Committee Opinion No. 663

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Aromatase inhibitors are effective for treating breast cancer, inducing ovulation in women with PCOS, and managing endometriosis, with varying side effect profiles compared to tamoxifen.

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Abstract

Aromatase inhibitors have been used for the treatment of breast cancer, ovulation induction, endometriosis, and other estrogen-modulated conditions. For women with breast cancer, bone mineral density screening is recommended with long-term aromatase inhibitor use because of risk of osteoporosis due to estrogen deficiency. Based on long-term adverse effects and complication safety data, when compared with tamoxifen, aromatase inhibitors are associated with a reduced incidence of thrombosis, endometrial cancer, and vaginal bleeding. For women with polycystic ovary syndrome and a body mass index greater than 30, letrozole should be considered as first-line therapy for ovulation induction because of the increased live birth rate compared with clomiphene citrate. Lifestyle changes that result in weight loss should be strongly encouraged. Aromatase inhibitors are a promising therapeutic option that may be helpful for the management of endometriosis-associated pain in combination therapy with progestins.

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Condition tags

endometriosis

MeSH descriptors

Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Aromatase Inhibitors Breast Neoplasms Breast Neoplasms Endometriosis Endometriosis Estrogens Estrogens Female Gynecology Gynecology Humans Infertility, Female Infertility, Female Osteoporosis Osteoporosis

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