Why Healthy Estrogen Levels Are Important For Men
This guide to understanding your testosterone wouldn't be complete without a good discussion about estrogen where I address some of the myths and misconceptions about this important hormone.
Aside from some very obvious differences between men and women, which most of us learned in kindergarten, we really aren't that different physiologically. In fact, the vast majority of human hormones are shared by both males and females.
So, while it's not accurate to say that men have testosterone exclusively and women only have estrogen, it is accurate to say that men have more testosterone than women and women have relatively more estrogen than guys do.
Fun Fact: women actually have more testosterone than they do estrogen, but still far less than men.
There's so much discussion on social media by doctors and bro-scientists alike about the importance of maintaining healthy testosterone levels in men as we age. While testosterone is getting much of the spotlight, we also need to pay attention to our estrogen levels if we want to truly optimize our health and performance. Most men assume that we want to decrease our estrogen levels and increase our testosterone levels in order to perform at high levels, but this misconception can be dangerous.
Having low estrogen levels, specifically estradiol (< 20 ng/dl), can undermine our health efforts and cause a whole cascade of health issues, many of which go undiagnosed or are misdiagnosed as normal age-related decline.
The main symptoms of estrogen deficiency in men are:
joint pain
cognitive decline / brain fog
moodiness, depression, and anxiety
reduced libido
bone density loss (after long periods)
Most primary care doctors will never even think to measure your estrogen levels during your annual exam, but lower than optimal estrogen in men can often explain many of the symptoms they are experiencing that are normally associated with aging.
In fact, many of the symptoms that men often seek testosterone replacement therapy (TRT) for such as low energy, brain fog, hair loss, chronic joint pain, and low libido can actually be caused by low estrogen levels.
The main causes of low estrogen in men are:
Decreases in total sex hormone production related to sedentary lifestyle, obesity, high stress, poor sleep and excessive exposure to environmental toxins.
Estrogen blocking as part of Testosterone Replacement Therapy (TRT).
Autoimmune conditions that affect the testes.
Autoimmune conditions or tumors that affect the hypothalamus or pituitary in the brain.
Excessive exposure to radiation
Ironically, one of the main causes of low estrogen in men is actually lower than optimal levels of testosterone. The reason for this is the majority of estrogen produced in men is derived from the breakdown of testosterone through a process called aromatization.
When testosterone levels are sufficiently high, the breakdown of the testosterone will ensure our estrogen levels are also optimized.
The Concern With Testosterone Replacement Therapy
The reason I'm pointing out this seemingly arbitrary paradox is because a lot of men are seeking testosterone replacement therapy (TRT) and going to clinics online that sell prescriptions for testosterone. When TRT increases testosterone to beyond normal physiologic levels (800-1200ng/dL), estrogen levels can increase, which can have unwanted side effects. To balance this out other drugs like aromatase inhibitors are prescribed to inhibit or block estrogen. This is where things can go sideways unless hormone levels and physical signs & symptoms are regularly monitored which many of these online testosterone clinics often fail to do.
Testosterone and estrogen are master hormones whose roles and responsibilities go FAR beyond the effects that most people associate with them. In fact, your sex hormones touch or influence almost every physiological process in your body. Once you start fiddling with sex hormones, you're altering many physiological processes that have thousands of hidden, down-stream effects.
To be clear, I'm not against TRT when it's done by a trained and skilled doctor who really understands hormones and hormone interactions.
When men take aromatase inhibitors, supplements, or peptides to decrease their estrogen (estradiol) levels to lower than 20 ng/dl, they run the risk of experiencing any of the symptoms listed above.
I've talked with a handful of men who wished they knew this or had been explained this before starting hormone replacement therapy, so if you're considering TRT this is something to pay attention to.
One more cool thing about estrogen...
Estrogen is a very potent antioxidant which means that estrogen is a necessary chemical for immunity, cellular detoxification and cellular repair. So, when men and their health providers use drugs or supplements to drive estrogen down below healthy levels, they are increasing their risks for dementia, depression, osteoporosis, lower immunity, and all forms of cancer.
Ok, so what about when estrogen is too high?
The main symptoms of excessive estrogen in men 40 and over are:
Mood swings, depression, and anxiety
Erectile dysfunction
Abnormal breast overdevelopment (gynecomastia)
Fatigue and brain fog
The primary causes for high estrogen in men are:
Testosterone replacement therapy that increases testosterone to beyond normal physiologic levels
Long-term antibiotic use
Some psychiatric drugs like phenothiazines
Long-term stress
Tumors and autoimmune conditions that affect the hypothalamus and pituitary in the brain
Obesity, excessive fat around the internal organs (visceral adiposity)
Exposure to environmental toxins, pesticides and plastics
The two factors I'd like to hone in on here are 1) exposure to environmental toxins and 2) excessive body fat.
As we covered in a previous part of this guide, some environmental toxins like plastic increase production of estrogen when they get into our bloodstream. Common industrial chemicals and pesticides we encounter every day, like bisphenol-A (BPA), can also drive up our estrogen beyond healthy levels.
In order to keep our hormones balanced and our health optimized we can try to avoid exposure to environmental toxins which is hard to do considering they're everywhere. Another strategy is to keep our internal detoxification systems primed and working well.
We can assist our detox system by:
Eating a diet high in cruciferous veggies (kale, cauliflower, broccoli, etc).
Getting 7-8 hours of high quality sleep each night.
Sweating through saunas and exercise.
Taking supplements to help your detox system such as N-Acetyl-Cysteine and Glutathione.
Myth Buster: Soy products do not increase estrogen levels in men.
Some men avoid soy products because they're concerned about soy increasing their estrogen levels. All the research I've found so far negates the claim that soy products reduce testosterone or increase estrogen to any relevant degree.
The effects of high body fat on estrogen and testosterone levels in men
High body fat can both drive down testosterone and increase estrogen levels in men. This is especially true when the fat is centrally located around the gut and internal organs.
It's not safe to assume that this applies only to men who are obviously overweight. Even men who have a BMI below 25 can have excessive fat stored around their organs and in their muscle tissue which can contribute to hormone imbalance.
You will see this mostly in men who:
Are sedentary
Have low muscle mass
Use alcohol excessively (>1 drinks per day)
The best ways to see if body fat is contributing to your low testosterone and high estrogen is to use this 4-part assessment.
Gut Check - look at yourself sideways in the mirror wearing comfortably-fitting pants or underwear. Is your belly is protruding well beyond or over your waistband? If so, you probably have a body fat percentage of > 20% which could be affecting your hormone balance.
Do you have a sedentary lifestyle or avoid exercise?
Have you noticed a reduction in muscle mass, especially around your neck, chest and buttocks?
Do you drink more than 1 alcoholic beverage per day?
If you can answer yes to any of the above questions, body fat, especially body fat around your internal organs, could be a factor affecting your hormonal balance.
Summary and Key Take-Aways
Hormone balance is one of the keys for staying healthy and performing at high levels as you age. While there is a lot of focus these days on testosterone, it's important to monitor your estrogen levels as well. There are a lot of factors that can throw your hormones out of balance, and I believe if you want to optimize you health, it's critical to:
Regularly measure your hormone levels (twice per year).
Identify any imbalances.
Use an informed, strategic approach to correct those imbalances.
Thanks For Reading!
I hope this article was helpful in shedding some light on this complex situation. My goal with these guides and articles is to untangle these messy topics and lay them out in a way that makes sense and helps you build a personal framework for improving your own health and performance.
I'd love for you to let me know how I'm doing by finding and friending me on Instagram where I share even more tools and strategies for men's health and performance.
Also, be sure to subscribe to the newsletter so you can get tips, tools and strategies delivered to you each week.