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Also known as: Aromasin
A steroidal (irreversible) aromatase inhibitor used off-label as an alternative to anastrozole for controlling estrogen on testosterone therapy. Prescription medication (approved for breast cancer).
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Exemestane is a steroidal 'suicide' aromatase inhibitor: it binds aromatase irreversibly and permanently inactivates the enzyme, lowering the conversion of testosterone to estradiol. Because the enzyme must be regenerated, it avoids some of the rebound seen with reversible inhibitors. As with any aromatase inhibitor, some estradiol is essential for male health, so over-suppression is harmful and dosing is conservative and lab-guided.