The following is a summary of “Loss of Estradiol by Androgen Deprivation in Prostate Cancer Patients Shows the Importance of Estrogens in Males,” published in the July 2024 issue of Endocrinology by Bennink, et al.

Estradiol (E2), an estrogen hormone, plays a crucial role in men, yet its significance is often underestimated. For a study, researchers sought to explore clinical scenarios highlighting the consequences of E2 deficiency in men and the effects of restoring this hormone to optimal levels. In men undergoing androgen deprivation therapy (ADT) for advanced prostate cancer (PCa), both testosterone and E2 levels are suppressed, leading to various side effects that significantly impact quality of life. These include hot flashes, arthralgia, fatigue, mood changes, cognitive impairment, weight gain, bone loss, and increased cardiovascular disease risk.

Traditionally, gonadotropin-releasing hormone (GnRH) agonists have been used for ADT, which suppress both testosterone and E2. However, transdermal E2 therapy alone has demonstrated comparable testosterone suppression efficacy to GnRH agonists while effectively mitigating estrogen-deficiency symptoms such as hot flashes and bone loss. Furthermore, co-administration of fetal estrogen estetrol (E4) alongside ADT has shown promising results in alleviating these symptoms.

The findings underscored the critical role of estrogen in maintaining men’s health and highlighted the importance of considering estrogen management strategies in clinical practice. It is essential to enhance awareness among both healthcare professionals and the general public regarding the significant impact of estrogen on men’s health.

Reference: academic.oup.com/jes/article/8/7/bvae107/7687567