Aromatase Inhibitor Matches Testosterone Gel for Treating Low T in Older Men

This National Institute on Aging trial examined whether anastrozole, an aromatase inhibitor, could provide similar benefits to testosterone gel for treating age-related testosterone decline in older men. The study addressed a critical need, as traditional testosterone replacement often creates hormonal imbalances and side effects.

Researchers conducted a 12-month randomized, placebo-controlled trial with 44 healthy men aged 65 and older who had clinically low testosterone levels. Participants were divided into three groups: testosterone gel with placebo tablet, anastrozole tablet with placebo gel, or double placebo. All received calcium and vitamin D supplements.

The comprehensive assessment protocol included muscle strength testing, bone density scans, cognitive evaluations, balance assessments, and questionnaires measuring sexual function, mood, and quality of life. Blood and urine tests tracked hormone levels throughout the study, with measurements at baseline, 6 weeks, 3 months, 6 months, and 12 months.

Anastrozole works by inhibiting the enzyme that converts testosterone to estrogen, theoretically allowing natural testosterone levels to rise while reducing estrogen. This mechanism could provide testosterone's benefits without the hormonal disruption seen with direct replacement therapy. The trial's completion in 2015 provides valuable data on this alternative approach to treating hypogonadism in aging men, potentially offering a safer option for maintaining muscle mass, bone health, and cognitive function in older adults.