Should I Take Anastrozole with Testosterone?

However, aromatase inhibitors have been shown to have a higher success rate at stopping increased estrogen production. For premenopausal women, it is also necessary to incorporate ovarian suppression therapy. Testosterone Replacement Therapy (TRT) is often viewed as a simple fix—inject testosterone and reap the benefits of increased muscle mass, energy, and libido.

Effects of aromatase inhibition on luteinizing hormone release and testosterone production

Not all of these roles of the enzyme described in animal studies have been ascertained in humans. Available data also indicate that brain aromatase expression is altered with aging and under neurodegenerative conditions. Further, genetic and neuropathological findings suggest that the enzyme may participate in the manifestation of brain diseases, including major depressive disorder, Steroid Injections buy autism spectrum disorders (ASDs), and neurodegenerative diseases. Here, we review the available information on the distribution and function of aromatase in the human brain, discussing future avenues for research and potential clinical and therapeutic implications. The seeds of grapes (Vitis vinifera) are a rich source of proanthocyanidins and anthocyanidins, among a myriad of other phenolic compounds. The phytochemicals in grape seed extracts are revered for their antioxidant, antihypertensive, anti-diabetic, and anti-hyperlipidemic effects, in addition to being well-tolerated.

• Chronic stress is also known to disrupt the hypothalamic-pituitary-gonadal (HPG) axis and the release of testosterone (12).
• Additional end points included rates of endogenous glucose production and lipolysis, body fat, lipid profile, plasma adipocytokines, and mRNA transcript abundance in sc adipose tissue.
• Available data also indicate that brain aromatase expression is altered with aging and under neurodegenerative conditions.
• The best known prescription aromatase inhibitor is anastrozole (Arimidex is the brand name).

Evidence-Based Strategies for Prevention and Treatment of Age-Related Cognitive Decline – Part One

Thus, in vitro research using cancer cells from breast tissue is a primordial stage in discovering natural aromatase inhibitors like grape seed extract. Although anecdotal responses have been observed in women with ER- and PgR-negative tumours, in current clinical practice, only postmenopausal women with ER-positive and/or PgR-positive tumours are selected for treatment with AIs (9,16). There are several clinical studies evaluating the use of AIs in premenopausal women combined with ovarian suppression with a LH-releasing hormone (LHRH) analogue. AIs are generally not used off-label for premenopausal women except in special circumstances, such as prior tamoxifen failure or medical contraindications to tamoxifen. When AIs are used in premenopausal women they must be combined with surgical or medical ovarian ablation. Results with AIs in the adjuvant or neoadjuvant setting are detailed below.

Ongoing phase III prevention trials will define the incidence of these adverse events relative to placebo in a healthy population, and potential solutions to avoid some of these problems in the prevention setting are already being explored. “If you have high estrogen levels and are experiencing symptoms such as gynecomastia (man boobs), despite having healthy testosterone levels, anastrozole might be a great treatment option,” Staheli explains. This was already discussed in my first blog, The Importance of Oestrogen in TRT. To recap, oestrogen receptors exist throughout the body in different tissues and serve different roles. In the brain, there is a large number of oestrogen receptors in the pre-optic area, and the anterior hypothalamus contains a large amount of both aromatase and oestrogen receptors, both of which contribute to the regulation of libido 1.

The possibility that SSRIs might, by inhibiting CYP2D6, slow the metabolism of tamoxifen and reduce its effectiveness is a concern given that as many as one-fourth of breast cancer patients experience clinical depression and may be treated with SSRIs. In addition, SSRIs are sometimes used to treat hot flashes caused by hormone therapy. The side effects of hormone therapy depend largely on the specific drug or the type of treatment (7). The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy (30).

Preclinical studies indicate that AIs might be effective in reducing the risk of breast cancer in hormonally intact animals under circumstances in which breast aromatase is up-regulated (88). In studies of postmenopausal women, breast estradiol levels have been found to be 10- to 50-fold higher than serum levels, and aromatase – which is up-regulated in proliferative breast disease – is responsible for much of this local synthesis (89,90). We have performed a 6-month pilot study of letrozole in high-risk women who continued to take their hormone replacement during the study period. An approximate two-thirds reduction in breast tissue proliferation (Ki-67) was observed after 6 months of letrozole. There was no increase in hot flushes or arthralgias for the majority of women in the trial (91). The concept of using an AI in women already receiving hormone replacement therapy will be explored further in a placebo-controlled, randomised, proof-of-principle trial in which change in Ki-67 in benign breast tissue is the primary end-point.