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The effects of the aromatase inhibitor anastrozole on bone metabolism and cardiovascular risk indices in ovariectomized, androgen-treated female-to-male transsexuals.
[aromatase deficiency]
Cases
of
men
with
estrogen
resistance
and
aromatase
deficiency
have
highlighted
the
effects
of
estrogens
on
bone
metabolism
,
the
cardiovascular
system
and
biochemical
variables
of
the
metabolic
syndrome
.
In
eugonadal
men
,
administration
of
an
aromatase
inhibitor
induces
a
substantial
elevation
of
LH
and
testosterone
due
to
the
decreased
negative-feedback
signal
of
estrogen
and
may
thwart
the
interpretation
of
results
.
As
there
is
no
gonad
for
LH
to
act
on
,
no
increase
of
serum
testosterone
concentration
will
be
seen
in
female
-
to
-male
transssexuals
.
The
aim
of
this
study
was
to
investigate
the
effects
of
estrogen
deprivation
on
bone
metabolism
and
vascular
parameters
without
the
interference
of
counter-regulatory
effects
as
seen
in
eugonadal
men
.
Thirty
ovariectomized
female
-
to
-male
transsexuals
participated
in
this
double
-blind
,
randomized
trial
.
During
3
months
,
subjects
received
the
aromatase
inhibitor
anastrozole
1
mg
/
day
(
n
=
16
)
or
a
placebo
(
n
=
14
)
in
addition
to
parenteral
testosterone
esters
(
Sustanon
250
every
2
weeks
)
.
Serum
17
beta
-estradiol
(
E
(
2
)
)
concentration
fell
significantly
from
134
.
0
+
/
-
78
.
8
to
77
.
7
+
/
-
130
.
6
pmol
/
l
compared
with
placebo
(
P
<
0
.
01
)
.
LH
and
FSH
levels
rose
without
the
rise
of
testosterone
levels
observed
in
eugonadal
men
.
Within
the
placebo
group
,
E
(
2
)
remained
at
baseline
levels
.
Of
the
endpoint
variables
measured
(
bone
metabolism
and
vascular
parameters
)
no
significant
changes
were
observed
compared
with
placebo
,
or
within
the
anastrozole-treated
group
.
These
results
may
indicate
that
the
negative
effects
of
estrogen
deprivation
in
men
only
become
manifest
when
the
concentration
falls
below
the
levels
induced
by
our
intervention
with
anastrozole
(
77
pmol
/
l
)
.
This
assumption
is
supported
by
the
observation
in
the
anastrozole
group
that
,
although
effects
of
the
reduction
of
serum
E
(
2
)
on
vascular
parameters
could
not
be
demonstrated
in
subjects
as
a
group
,
there
was
a
correlation
between
individual
serum
E
(
2
)
and
several
vascular
parameters
.
