Study analysis · Epilepsy & behavior : E&B · 2010

Adding an estrogen-blocker to testosterone didn't significantly improve sex life in men with epilepsy — but it did lower estradiol and triglycerides, and seizures dropped in both groups.

In 40 men with epilepsy and low sex hormones, adding anastrozole to testosterone made sexual function normal in 72% versus 47% with placebo, but that difference could be chance; the drug did lower estradiol and triglycerides.

Reading level
Low certainty
Level 1b · Individual RCT

Overview

What the study found

The study in plain English — the bottom line, every takeaway we extracted, and what to do with them.

In simple terms

This study is a randomized controlled trial, which is a strong type of study for testing treatments. However, because it only had 40 men and the main result about sexual function wasn't clearly positive, we can't be sure the treatment works for that. It can show the drug changes some hormone levels, but we need more research to know if it truly helps.

What’s the bottom line?

A small 3-month study tested whether adding anastrozole to testosterone improves sexual function, mood, seizures, and hormone levels in men with epilepsy, hyposexuality, and hypogonadism.

How strong is this study?

The study was double-blind and randomized, which means it was designed well to reduce bias. But it was very small and many results were not statistically significant, so we should be cautious about trusting the main conclusions. Also, we only have the summary, not the full details, which makes it harder to judge.

Reporting

0 / 100

  • COI disclosureconflicts of interest not disclosed
  • Data availabilitydata not shared
  • Code availabilitycode not shared
Methodology

80 / 100

  • Randomization+20/20
  • Blinding+15/15
  • Control group+15/15
  • Sample size (n=40)+3.6/20
  • Follow-up+10/10
Publication

100 / 100

Statistical

0 / 100

  • P-valuesno p-values reported
  • Effect sizeno effect size reported
  • Confidence intervalsno confidence intervals
  • Pre-registrationnot pre-registered

Each component is scored out of 100 and then capped by the study design — a case series cannot reach the ceiling a randomised trial can, however well it is reported.

Where it sits

RCT reviews

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
48

48 / 100

Probability of being correct

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

This design can establish causation. The randomized, double-blind, placebo-controlled design can establish causation in principle, but the small sample size (n=40), non-significant primary outcome, multiple comparisons, and abstract-only availability limit causal inference for specific claims. Significant secondary outcomes (e.g., estradiol, triglycerides) may support causal statements with low confidence.

COI Unknown

Could not determine conflict of interest status

Not Disclosed

No conflicts of interest or funding disclosures are present in the provided text; therefore, potential conflicts cannot be assessed.

Undisclosed — Suspicious

The text lacks a conflict of interest section, funding statement, and author affiliations. The study evaluates a drug combination including anastrozole, but no commercial sponsor or author-industry relationships are identified. Absence of disclosure prevents a full assessment of bias risk.

Key takeaways

  1. 01

    Sexual function normalized in 72.2% of men taking anastrozole plus testosterone versus 47.4% taking placebo plus testosterone.

  2. 02

    The absolute difference was 24.8 percentage points, but it was not statistically significant.

  3. 03

    Anastrozole significantly lowered estradiol levels.

  4. 04

    Seizure frequency decreased in both groups and correlated with estradiol and depression score changes.

  5. 05

    Triglycerides increased with placebo plus testosterone and decreased with anastrozole plus testosterone; the difference was significant.

  6. 06

    In this 40-man, 3-month trial, the main result was an absolute difference of 24.8 percentage points in sexual function normalization (72.2% vs 47.4%), but this was not statistically significant, so it could be due to chance.

  7. 07

    The study did not report absolute risk numbers or event rates for the other findings; estradiol lowering, triglyceride changes, and correlations were reported without absolute differences or confidence intervals.

Practical takeaways

Do not change or start hormone therapy based on this abstract. If you have epilepsy, hypogonadism, and sexual dysfunction, discuss with your doctor whether a clinical trial or specialist referral is appropriate.

This was a small 3-month trial of 40 men. The primary sexual function difference was not statistically significant. Full methodology and safety data are not available in the abstract.

low confidence

If you are a man on testosterone therapy, ask your clinician whether monitoring estradiol and triglycerides is appropriate for your situation.

The study only included men with focal epilepsy, hyposexuality, and hypogonadism. Findings may not apply to other groups. The abstract does not specify clinical monitoring recommendations.

low confidence

Why this study matters

Primary result missed statistical significance

Normalization of sexual function occurred in 72.2% of the testosterone-plus-anastrozole (T-A) group versus 47.4% of the testosterone-plus-placebo (T-P) group. That is an absolute difference of 24.8 percentage points, but it was not statistically significant. The trial included only 40 men and lasted 3 months.

A 25-percentage-point difference sounds impressive, but with a small sample it could easily be due to chance. This is a classic example of why 'not statistically significant' does not mean 'no effect' — it may just be underpowered.

Anastrozole significantly lowered estradiol

T-A resulted in significantly lower estradiol levels compared with T-P. Sexual function scores correlated inversely with estradiol levels at baseline and during treatment — meaning higher estradiol was associated with worse sexual function.

Estrogen is often thought of as a female hormone, but it matters in men too. Blocking estrogen production with anastrozole changed hormone levels, though that did not translate into a statistically significant sexual function benefit in this small study.

Seizure frequency decreased in both groups

Seizure frequency decreased with both T-A and T-P treatments over 3 months. Changes in seizure frequency correlated significantly with estradiol levels and with changes in depression scores (BDI-II).

This raises the possibility that testosterone therapy — with or without anastrozole — might influence seizure control. But because there was no untreated control group, we cannot know whether the decrease was due to the drug, placebo effect, or natural variation.

Triglycerides moved in opposite directions

Triglyceride levels increased with T-P and decreased with T-A. The between-group difference was statistically significant and correlated with changes in estradiol levels.

Testosterone alone raised a cardiovascular risk marker, while adding anastrozole lowered it. This suggests estrogen suppression may have metabolic effects, but the clinical significance is unknown from this short trial.

Depression improved in both groups

BDI-II depression scores improved significantly in both the T-A and T-P groups. Changes in sexual function scores correlated inversely with changes in BDI-II scores — as mood improved, sexual function tended to improve too.

Mood and sexual function are tightly linked. Treating low testosterone may lift mood, which in turn could improve sexual satisfaction, regardless of estrogen blockade.

Want the whole report?

Detailed mode opens the full scientific breakdown — every score component, the methodology, conflicts of interest, the evidence analysis behind each claim, and the raw study data.

Standing

The people behind it

The researchers who wrote the study this analysis is built on.

Authored by

8 researchers

If this is your work, this is how we attribute it on Fit Body Science. Andrew G. Herzog is listed as the lead author.