Aromatase Inhibitors in Erectile Dysfunction

Abstract Hyperestrogenism may cause erectile dysfunction(ED) by impeding normal penile development,increasing venous vascular permeability and leakage(via VEGF) inhibiting testosterone(T)production. Estrogen excess can impair spermatogenesis increase the risk of estrogen-sensitive cancers(viz.breast cancer)[1,2]Weekly biweekly letrozole(2.5 mg),an aromatase inhibitor,has been reported to normalize serum T in males with obesity related hypogonadism poor sperm quality,respectively.[3,4]A 40-year old insulin requiring,normotensive,obese(BMI-26.9),diabetic(12 years duration) was evaluated for ED.T 187 ng/dl estradiol(E2) 69 pg/ml(normal-11-44 pg/ml) LH prolactin levels. There normalization T(increased 487 ng/dl) 2.5 mg letrozole every 3 weeks. Another patient,55 year male, requiring,hypertensive,obese(BMI-28.8),diabetic(21 had T(401 baseline low T(224.4 E2(33 T-E2 ratio less than 10,with weekly letrozole. one kg weight gain 0.2 ng/ml PSA two years. These cases highlight significance estimating both E2 evaluation ED. Moreover,it also highlights efficacy safety even 3-week therapy. References: 1. .Schulster M,Bernie AM,Ramasamy R:The role estradiol male reproductive function.Asian Journal Andrology,2016,18(3),435-440. 2. Goldfrank LR Flomenbaum N:Goldfrank’s Toxicologic Emergencies,McGraw- Hill Professional,2006,p443. 3.Loves S,Ruinemans-Koerts,de Boer H:Letrozole once a week normalizes testosterone obesity-related hypogonadism. Eur J Endocrinol,2008,158,741-747.4. Singh SK:Aromatase inhibitors sex. Indian Endocrinol Metab,2013,17,S259-261.