Estrogens in Men

We all are aware that women have estrogens and men have testosterone. That is what makes us different. At puberty, testosterone help makes the masculine body whereas estrogen develops breast and other female structures. It may surprise the reader that men also make estrogens! Men normally produce small amounts of the “female” hormone estrogen, and this occurs through conversion from testosterone from a process called aromatization, that occurs in fat cells. It is believed that estrogens have a function for men, including maintaining bone integrity.

Certain conditions result in abnormally high levels of estrogen in men and can sometimes lead to breast development in them. Two conditions in which men have abnormally high levels of estrogens are Klinefelter’s Syndrome and cirrhosis of the liver. Klinefelter’s syndrome, 47,XXY or XXY syndrome is a rare condition caused by a chromosome problem. Affected males have an extra X sex chromosome. The principal effects are development of small testicles and reduced fertility. Cirrhosis of the liver often results from chronic alcohol abuse.

The term gynecomastia refers to the condition in which the male breasts become abnormally enlarged in response to elevated levels of estrogen. High levels of estrogens also can increase the risk for development of male breast cancer, albeit very rare. The majority of breast cancers in men are estrogen receptor-positive (meaning that they grow in response to stimulation with estrogen).

In men, excess estrogens over time can lead to an enlarged prostate. There may be more conversion of testosterone to estrogens within the prostate among men with benign enlarged prostate (BPH). Patients with BPH are also characterized by a reduced urine androsterone/etiocholanolone ratio. This could reflect diminished conversions involving 5 alpha-reductase among these men. A large study known Framingham has found an association with high estrogen and coronary artery disease. Some other studies have associated high estrogens with loss of libido, hyperthyroidism, dementia & obesity.

At this time, most doctors are unclear about how to treat high estrogen in men. Ruling out a cause of high estrogen is not always easy. Weight loss can lead to lowering of estrogen levels in men. The FDA has not approved any drugs yet, but we know that aromatase inhibitors (e.g. Arimidex & Femera) can lower estrogen levels. These drugs are used to lower estrogens in women with breast cancer. Other possible aromatase inhibitors can include zinc, chrysin and grape seed extract.

The dose of medications used to lower estrogen in men has to be lowered and it is often compounded. We work with compounding pharmacists to deliver the right dose. In addition, we do measure the blood levels and try to maintain the right balance of the reproductive hormones in men. If you are in need of talking to a specialist treatment of testosterone in Houston, do contact us at the Opal Medical Clinic. Our web site is