What is the use of Arimidex (anastrozole) in men?

From the Guidelines

Arimidex (anastrozole) is not recommended as a first-line treatment for men with prostate cancer, according to the most recent guidelines from the American Society of Clinical Oncology (ASCO) 1. The ASCO guideline update from 2021 focuses on the initial management of noncastrate advanced, recurrent, or metastatic prostate cancer, and it does not mention Arimidex as a treatment option for men with prostate cancer. Instead, the guideline discusses the use of other medications such as docetaxel, abiraterone, enzalutamide, and apalutamide in combination with androgen deprivation therapy (ADT) for men with metastatic noncastrate prostate cancer.

Some key points to consider when discussing Arimidex in men include:

• The medication is primarily used to manage estrogen-related side effects from testosterone therapy or to treat conditions like gynecomastia
• The typical dose for men is 0.5 to 1 mg taken orally once daily
• Potential side effects include joint pain, decreased bone density, and impacts on cholesterol levels
• Regular blood tests and bone density scans are important during treatment
• Arimidex is not FDA-approved specifically for male use, though doctors may prescribe it off-label when clinically appropriate

It's essential to note that the ASCO guideline update from 2021 does not support the use of Arimidex as a treatment for prostate cancer in men, and alternative treatments such as docetaxel, abiraterone, enzalutamide, and apalutamide should be considered instead 1. Men should only use Arimidex under medical supervision, and treatment duration varies based on the specific condition being addressed and individual response to therapy.

From the Research

Arimidex in Men

• Arimidex, also known as anastrozole, is a non-steroidal aromatase inhibitor that has been used to treat various conditions in men, including gynecomastia and hypogonadism 2, 3, 4.
• In the treatment of pubertal gynecomastia, anastrozole has been shown to decrease estrogen levels and increase testosterone levels, leading to a reduction in breast size and tenderness in some patients 2, 3.
• However, the effectiveness of anastrozole in treating gynecomastia is limited, and further studies are needed to determine its efficacy and safety 2, 3.
• Anastrozole has also been used to treat hypogonadal, subfertile men with a body mass index (BMI) of 25 kg/m2 or higher, with improvements in hormonal profiles, semen parameters, and fertility outcomes observed in some studies 4, 5.
• The use of aromatase inhibitors, including anastrozole, in the treatment of male infertility is still empirical and requires further research to fully understand their mechanisms of action and potential side effects 5.

Potential Benefits and Risks

• Potential benefits of anastrozole in men include:
  • Reduction in breast size and tenderness in patients with gynecomastia 2, 3
  • Improvement in hormonal profiles and semen parameters in hypogonadal, subfertile men 4, 5
  • Increased fertility outcomes in some patients 4, 5
• Potential risks and side effects of anastrozole in men include:
  • Limited efficacy in treating gynecomastia 2, 3
  • Unknown long-term effects on fertility and overall health 5
  • Potential side effects such as changes in lipid profiles and bone density 5