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Thursday, May 17, 2012


A placebo controlled study using a 1 percent testosterone gel (Testim) in  700 older men  (aged 65 and older) was stopped early due  a higher incidence of cardiovascular events in the testosterone arm.

These findings contradict those from a previously published study performed in 2,416  men  that reported  that a 30% reduction in cardiovascular events occurred in men with higher blood levels of testosterone.

The halted study associated the higher incidence of events with higher total and free testosterone and higher estradiol blood levels. The study does not provide relative risk differences between testosterone and estradiol levels, so it is not known which factor has the highest impact on cardiovascular risks.  

Testosterone converts into estradiol, a female hormone, via aromatization in the liver and other tissues. Previous studies have shown that men with even slightly elevated estrogen levels doubled their risk of stroke and had far higher incidences of coronary artery disease. High estradiol can also cause enlargement of breast tissue, water retention and possibly erectile dysfunction in men.  However, men with low estradiol are more prone to osteoporosis and cognitive loss, so a good balance of this hormone is important for a man’s health.

Nelson Vergel, author of the best-selling book Testosterone: A Man’s Guide, said “ I am glad that the  study authors suggest that a similar study needs to be performed by providing not only testosterone supplementation but also an aromatase inhibitor to assess if any decrease in cardiovascular events is seen by decreasing testosterone conversion into estradiol. Reducing aromatase conversion of testosterone into estradiol also frees up more testosterone to do its job”.

The most popular aromatase inhibitor used in men is anastrazole (brand name: Arimidex), which is dosed in small oral doses 3 times a week. But a mixture of testosterone plus anastrazole cream has recently entered the market.

“We  are the only pharmacy that provides by prescription a testosterone cream that has been formulated with anastrazole for both  products to be absorbed through the skin”, said Jaime Rios, co-owner of APS Pharmacy , a specialty pharmacy that ships economical hormone products nationwide. "This cream makes it easy for men to control their estradiol without having to remember to take an oral medication", added Rios.

More men’s clinics are taking notice of balancing estradiol in men using testosterone. One of them is Defy Medical  .  “We monitor estradiol closely in men served by our clinic and provide treatment solutions that are affordable to any man”, said Jasen Bruce, clinic manager for Defy." We also provide the most economical testosterone and estradiol blood test to any man who wishes to have these hormones tested", added Bruce.

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