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Aromatase inhibitors (AIs) are a class of drugs used in the treatment of breast cancer in postmenopausal women and in men, [1] [2] and gynecomastia in men. They may also be used off-label to reduce estrogen conversion when supplementing testosterone exogenously.
Aromatase (EC 1.14.14.14), also called estrogen synthetase or estrogen synthase, is an enzyme responsible for a key step in the biosynthesis of estrogens. It is CYP19A1 , a member of the cytochrome P450 superfamily, which are monooxygenases that catalyze many reactions involved in steroidogenesis .
17β-Hydroxysteroid dehydrogenase (17β-HSD) inhibitors prevent the reversible conversion of the weak androgens dehydroepiandrosterone (DHEA) and 4-androstenedione into the more potent androgen testosterone and the weak estrogen estrone into the more potent estrogen estradiol. [27]
“Testosterone doesn’t drop off like estrogen does—it goes down a linear decline,” says Casperson. “Women in their mid-40s and 50s have half the testosterone that we had in our 20s.”
These agents inhibit the enzyme 5α-reductase, which is involved in the metabolic transformations of a variety of endogenous steroids. 5-ARIs are most known for preventing conversion of testosterone, the major androgen sex hormone, to the more potent androgen dihydrotestosterone (DHT), in certain androgen-associated disorders.
The idea that testosterone could be the missing piece of the hormone therapy (HRT) jigsaw puzzle, alongside the female sex hormones estrogen and progesterone, was first sparked by a change in the ...
Testosterone levels very with age, according to the Cleveland Clinic, and start to drop around age 30 or 40. Women turn to weight loss drugs in menopause: What to know about the benefits and risks
The effect of feminizing hormone therapy on fertility is not clear, but it is known that testosterone suppression can prevent sperm production. [302] The age of starting and stopping hormone therapy seems to be a significant factor, but no direct causation has been found between length of treatment and ability to reproduce. [303] [304]
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