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Aromatase (CYP19A1) is a monooxygenase from the family of cytochrome P450 that plays role in the androgens to estrogens conversion. Aromatase inhibitors prohibit the aromatase enzyme function. This study reviewed the different usages of aromatase inhibitors in the male gender. In this review study, all articles related to the effect of aromatase inhibitors in males were evaluated through databases such as PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane library using the keywords “aromatase inhibitors”, “infertility”, “bone metabolism”, “Breast cancer”, “obesity”, “men” and “male”. Estrogen excess in males shows a correlation with premature closure of the epiphyses. Aromatase inhibitors reduce estrogen by preventing the testosterone to estrogen conversion and have thus been used in patients with short stature or with a delay of puberty. The breast cancer cells show aromatase activity, a probable source of local estrogen for the tumor cells. The inhibition of aromatase suppresses the amounts of serum estrogen and reduces cancer cell proliferation mediated by estrogen in hormone receptor-positive breast cancer. Aromatase inhibitors have also been used in late-onset hypogonadism by lowering the levels of estrogen which is correlated with luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and testosterone increase. In obese males, an augmented androgen-to-estrogen conversion happens in the adipose tissue, resulting in raised estrogen levels. Aromatase inhibitors by reducing this conversion lead to a reduction of estrogen and elevation of testosterone and FSH in males with obesity-associated hypogonadotropic hypogonadism. Furthermore, aromatase inhibitor therapy reduced the breast size in males with gynecomastia. They may affect bone metabolism. Resumen: La aromatasa (CYP19A1) es una monooxigenasa de la familia del citocromo P450 que desempeña un papel en la conversión de andrógenos a estrógenos. Los inhibidores de la aromatasa prohíben la función de la enzima aromatasa. Este estudio revisó los diferentes usos de los inhibidores de la aromatasa en el género masculino. En este estudio de revisión, todos los artículos relacionados con el efecto de los inhibidores de la aromatasa en los hombres se evaluaron a través de bases de datos como PubMed, Web of Science, Scopus, Science Direct, Google Scholar y la biblioteca Cochrane utilizando las palabras clave ''inhibidores de la aromatasa'', ''infertilidad''. , “metabolismo óseo”, “cáncer de mama”, “obesidad”, “hombres” y “masculino”. El exceso de estrógenos en los varones muestra una correlación con el cierre prematuro de las epífisis. Los inhibidores de la aromatasa reducen el estrógeno al evitar la conversión de testosterona en estrógeno y, por lo tanto, se han utilizado en pacientes con baja estatura o con un retraso en la pubertad. Las células de cáncer de mama muestran actividad aromatasa, una fuente probable de estrógeno local para las células tumorales. La inhibición de la aromatasa suprime las cantidades de estrógeno sérico y reduce la proliferación de células cancerosas mediada por estrógeno en el cáncer de mama con receptores hormonales positivos. Los inhibidores de la aromatasa también se han utilizado en el hipogonadismo de inicio tardío al reducir los niveles de estrógeno que se correlacionan con la hormona luteinizante (LH) y la hormona estimulante del folículo (FSH) y el aumento de testosterona. En el hombre obeso, ocurre una conversión aumentada de andrógenos a estrógenos en el tejido adiposo, lo que resulta en niveles elevados de estrógenos. Los inhibidores de la aromatasa al reducir esta conversión conducen a una reducción de los estrógenos y una elevación de la testosterona y la FSH en los hombres con hipogonadismo hipogonadotrópico asociado a la obesidad. Además, la terapia con inhibidores de la aromatasa redujo el tamaño de los senos en hombres con ginecomastia. Pueden tener un efecto sobre el metabolismo óseo.

Women with breast cancer who receive aromatase inhibitors (AI) are at risk of bone mass loss and bone fracture. Many of these women have been previously treated with chemotherapy and/or tamoxifen, also with known deleterious bone effects. We studied the bone mineral status of a group of postmenopausal women with non-advanced breast cancer about to initiate AI treatment.Between 2007 and 2010, 127 women aged 63 ± 9 years were prospectively included. Clinical, epidemiological, analytical, radiological, and densitometric data were collected.Prior to initiating AI treatment, the patients exhibited a high prevalence of bone mass loss (62.2%): 16.5% had osteoporosis and 45.7% osteopenia by OMS criteria. Besides, 7.4% of their dorso-lumbar spine x-rays revealed one or more vertebral fractures, all of which were found in patients with densitometry-defined osteoporosis or osteopenia. Surprisingly, 25-OH-vitamin D levels were normal (≥30 ng/ml) in 87.4% of the women. Obesity was prevalent (BMI 30 ± 5). Their most common tumour was infiltrating ductal carcinoma (76.4%). The women who had received adjuvant chemotherapy (50%) were younger (59.1 ± 8.3 vs. 66.2 ± 8.2, p