ISSN 1849-9031 (Online)

ISSN 1849-8922    (Print)

Hypogonadotropic hypogonadism in men due to obesity – Is there a place for aromatase inhibitors?
Andrej Belančić, Sanja Klobučar Majanović.



High expression of adipose tissue aromatase is a common finding among severely obese men. Aromatase enhances the peripheral conversion of androgens into estrogens, which exerts estradiol-mediated negative feedback on the pituitary and results in inhibition of gonadotropin production and hypotestosteronemia. Therefore, we are scrutinizing aromatase inhibition as a potential novel therapeutic (second-line) strategy for men with hypogonadotropic hypogonadism due to obesity. Several questions remain and will be considered in this review. Could we use aromatase inhibitors to increase gonadotropin secretion and normalize the testosterone/estradiol ratio to improve fertility? Could we use them to treat/ prevent gynecomastia? And finally, if we were to use aromatase inhibitors for these indications, what would be the recommended safe dose that would not trigger the potential detrimental therapy effect on bone mineralization?