ROLE OF AROMATASE INHIBITORS ON SEXUAL DESIRE IN MEN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Considering that the use of aromatase inhibitors (AIs) has been associated with an increase in hypothalamus pituitary testis axis (HPT) activity these medications were also tried for the treatment of male hypogonadism. However, their effect on male sexual function, and, libido in particular, has been poorly investigated.

An extensive Medline, Embase and Cochrane search was performed. All studies reporting data on sexual function after the use of AIs were considered. The search, which accrued data from January 1, 1969, up to October 31st, 2023, was restricted to English-language articles and studies of human participants.

Overall, 9 studies were collected including 457 subjects with a mean age and mean body mass index (BMI) of 42.9 years and 32.1 kg/m2. Overall, the use of AIs significantly increased the risk of low libido, up to 44%. Interestingly, meta-regression analysis showed that the risk of low sexual desire was inversely related to estradiol (E2) levels and increased as a function of the T/E2 ratio at the endpoint. The latter findings were confirmed after the adjustment for age and BMI (r = -0.370 and 2.981 for E2 and T/E2 respectively; both p < 0.0001).

ARis do not represent a valid therapeutic option in hypogonadal men with sexual dysfunction.

none.