After suffering weird bone/nerve pain from compounds that lower aromatase I became curious in the negative effects of low estrogens. Thanks to @Dante for the last one. Feel free to add more and discuss :
Management of arthralgias associated with aromatase inhibitor therapy
Management of arthralgias associated with aromatase inhibitor therapy
@ecstatichamster @haidut
Management of arthralgias associated with aromatase inhibitor therapy
Results: DHT treatment increased serum DHT with complete suppression of serum T, luteinizing hormone, follicle stimulating hormone, and estradiol throughout the 24-month study resulting in reduced spinal bone density.
DHT administration had no effects on any of 33 measures of sexual function and mood, apart from a mild, but significant decrease in overall sexual desire, which was reversible after cessation of treatment.
Management of arthralgias associated with aromatase inhibitor therapy
Aromatase Deficiency, a Rare Syndrome: Case ReportAdverse events such as arthralgia and myalgia are more frequent with adjuvant ai therapy than with tamoxifen. However, they are predictable and may be easily managed with appropriate lifestyle changes and non-pharmacologic interventions, or with pain medications after accurate musculoskeletal evaluation and differential diagnosis. Although a few studies suggest the use of bisphosphonates to manage bone-related side effects 40, current evidence is insufficient to support the use of those agents in preventing skeletal events or improving survival in women with early-stage breast cancer 37. Although the association of estrogen deprivation with osteoarthritis and rheumatoid arthritis in postmenopausal women needs further study, it is essential to understand that the symptoms are usually transient and resolve when the ais are discontinued at the end of therapy.
A 27-year-old male presented to our outpatient clinic with complaints of bone pain, recurrent forearm fracture associated with minimal trauma, and progressive increase in height.
First, a right forearm fracture developed after minimal trauma at age 15, and later, right and left forearm fractures occurred with minimal trauma at ages 19 and 24. A left forearm radiography performed at age 24 showed osteopenia, and the epiphyses were detected to be open. A diagnosis of osteoporosis was made based on bone densitometry performed in the medical facility to which he applied at age 26 with the complaint of pain in the bones, and alendronate 70 mg/week was started. After nearly one year of treatment, due to the progression of osteoporosis and progressive increase in height noted on follow-up, the patient was referred to our center for further evaluation. In his family history, the mother and father were first-degree cousins and he had two brothers. There was no infertility, primary amenorrhea, or hirsutism history in the family, but there was a history of kidney stones in two babies (relatives) who died in their early infancy (1-2 week). Our patient was born with ambiguous genitalia.
[...]body mass index was 25.7.[...]
A eunuchoid body habitus was noted. Secondary sexual characteristics were normal. The length and thickness of the penis was normal. Testicular volume, measured with an orchidometer, was >20 mL. No gynecomastia, goitre, acanthosis nigricans, or acromegalic appearance were noted.
[...]
Clinical and radiological findings include delay in bone maturation, lack of epiphyseal closure, continuation of linear growth, tall stature, eunuchoid body habitus, genu valgum, bone pain, osteopenia, and osteoporosis. Abnormal spermatogenesis, oligospermia, increase in testis volume, and cryptorchidism are often present. Metabolic syndrome findings such as abdominal obesity, insulin resistance, impaired glucose tolerance, acanthosis nigricans, non-alcoholic fatty liver, and dyslipidemia develop at early ages (1,4,8).
Treatment consists of estrogen replacement. Bone maturation and mineralization are normalized through estrogen treatment. Fast bone maturation is noted in 6-9 months when estrogen is used in high doses (25-50 µg/day) (11,12). 25 µg transdermal estradiol treatment was given every three days in our patient. In AD, estrogen treatment also normalizes gonadotropin secretion, glucose metabolism and liver functions, decreases lipids and insulin levels (13,14,15). In the third month of the treatment, decreases in FSH, LH, testosterone, total cholesterol and triglyceride levels, and increase in HDL level were detected in our patient. The increase in serum alkaline phosphatase and osteocalcin levels were linked to increase in remodeling activity within the bone.
@ecstatichamster @haidut
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