Purpose of review: In men estrogens are important for achieving and maintaining bone mass, epiphysial maturation and feedback on gonadotrophin secretion. Potent aromatase inhibitors offer a convenient way to suppress estrogen production in men. This review aims to present an overview of the potential indications for aromatase inhibitors in men and to discuss results of clinical trials.
Recent findings: Aromatase inhibitors are particularly useful to delay epiphysial maturation and increase predicted adult height in boys with pubertas praecox, idiopathic short stature and constitutional delay of puberty. In older men with late-onset hypogonadism aromatase inhibitors improve plasma testosterone levels but evidence for long-term benefit is presently lacking. Preliminary evidence shows no detrimental effects of aromatase inhibition on bone metabolism in men.
Summary: Aromatase inhibitors effectively delay epiphysial maturation in boys and improve testosterone levels in adult men and may be used to increase adult height in boys with pubertas praecox, idiopathic short stature and constitutional delay of puberty. Long-term efficacy and safety is not established in adult men and their use in older men with late-onset hypogonadism is therefore not yet recommended.