No matter how much I write about the fact that everything in the body should be balanced and obey general laws, many of my male patients are still sure: there is never enough testosterone. The more the better.
This is, of course, a very dangerous delusion.
At least because excess testosterone in the body is very easily converted to estradiol through a reaction with the poetic name of aromatization. And the hormone estradiol is the main hormone of the female body. (Conditionally). An overabundance of it in men leads to sad consequences, as well as a lack.
During the preparation of my dissertation, I came across a very interesting study.
In our country, it is believed that aromatase inhibitors (drugs that prevent aromatization from starting and, accordingly, do not allow testosterone to be converted to estradiol) to use in men, it is dangerous, useless and there are no registered indications.
Meanwhile, the whole world has gone ahead, and there has been a lot of research using aromatase inhibitors. In February 2020, there were
American poll results published, which showed that more than 50% of American doctors who prescribe testosterone replacement therapy use aromatase inhibitors.So, in 2016 there were results of annual research publishedwhere the effects of testosterone and aromatase inhibitors were compared.
In one group, patients took testosterone, in the second, inhibitors:
1. In both groups increased testosterone levels from 12.1 nmol / l above 17.4 nmol / l; p <0.05
2. In the testosterone group, significantly increased bone mineral density in the lumbar spine (this is an indicator of how strong the bone is and what the likelihood of fractures is); p <0.01
3. Both groups strengthened their bones in the knee area; p <0.01.
4. Muscle mass increased significantlyb only in the group of aromatase inhibitors; p <0.01. In the testosterone group, it also increased, but to a lesser extent;
5. In the testosterone group increased gait speed, also significantly (p <0.01 and p <0.05 after 6 and 12 months). Gait speed is a rather important indicator of youth and general physical fitness.
6. Only in the Aromatase Inhibitor Group did estradiol decrease, while in the Testosterone Group it increased. And this, a healthy man, is useless. On the dangers of high estradiol levels in men, I've already done a post.
The conclusion is this: both methods of treatment are effective. Each therapy has its own indications, and in order to help the patient, the doctor must necessarily study the experience of colleagues, including foreign ones.
Your Doctor Pavlova
Continued here.
