Aromatase inhibitors are drugs that block the enzyme aromatase, which converts testosterone into estrogen in the body. Estrogen is a hormone that is mainly produced in women, but it also has effects on men’s health and body weight. High levels of estrogen can lead to obesity, insulin resistance, and cardiovascular disease in men. Obesity, in turn, can increase the production of estrogen in fat tissue, creating a vicious cycle of weight gain and hormonal imbalance.
One way to break this cycle is to use aromatase inhibitors along with weight loss interventions, such as diet and exercise. By reducing estrogen levels, aromatase inhibitors can help obese men restore their testosterone levels, which can have positive effects on their metabolism, energy balance, and body composition. Aromatase inhibitors can also prevent the accumulation of visceral fat, which is the most dangerous type of fat for health.
There are different types of aromatase inhibitors, such as anastrozole (Arimidex) and exemestane (Aromasin). These drugs have different effects on cholesterol levels, bone density, and muscle strength. Anastrozole can lower total and LDL cholesterol, but it can also decrease bone density and muscle strength. Exemestane can preserve bone density and muscle strength, but it can slightly increase cholesterol levels. Therefore, the choice of aromatase inhibitor should be based on the individual’s risk factors and preferences.
Aromatase inhibitors are not without side effects, such as joint pain, hot flashes, and mood changes. They should be used under medical supervision and only for men who have confirmed hypogonadism, which is a condition of low testosterone and high estrogen levels. Aromatase inhibitors are not recommended for men who have normal or high testosterone levels, as they can cause unwanted side effects and health risks.
In summary, aromatase inhibitors can be a useful tool for obese men who have hypogonadism, as they can lower estrogen levels and increase testosterone levels, which can improve their weight loss and metabolic health. However, aromatase inhibitors should be used with caution and in combination with lifestyle changes, such as diet and exercise. Aromatase inhibitors are not a magic bullet for obesity, but they can be a helpful adjunct to a comprehensive weight management program.
How long does it take to see results from aromatase inhibitors?
The results from aromatase inhibitors may vary depending on the type of drug, the dose, the duration, and the individual response. However, some general guidelines can be given based on the available evidence:
- For postmenopausal women with estrogen receptor-positive breast cancer, aromatase inhibitors can reduce the risk of recurrence and improve survival when used as adjuvant therapy after surgery or chemotherapy. The optimal duration of aromatase inhibitor therapy is still under debate, but some studies suggest that extending the treatment to 10 years may provide additional benefits over 5 years1.
- For obese men with hypogonadism, aromatase inhibitors can lower estrogen levels and increase testosterone levels, which can improve their weight loss and metabolic health. The effects of aromatase inhibitors on body composition and hormonal balance can be seen within a few months of treatment, but the long-term outcomes and safety are not well established2.
- For postmenopausal women who are at high risk of developing breast cancer, aromatase inhibitors can lower the incidence of invasive and non-invasive breast cancer by about 50 percent. The preventive effect of aromatase inhibitors can be observed after 3 to 5 years of use3.
- For postmenopausal women who are taking aromatase inhibitors, the most common side effect is bone loss, which can increase the risk of fractures. Bone loss can occur rapidly within the first year of treatment and then stabilize or slow down. Bone density should be monitored regularly and preventive measures, such as calcium, vitamin D, and bisphosphonates, should be considered2.
- For both men and women who are taking aromatase inhibitors, the impact on cognitive function is unclear. Some studies suggest that aromatase inhibitors may impair verbal memory and executive function, while others show no significant difference compared with placebo or tamoxifen. Cognitive function should be assessed periodically and any changes should be reported to the doctor4.