Aromatase inhibitors may be an attractive alternative for traditional testosterone substitution in elderly men because these compounds can be administered orally once daily and may result in physiological 24 h testosterone profiles. Additionally, misuse of aromatase inhibitors is unlikely since testosterone levels will not be stimulated to vastly supraphysiological levels. A small, controlled study demonstrated that anastrozole in a dose of 1 mg daily during 12 weeks will result in doubling of the mean bioavailable testosterone level in older men. A more recent study also showed a moderate but significant effect of aromatase inhibition on estradiol and testosterone levels in older men. Treatment with atamestane 100 mg once daily resulted in a 40% increase in total testosterone levels after 36 week
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