question from a user
What is your opinion on exemestane monotherapy to restore testosterone levels of someone with secondary hypogonadism?
AlphaMD's Answer
Exemestane can increase testosterone levels by reducing circulating estrogen. Estrogen has a negative feedback loop on the pituitary's production of FSH and LH. So logically, you might be able to increase testosterone production by reducing the estrogen and thereby increasing FSH and LH.
The problem with this is that to lower estrogen to a level that would achieve a therapeutic testosterone in men with hypogonadism, you would have to drop the estrogen to a level of almost zero. This would likely cause more side effects than the low testosterone caused in the first place.
For this reason, we would not recommend exemestane monotherapy to restore testosterone levels in any man with hypogonadism.
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