Language

English

Publication Date

5-1-2026

Journal

Urology Case Reports

DOI

10.1016/j.eucr.2026.103417

PMID

41908849

PMCID

PMC13019929

PubMedCentral® Posted Date

3-18-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Congenital aromatase deficiency is an autosomal recessive CYP19A1 loss-of-function disorder that blocks conversion of androgens to estrogens. A man with homozygous CYP19A1 c.628G > A (exon 5) presented with longstanding fatigue, low libido, and desire to maintain fertility. Physiologic estrogen replacement was started with transdermal estradiol 0.0375 mg. After three months of estrogen therapy, the patient reported markedly improved energy and libido. Follow-up evaluation showed a rise in serum estradiol with normalization of gonadotropins, while maintaining spermatogenesis. This case illustrates the essential role of estrogen in male physiology, sexual function, and fertility. Estradiol replacement can alleviate hypoestrogenic symptoms with preservation of spermatogenesis.

Published Open-Access

yes

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