Normalizing obesity-related male hypogonadism

**Doctor Dan** · 11-24-2009, 12:20 AM

I was having a discussion with one of my urologist colleagues today on how hypogonadism seen in many overweight and obese men is caused in part by aromatase-dependent conversion of testosterone to estradiol (E2) in adipose tissue.

I thought some of you might find the clinical research on this interesting: http://www.eje-online.org/cgi/content/full/158/5/741

In summary, through pharmacologic aromatase inhibition, this effect can be modulated.

- Dan

**Vaporeizied** · 11-24-2009, 10:47 AM

for the little people,

this means

**Doctor Dan** · 11-24-2009, 11:59 AM

Originally Posted by Vaporeizied

for the little people,

this means

Oh sorry about that...

Aromatase is an enzyme which converts testosterone to estradiol and androstenedione to estrone. in other words, it is a mechanism by which these estrogens are synthesized in the body.

Adipose (fat) tissue contains a good bit of aromatase activity, so if you are a guy who is overweight or obese, more conversion takes place. Essentially the excess fat can cause a hormonal imbalance, depleting androgens.

So, the question is whether a pharmacologic intervention, namely an aromatase inhibitor (AI), can treat this. That's what this journal article discusses, and it appears to work very well. The issue now is whether this should this be used as a component of an overall management plan, i.e. how this should be used clinically in combination with weight loss, diet, and exercise. What's particularly interesting is that letrozole is so potent that a very low dose is effective in this application.

- Dan