Men….do you think that your testosterone level may be too low? What about your estrogen level being too high? We normally think of the hormone testosterone as being male and the hormone estradiol (estrogen) as being female, but the truth is we all have them both, amongst other hormones.
Testosterone
In men, testosterone is known to give energy, help strength and stamina especially when combined with exercise, and improve sexual interest and response. However, there are other things which are not spoken about as often which are probably the finest gifts a good testosterone level can deliver. They include sharp brain function, that competitive edge feeling, and improvement of every cardiovascular function including lowering cholesterol and blood pressure, to improving your blood sugar. Many men just feel like they may be depressed, getting “that belly”, or just plain aging…and they are right. However, a declining testosterone level is usually responsible and you may have been told that your level is “normal and within range”. The good news is that it can be optimized, meaning that the level can be improved upon so that the symptoms are relieved.
Estrogen
Estrogen (estradiol), on the other hand is also present in men. When you are young, your testosterone levels are high and the estrogen level is low. As men age, the testosterone level begins to fall and the estrogen levels increase. Estrogen, in men, is necessary and even good in low levels. It is known to help prevent Alzheimer’s disease and improves some cardiovascular functions. However for the most part, a higher level inactivates testosterone. Higher estrogen levels are also thought to be associated with increases in prostate cancer. This increased estrogen level mimics the same symptoms of lower testosterone, since the estrogen inactivates the testosterone.
A few of the causes for increased estrogen levels in men include consuming street drugs, especially marijuana, consuming alcohol even in moderate amounts, having too many fat cells and consuming grapefruit. Early on when a man is just beginning to not feel his optimal self, the reason can simply be an elevated estrogen level. This creates an out of balance testosterone-to-estrogen ratio. Sometimes this is all that needs to be addressed.
Physiologic Demands
At times, more than just the estrogen level needs to be corrected as a man ages. Sometimes the signal from the pituitary gland in the brain fails to trigger the correct response in the testicle leading to lower than optimum levels of testosterone. Sometimes, the testicle just cannot simply keep up with the physiologic demands and comes up short. It is estimated that there is a 1-3 % decline in testosterone levels per year beginning in the 30’s for men. For other men, testosterone levels are quite low earlier than expected because of stress and the loss of the hypothalamic-pituitary axis signals (disruptions in the glands of the brain). Whatever the case, testosterone levels are capable of being optimized in several different ways depending on the particular situation.
Testosterone Therapy
Often, when a man begins testosterone therapy he feels great, but after a few weeks he may notice that old feeling of fatigue coming back. This is very likely due to the testosterone converting to estrogen, thus inactivating the testosterone he is receiving. There are different ways of blocking the conversion of testosterone into estrogen and this can be accomplished easily most of the time. Substances such as zinc and progesterone can slow this pathway down. Other times it is necessary to use chrysin or anastrozole in very minute doses to accomplish this goal.
Your doctor should follow your estrogen level, as well as your testosterone level, to assure you that your ratio is normalized. This can often mean the difference between feeling like testosterone therapy did not work for you and feeling great again. And choosing to have your testosterone levels optimized should also be a discussion. Together, these treatments can bring you back to balance and wellness!
Marie Dam, MD is a traditionally trained internist who now embraces a more holistic paradigm of healthcare. Having completed a fellowship at the American Academy of Anti-aging and Regenerative medicine , she approaches wellness by seeking to optimize hormonal balance in both men and women with a variety of tailored approaches including bioidentical hormones, diet and nutritional supplements, metabolism medicine and detoxification strategies . She is the owner of Healthstream, LLC in Avon CT. www.drmdam.com.