Natural Health Advisory

Too much estrogen isn’t just a problem for some women. Men make estrogen, too, and levels can become elevated (or depressed). Although research thus far has focused almost exclusively on how estrogen affects women and how testosterone affects men, it is now known that estrogen in men plays an important role in the regulation of testosterone, several brain functions, bone health, skin health, sexual function/libido, cardiovascular function, and cholesterol regulation.[1]

Symptoms of high estrogen levels in men

Normally in men, testosterone and estrogen are maintained in the correct balance. When estrogen levels in men increase, testosterone levels tend to decrease, so that symptoms of high estrogen tend to occur along with symptoms of low testosterone. High estrogen symptoms in men can therefore be difficult to differentiate from low testosterone symptoms.

The most common high estrogen symptoms in men include:

• Sexual dysfunction (low libido, decreased morning erections, decreased erectile function)
• Enlarged breasts
• Lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH)[2]
• Increased abdominal fat (can also be a symptom of low estrogen)
• Feeling tired
• Loss of muscle mass
• Emotional disturbances, especially depression
• Type 2 diabetes

As you can see from the list above, men with too much estrogen aren’t just at risk for non-serious symptoms like decreased sexual function and enlarged breasts. They are also at high risk for more serious problems such as type 2 diabetes.

The latest research shows that the increased diabetes risk is independent of testosterone levels—that is, high estrogen raises diabetes risk whether testosterone is low or not.[3] High estrogen in men also increases the risk for prostate cancer and autoimmune diseases.[4]

What causes high estrogen levels in men?

A number of factors can throw the estrogen/testosterone balance out of whack in men, leading to high estrogen symptoms. Some of these factors include:

Aging. Advancing age is associated with an increase in aromatase, the enzyme that converts testosterone to estrogen.[1] Older men actually have higher estrogen levels than postmenopausal women.

Increased fat relative to muscle. A loss of lean muscle tissue and an increase in fat tissue also typically occurs with advancing age, as well as with metabolic disorders such as obesity and type 2 diabetes. Fat tissue contains aromatase and thus converts testosterone to estrogen. Fat also serves as a reservoir for storing estradiol. Both these factors lead to increased estrogen levels in men.

Testosterone therapy. Men who are treated with injectable forms of synthetic testosterone almost always make too much estrogen. In my own clinical practice, I saw firsthand that bioidentical (natural) testosterone therapy can also lead to high estrogen levels in men, especially when used in excess or used in men with obesity.

Faulty feedback. Once a man has too much estrogen in his system, a vicious cycle can ensue in which the high estrogen levels lead to a faulty feedback system, tricking the brain and testes into producing even less testosterone. This can lead to even higher levels of estrogen and more severe estrogen dominance, magnifying the high estrogen symptoms.

Estrogen deficiency can also be a problem for men

Surprisingly, men can also have too little estrogen and suffer from symptoms of estrogen deficiency. Some of these symptoms are, ironically, the same as those of estrogen excess. A recent study examining the important role of estrogen in the regulation of body fat and sexual function in men found that the most severe effects of estrogen deficiency in men were on sexual desire, with estrogen deficient men reporting dramatic declines in arousal and erectile function.[5]

Additionally, the men with decreased estrogen showed higher levels of the type of inner abdominal fat known to increase the risk of cardiovascular disease, diabetes, and metabolic syndrome. Men with estrogen deficiency also have decreased bone strength and are at increased risk for fractures.[6]

How men can control estrogen levels and reduce high estrogen symptoms

The important lesson may be that hormonal balance of estrogen with testosterone is key, rather than absolute levels of estrogen itself. Fortunately, a number of diet, lifestyle, and natural therapies have been found to keep estrogen levels balanced. The best-researched treatments for lowering estrogen levels and improving estrogen balance are:

• Eat cruciferous vegetables multiple times per week. Cruciferous vegetables, such as broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, and turnip greens, contain high amounts of glucosinolates, which the body transforms into bioactive compounds that help to decrease estrogen activity and increase estrogen detoxification.
• Supplement with indole-3-carbinol (I3C) and 3,3′-diindolylmethane (DIM). You can supplement your cruciferous vegetable intake with their most beneficial compounds, I3C (200 mg per day) and DIM (100 mg per day), in supplement form.
• Get enough vitamin B12, folate, betaine, and choline. These nutrients, known as methyl donors, help to improve the biochemical process known as methylation, which is an important function in estrogen metabolism and detoxification. Good dietary sources include meat, fish, shellfish, eggs, spinach, beets, and quinoa.
• Increasing fiber, exercising, and reducing weight are also important natural treatments for reducing high estrogen symptoms in men.

If you’re experiencing symptoms of high estrogen and/or low testosterone and you don’t get relief within a few months of implementing these natural therapies, it’s important to see a healthcare practitioner who can evaluate your symptoms and test you hormone levels. You may benefit from hormone replacement therapy and/or a more intensive natural treatment regimen.

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[1] Aging Male. 2002 Jun;5(2):98-102.

[2] Curr Urol Rep. 2015 Sep;16(9):534.

[3] Diabetes Care. 2013 Sep; 36(9): 2591–2596.

[4] J Cell Biochem. 2007 Nov 1;102(4):899-911.

[5] N Engl J Med. 2013 Sep 12;369(11):1011-22.

[6] J Clin Endocrinol Metab. 2014 Jul;99(7):E1322-6.

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