Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Anti-aromatase agents are scientifically validated for use in supporting or treating low testosterone, particularly in men with hypogonadism or those undergoing testosterone replacement therapy. Aromatase is an enzyme that converts testosterone into estrogen. In certain individuals, especially as they age or in cases of obesity, increased aromatase activity can lead to excessive conversion of testosterone to estradiol, resulting in lower testosterone levels and sometimes symptoms of estrogen excess (e.g., gynecomastia).

Pharmaceutical anti-aromatase agents (aromatase inhibitors), such as anastrozole or letrozole, are used to inhibit this enzyme, thus reducing estrogen levels and allowing for higher or more sustained testosterone concentrations. Multiple clinical trials and case reports demonstrate that aromatase inhibitors can increase endogenous testosterone levels in men with hypogonadism, improve the testosterone-to-estradiol ratio, and sometimes restore fertility in men with subfertility associated with elevated estrogen.

However, routine use is not recommended for all men with low testosterone, as suppressing estrogen too much can have negative effects on bone health and lipid profiles. The primary populations benefiting from anti-aromatase therapy are those with demonstrated excessive aromatase activity or when testosterone replacement leads to unwanted rises in estradiol. Thus, the use of anti-aromatase agents in this context is well-supported by scientific evidence but should be individualized and monitored by a healthcare professional.

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