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May 14, 2012

Estrogen Levels in Men: Say What?

Estrogen Levels in Men“Estrogen, isn’t that the female hormone?”  Well, yes and no.  Women make estrogen, which plays a huge role in regulating a woman’s menstrual cycle, but men also make some estrogen and need a certain amount of it as well.  Just like in women, too low an estrogen level in men increases the risk  cardiovascular disease, osteoporosis, cancer, and mental (cognitive) impairment. But, too much in men can also be detrimental to health.

Estrogen Levels in Men

Healthy estrogen levels in men are between 16 pg/ml and 34 pg/ml.  This is the range we like to see in men in our practice. Estrogen in men is largely derived from the aromatization of testosterone into estrogen.  There tends to be more aromatization into estrogen as men age.  In fact, it is not uncommon for a 55-year-old male to have higher estrogen levels than a 55-year-old woman.

Health Benefits of Estrogen in Men

Healthy estrogen levels can reduce LDL cholesterol, improve blood sugar control, and reduce abdominal fat. Increased abdominal fat is more likely with lower estrogen levels in men.

Estrogen also facilitates bone density.  Men with low estrogen have been shown to be at increase risk for hip fractures. And, higher estrogen (healthier) levels in men are associated with greater bone density.

Men with healthier estrogen levels have also been shown to be associated with a lower incidence of cardiovascular disease in this study. And, this study showed healthier estrogen levels in men to be related to healthier lipid and blood glucose metabolism.

We’ve mentioned in the past the mortality rates are higher in men whose testosterone levels are in the lower third of the reference range compared to men with levels in the upper third of the range. Mortality rates are also higher in men with lower estrogen levels.

What Happens with Too Much Estrogen?

Estrogen levels that are too high can increase the risk of type 2 diabetes, stroke, metabolic syndrome, heart disease, and rheumatoid disease.

Too much estrogen in men seems to thicken the arterial walls and some studies show that heart attack patients were more likely to have higher estrogen levels than men with normal coronary arteries.

Both low testosterone and high estrogen levels in men are linked to type 2 diabetes.

Too much estrogen can lead to chronic inflammation and raise C-reactive protein, an inflammatory marker.  Testosterone minimizes inflammation.  This may explain why women are more likely to suffer from autoimmune diseases than men – they have high estrogen levels and low testosterone levels.

High estrogen levels can also lead to breast development (gynecomastia) or nipple tenderness.  Some men also report being more emotional if estrogen levels are too high.

What Can I Do if My Estrogen Levels are Too High?

For men whose estrogen levels are too high there are several options. Aromatase inhibitors can be prescribed that block the conversion of testosterone into estrogen.  They work extremely well and have a long half-life.  Anastrazole is the most common aromatase inhibitor used in men. Generally 1 mg a week is all that is needed to bring estrogen levels into the healthy range.

There are some nutritional supplements that can also be considered. Chrysin which is extracted from the blue passionflower is an aromatase inhibitor but is poorly absorbed. However, if taken with piperine (pepper extract) has been shown to be better absorbed and lower estrogen levels.  The usual dose is 1.000 mg to 3,000 mg a day.

Zinc is a weak aromatase inhibitor. Doses of 50 mg to 100 mg a day can lower estrogen levels.

The cruciferous vegetables (broccoli, cabblage, Brussel sprouts) contain indole-3-carbinol (IC3) which balances estrogen metabolism.  The usual dose of IC3 is 200 mg to 400 mg a day.

Resveratrol has been shown to attach to estrogen receptors.  This essentially blocks estrogen from linking to the receptor lessening the effects of estrogen.

So estrogen is not just for women.  Like all hormones the key is balance – not too little and not too much.

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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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