From the Guidelines
Aromasin (exemestane) is not recommended for daily use in adult males outside of specific medical supervision due to its potential to cause significant hormonal imbalances and adverse effects. Taking this medication daily can lead to decreased libido, erectile dysfunction, joint pain, and mood changes, as it blocks the conversion of testosterone to estrogen, potentially resulting in excessively low estrogen levels in men 1. This hormonal imbalance may cause bone density loss, increasing fracture risk over time, and negatively impact cardiovascular health, with potential increases in cholesterol levels and higher risk of cardiovascular events. Some men might experience hot flashes, fatigue, and cognitive issues.
Key Considerations
- Aromasin is primarily approved for breast cancer treatment in women and has no FDA approval for male use.
- The body requires some estrogen even in males for proper functioning of multiple systems, including bone, brain, and cardiovascular health.
- Any consideration of this medication should only occur under strict medical supervision for specific conditions like gynecomastia or certain hormone-sensitive cancers, with regular blood work to monitor hormone levels and potential side effects.
- The potential benefits of Aromasin in men are outweighed by the risks, and alternative treatments should be considered for conditions like hypogonadism, which may involve testosterone replacement therapy, as discussed in the context of obesity-related hypogonadism 1.
Monitoring and Safety
- If Aromasin is prescribed, regular monitoring of hormone levels, bone density, and cardiovascular health is crucial to mitigate potential adverse effects.
- Patients should be aware of the potential side effects and report any changes in their condition to their healthcare provider.
- The use of Aromasin in men should be approached with caution, and the decision to prescribe it should be made on a case-by-case basis, considering the individual's specific medical needs and risks.
From the Research
Potential Effects of Aromasin (Exemestane) on Adult Males
The provided studies primarily focus on the effects of Aromasin (Exemestane) in postmenopausal women with breast cancer. However, we can infer some potential effects of Aromasin on adult males based on its mechanism of action and the available data.
- Hormonal Changes: Aromasin is an aromatase inhibitor, which means it blocks the conversion of androgens to estrogens in the body 2, 3. In adult males, this could lead to a decrease in estrogen levels and potentially an increase in testosterone levels.
- Bone Health: Aromatase inhibitors have been shown to increase the risk of bone fractures in postmenopausal women due to the decrease in estrogen levels 2, 3. Similarly, adult males taking Aromasin may be at risk of bone health issues, such as osteoporosis.
- Efficacy and Safety: The studies suggest that Aromasin is effective in reducing estrogen levels and preventing breast cancer in postmenopausal women 2, 4. However, the safety and efficacy of Aromasin in adult males are not well established, and more research is needed to determine its potential effects.
- Alternative Uses: Clomiphene citrate, another medication used to treat hypogonadism, has been shown to be safe and effective in adult males 5. However, Aromasin is not typically used for this purpose, and its effects on male hypogonadism are not well understood.
Key Considerations
- The available studies do not provide direct evidence on the effects of Aromasin in adult males.
- Aromasin's mechanism of action suggests potential hormonal changes, bone health risks, and unknown efficacy and safety in adult males.
- More research is needed to determine the potential effects of Aromasin in adult males.