thread. By posting, I am not stating I agree or support the article. The full-text is at the link.
Over the past 15 years, it has become evident that in men estradiol is responsible for a number of effects originally attributed to testosterone. Estradiol has an important role in gaining and maintaining bone mass, closing of the epiphyses, and the feedback on gonadotropin secretion. This fact became particularly evident in men with aromatase deficiency. Aromatase is the enzyme responsible for conversion of androgens to estrogens.
Men with estrogen deficiency caused by a mutation in the CYP19 gene suffer from low bone mineral density (BMD) and unfused epiphyses, and have high gonadotropin and testosterone levels. Estrogen excess in turn has been associated with premature closure of the epiphyses, gynecomastia, and low gonadotropin and testosterone levels.
Lowering estrogen levels in men has emerged, consequently, as a potential treatment for a number of disorders including pubertas praecox, the andropause (also referred to as late-onset hypogonadism), and gynecomastia. Aromatase inhibitors were proven to be safe, convenient and effective for the treatment of hormone sensitive breast cancer in women although their use is associated with a modest increase in bone resorption.
This review will discuss the potential targets and the evidence for the use of aromatase inhibitors in men.
Aromatase inhibitors, mostly combined with agonists of gonadotrophin-releasing hormone proved effective for the prevention of premature epiphysial closure in boys with pubertas praecox of various etiologies. There is also evidence that aromatase inhibitors can be used in boys with idiopathic short stature and boys with constitutional delay of puberty to increase adult height.
Aromatase inhibitors are not effective for the treatment of gynecomastia in pubertal boys and have limited efficacy for the prevention of gynecomastia in bicalutamide-treated men with prostate cancer.
Although aromatase inhibitors increase FSH levels, there is no consistent evidence for a beneficial effect on spermatogenesis. In older men with so-called late onset hypogonadism, aromatase inhibitors may emerge as an attractive alternative for traditional testosterone supplementation to improve testosterone levels.
The long-term benefits of higher testosterone levels in older men remain controversial, however. Moreover, it is questionable whether aromatase inhibitors are able to stimulate testosterone production sufficiently in men with truly low testosterone levels for whom testosterone treatment is currently recommended.
Although most of the recent studies with aromatase inhibitors in boys and adult men do not show major detrimental effects on bone long-term skeletal safety remains an issue of concern.
de Ronde W, de Jong FH. Aromatase inhibitors in men: effects and therapeutic options, Reproductive Biology and Endocrinology. 2011;9:93 (21 June 2011). http://www.rbej.com/content/pdf/1477-7827-9-93.pdf
Aromatase inhibitors effectively delay epiphysial maturation in boys and improve testosterone levels in adult men Therefore, aromatase inhibitors may be used to increase adult height in boys with gonadotropin-independent precocious puberty, idiopathic short stature and constitutional delay of puberty. Long-term efficacy and safety of the use of aromatase inhibitors has not yet been established in males, however, and their routine use is therefore not yet recommended.
Over the past 15 years, it has become evident that in men estradiol is responsible for a number of effects originally attributed to testosterone. Estradiol has an important role in gaining and maintaining bone mass, closing of the epiphyses, and the feedback on gonadotropin secretion. This fact became particularly evident in men with aromatase deficiency. Aromatase is the enzyme responsible for conversion of androgens to estrogens.
Men with estrogen deficiency caused by a mutation in the CYP19 gene suffer from low bone mineral density (BMD) and unfused epiphyses, and have high gonadotropin and testosterone levels. Estrogen excess in turn has been associated with premature closure of the epiphyses, gynecomastia, and low gonadotropin and testosterone levels.
Lowering estrogen levels in men has emerged, consequently, as a potential treatment for a number of disorders including pubertas praecox, the andropause (also referred to as late-onset hypogonadism), and gynecomastia. Aromatase inhibitors were proven to be safe, convenient and effective for the treatment of hormone sensitive breast cancer in women although their use is associated with a modest increase in bone resorption.
This review will discuss the potential targets and the evidence for the use of aromatase inhibitors in men.
Aromatase inhibitors, mostly combined with agonists of gonadotrophin-releasing hormone proved effective for the prevention of premature epiphysial closure in boys with pubertas praecox of various etiologies. There is also evidence that aromatase inhibitors can be used in boys with idiopathic short stature and boys with constitutional delay of puberty to increase adult height.
Aromatase inhibitors are not effective for the treatment of gynecomastia in pubertal boys and have limited efficacy for the prevention of gynecomastia in bicalutamide-treated men with prostate cancer.
Although aromatase inhibitors increase FSH levels, there is no consistent evidence for a beneficial effect on spermatogenesis. In older men with so-called late onset hypogonadism, aromatase inhibitors may emerge as an attractive alternative for traditional testosterone supplementation to improve testosterone levels.
The long-term benefits of higher testosterone levels in older men remain controversial, however. Moreover, it is questionable whether aromatase inhibitors are able to stimulate testosterone production sufficiently in men with truly low testosterone levels for whom testosterone treatment is currently recommended.
Although most of the recent studies with aromatase inhibitors in boys and adult men do not show major detrimental effects on bone long-term skeletal safety remains an issue of concern.
de Ronde W, de Jong FH. Aromatase inhibitors in men: effects and therapeutic options, Reproductive Biology and Endocrinology. 2011;9:93 (21 June 2011). http://www.rbej.com/content/pdf/1477-7827-9-93.pdf
Aromatase inhibitors effectively delay epiphysial maturation in boys and improve testosterone levels in adult men Therefore, aromatase inhibitors may be used to increase adult height in boys with gonadotropin-independent precocious puberty, idiopathic short stature and constitutional delay of puberty. Long-term efficacy and safety of the use of aromatase inhibitors has not yet been established in males, however, and their routine use is therefore not yet recommended.
