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Cited by 245Hormonal and reproductive studiesHypothalamic control of reproductive hormonesOvarian function and disorders

The hypogonadal-obesity cycle: Role of aromatase in modulating the testosterone-estradiol shunt—A major factor in the genesis of morbid obesity

Cohen, P.G.·1999·Medical Hypotheses
DOI 10.1054/mehy.1997.0624
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Abstract

Massive obesity in males is associated with decreased total and free testosterone levels as well as elevated estradiol levels. The decrease in testosterone occurs without the compensatory increases in gonadotropin and a progressive hypogonadotropic hypogonadal cycle develops. During the hypogonadal state, there is a preferential deposition of abdominal adipose tissue. With the increasing fatty-tissue accumulation, there is an increase of aromatase activity that is associated with a greater conversion of testosterone to estradiol (testosterone-estradiol shunt). This results in further depression of testosterone concentrations and leads to the increased preferential deposition of abdominal fat that, in turn, leads to a progressive hypogonadal state. Testalactone, an aromatase inhibitor, interrupts this cycle and repairs the depressed testosterone concentrations and decreases estradiol levels. This increases the testosterone levels and reverses the preferential deposition of abdominal fat, while increasing muscle protein and fat-free mass.

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Crossref · 10.1054/mehy.1997.0624

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  • Adipose tissue expansion correlated to weight gain is linked to an overexpression of the enzyme aromatase, which converts Testosterone into Estradiol.

    “The first risk factor is constituted by adipose tissue expansion correlated to weight gain, which is linked to an overexpression of the enzyme aromatase. This enzyme converts Testosterone into Estradiol (Testosterone-Estradiol shunt) [15].”

    From MOSH Syndrome (Male Obesity Secondary Hypogonadism): Clinical Assessment and Possible Therapeutic Approaches (2018) · cites this paper as [15]

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Authors
Cohen, P. G.
Corresponding author
Cohen, P.G.
Venue
Medical Hypotheses
Publisher
Elsevier BV
Published
1999-01
Volume
52
Issue
1
Pages
49-51
ISSN
0306-9877 (ISSN-L)
DOI
10.1054/mehy.1997.0624
OpenAlex
W1964441320
Cited by
245
References
13
Citations by year
2026: 10 · 2025: 6 · 2024: 12 · 2023: 6 · 2022: 8 · 2021: 7 · 2020: 16 · 2019: 24 · 2018: 15 · 2017: 14 · 2016: 7 · 2015: 16 · 2014: 12 · 2013: 17 · 2012: 9
FWCI
0.92
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Medical Hypotheses (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Keywords
aromatase, male obesity, hypogonadism, estradiol, abdominal fat deposition, aromatase inhibitors, fat-free mass, muscle proteins
MeSH terms
Aromatase, Enzyme Inhibitors, Estradiol, Humans, Hypogonadism, Male, Models, Biological, Obesity, Morbid, Testosterone, Aromatase Inhibitors

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