In the early 90s, a book called Men Are From Mars, Women Are From Venus was a huge sensation. While it had its charming moments, it essentially boiled down to a scientific echo of tired stand-up comedy: the notion that men and women are inherently different.
While there's some truth to this, it oversimplifies the complexities of sex and gender. Additionally, it fosters potentially harmful beliefs about health. The idea that men and women are so fundamentally different leads to misconceptions that hormones predominantly found in women must be detrimental to men.
This misconception has given rise to the over-the-counter availability of estrogen blockers for men. However, this can lead to harmful side effects and blur the lines between genuine medical need for estrogen moderation.
What are Estrogen Blockers Used for in Men?
Estrogen modulators, sometimes called anti-estrogens or estrogen blockers, are a group of compounds that suppress the body’s estrogen production or block estrogen from binding to receptors. Multiple types of estrogen blockers exist, including selective estrogen receptor modulators (SERMs) such as tamoxifen and aromatase inhibitors (AIs) such as anastrozole.
These drugs do have legitimate therapeutic uses, particularly for men with low testosterone and genuinely excessive levels of estrogen. With proper medical supervision, estrogen blockers can have meaningful benefits, including increasing testosterone and even reversing infertility. They’re also used (again, with a prescription) to help fight breast cancer.
The Problem with Over-the-Counter Estrogen Blockers:
The issue arises when some men turn to unregulated over-the-counter supplements marketed as estrogen blockers, hoping to boost testosterone for enhanced muscle mass, workout performance, and energy. The flawed logic behind this is the belief that estrogen, considered a "female hormone," hinders men from achieving strength, leanness, and virility.
This misconception is not only misguided but can also be potentially dangerous. Even the most popular over-the-counter estrogen blockers, such as diindolylmethane (DIM) supplements have only limited evidence of efficacy, and scientists know practically nothing about their potential long-term health effects. And even if they do lower estrogen levels, men may find themselves facing new and unexpected side effects due to low estrogen levels.
The truth is that estrogen is an important hormone for men’s health, and artificially blocking it is usually unnecessary or ill-advised. Often, there are better, healthier, and more effective ways to improve the symptoms of low testosterone.
What Estrogen Does For Men
We all know that estrogen plays a pivotal role in a woman’s body, regulating the reproductive cycle, protecting bone density, and even regulating mood. But it also does similar things, to different levels, in a man’s body. In fact, estrogen is found throughout a man’s body. It is produced in a man’s skin, brain, bones, and testicles—so we can already guess that it is pretty important.
Much like in women, estrogen is important to bone health in men. As one study on estrogen inhibitors pointed out, “Men with estrogen deficiency caused by a mutation in the CYP19 gene suffer from low bone mineral density (BMD) and unfused epiphyses.” (The latter part is the rounded part of a long bone; not having it fused can lead to serious mobility issues.) This does not mean that estrogen inhibitors will necessarily hurt bone density, but it is an example of the importance of estrogen to structural health.
Equally interesting is the role estrogen plays in the brain, where it works as a neuroregulator, helping to promote impulse control and curb anti-social behavior. Essentially, they modulate reactions. Of course, the brain is also a vital part of sexual health, and estrogen levels in both the brain and the testicles are instrumental in the functioning of the libido, sexual performance, and reproductive capacity. As noted in a 2016 study:
Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in brain, penis, and testis, organs important for sexual function. In the brain, estradiol synthesis is increased in areas related to sexual arousal.
Basically, you’re not doing your wellness any favors by taking estrogen blockers unless you’ve been diagnosed with excessive estrogen and are taking them under medical supervision. In myriad ways, estrogen is vital for men’s health, and low estrogen in men could be more dangerous than you think. Blocking it unnecessarily is not just dangerous, it can produce effects that are counterproductive to your goals.
When Estrogen Blockers for Men Are Appropriate
While estrogen is indeed essential for healthy physiological function, excess estrogen can also be disruptive. When your body has disproportionately high levels of estrogen, you might have these symptoms:
Infertility
Erectile dysfunction
Gynecomastia (swelling of breast tissue)
What we see here is that symptoms usually associated with low T could also be the symptoms of low estrogen. Indeed, infertility, erectile dysfunction, and other common symptoms shouldn’t be assumed to be caused by low testosterone levels alone.
In cases where estrogen is elevated, estrogen modulators may be used to regain balance. It must be emphasized that these are legitimate, prescription estrogen blockers, not unregulated over-the-counter products. With the guidance of an experienced healthcare practitioner, estrogen modulators can play a vital role in restoring healthy estrogen levels and alleviating disruptive symptoms.
Additionally, these medications can increase testosterone production, as a small but groundbreaking study discovered as early as 2004. According to this study, “aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism.” The researchers also found that while estrogen levels dropped, they remained within the normal range. This approach to treating low testosterone is known as testosterone restoration, as opposed to testosterone replacement.
For some men, there are well-founded reasons to choose testosterone restoration. Chief among them is the desire to preserve fertility; evidence that shows that testosterone therapy can dramatically lower sperm count. This infertility is different than sex drive, of course; one can be aroused and have a full sex life without the production of sperm. But for men who wish to have children, estrogen modulation treatment might be more productive than exogenous testosterone. In fact, research indicates that estrogen modulation might actually increase sperm count. As researchers from the David Geffen School of Medicine at UCLA write:
In a certain subset of infertile men, particularly those with hypogonadism, or those who have a low serum testosterone to estradiol ratio, there is some evidence suggesting that SERMs and AIs can reverse the low serum testosterone levels or the testosterone to estradiol imbalance and occasionally improve any associated infertile or subfertile state.
Here, we see that there are some very good reasons for some men to take estrogen modulators. But if high relatively high estrogen is accompanied by low testosterone, there are likely better and more sustainable methods of getting your body back in balance.
Finding the Best Way Forward
In the pursuit of hormonal balance, it's important to understand that suppressing one hormone isn't always the solution. Working with experts to accurately assess hormone levels, identify imbalances, and determine the best treatment approach is key.
For low testosterone, testosterone replacement therapy (TRT) is often the most effective solution. TRT can begin alleviating low T symptoms in as little as six weeks. In cases of elevated estrogen, estrogen blockers, when medically supervised, can play a vital role in restoring healthy levels and alleviating disruptive symptoms. Striving for the right balance, rather than suppressing hormones, is the path to optimal health and well-being.
Comments