This is a prospective, single-center, three-arm Phase 1 safety and feasibility trial evaluating anti-estrogen therapy in men age 50 years and older with symptomatic unilateral inguinal hernias. Participants will be randomized to receive fulvestrant 250 mg intramuscularly, fulvestrant 500 mg intramuscularly, or letrozole 5 mg orally for 6 months. The study will evaluate safety, tolerability, feasibility, hormone changes, hernia size, patient-reported outcomes, bone density, and imaging-based hernia classification.
Male sex
Age ≥ 50 years at time of enrollment
Symptomatic unilateral inguinal hernia confirmed on physical examination
Hernia visible / confirmed on groin ultrasound
Scrotal hernia (any)
Bilateral inguinal hernia
Recurrent inguinal hernia (prior repair at same site)
Clinically significant renal dysfunction judged by investigator to increase study risk