My male patients often have higher Estrogen levels than my female patients.  Have you noticed that you are developing very small breasts?  Did you see the Seinfeld episode suggesting the need for a Male Bra?

 

For men, the prime of life is when your Testosterone levels are at their peak.  Testosterone, just like the other hormones, does hundreds of things.  And Testosterone does not work alone.  Testosterone combines with an enzyme called aromatase to produce  Estrogens.  Male sexuality depends on having a small amount of Estrogen for their brain chemistry to trigger sexual function.  And  women need a very small amount of Testosterone. The point here is a small amount of Estrogen is necessary for men, and a small amount of Testosterone is necessary for women.

 

Men lose their hormones over decades.  As you know, most  women seem to lose all their hormones over the course of a month.  Between the ages of 25, yes 25, and 50, a man’s Testosterone level decreases by about 50%, and his Estrogen levels increase by 50%.  Also, older men produce more aromatase, which then triggers the cascade of losing muscle and growing hair.  This cause of producing more aromatase and producing more Estrogen in men is explained in detail in my Testosterone section.

 

Yes, men go through Andropause, just like women go through Menopause.  Although men’s loss of thier hormones is more gradual, the effects can be profound and effect strength, energy, mood, conversion of fat to muscle, memory, heart health (there are more receptors on your heart for Testosterone than anywhere else in your body), development of muscle, and sexual energy.  And, this loss of Testosterone accompanies the onset of Prostate problems.

 

Heretofore, we were trained that increased Testosterone means increased prostate cancer.  A  review of medical literature published in The New England Journal of Medicine (Volume350:482-492; January, 2004) and the International Journal of Andrology (25 (2), 119-125; April, 2002)  —  “concluded that Testosterone therapy is not associated with increases in the rate of prostate cancer, or any other prostate illness. Additonally, they found no evidence that Testosterone treatment causes prostate cancer, or that men with higher Testosterone levels have higher rates of Prostate Cancer. In fact, they note that Prostate Cancer increases exactly when the man’s Testosterone levels decline.  The IJofA article claimed that men with low Testosterone levels realized improvement in every parameter measured: their prostate glands decreased in size, their PSA levels lowered, and urinary symptoms such as frequency and urgency all improved.”

 

Please know this does not apply to those of you who are getting your Testosterone in gymnasiums, on the Internet, etc. My thoughts  —  although I agree with The NEJM  and IJofA articles and have experienced what they report with my patients, men must work with a physician who is knowledgeable regarding how Testosterone can convert into “stuff” that may cause cancer.  And this happens even you don’t take Testosterone, as your very own Testosterone converts into this “stuff” and that is why we have this great big fat concern.

 

Since Testosterone aromatizes (turns into) Estrogen in males, could it possibly be that increased Estrogen in males is what causes so many of patient’s prostate problems?  Anyway, that is what the European Endocrinologists think.  If Estrogen is too high, inflammation shortly follows. Estrogen levels are high when men look as though they are expecting.  I love when Dr. Oz measures men’s omentums and asks when the baby is due.

 

What exactly is the prostate?  The healthy prostate is the size of a walnut, right under the bladder and above the rectum, and it surrounds the urethra.    Muscles in the prostate help move sperm, and also help open the bladder so urine can pass through your prostate.  Unless your prostate is puffy, which is doctor talk for BPH (Benigh Prostatic Hypertrophy).   A healthy prostate is necessary for optimal urinary and sexual function.

 

Men with BPH (Benign Prostatic Hypertrophy/Enlarged Prostate) will experience some or all of the following symptoms:

 

 

    • Increased frequency of urination

 

    • Difficulty starting your stream of urine

 

    • Decreased force of urination

 

    • Reduced flow

 

    • Urinary leakage

 

    • Feelings of incomplete emptying

 

    • Painful unination

 

    • Awakening at night to urinate, maybe even every two hours

 

    • Urgency to urinate immediately

 

    • Urinary blockage (go to the Emergency Room)

 

 

A little history of  your prostate is interesting.   Only men have a prostate, and their is no R, it is not a prostrate.  Your prostate increases in size four times in life — at birth, puberty, young adulthood, and around age 50. Note that these growth spurts coincide with major hormonal changes.  Your prostate, testicles, and adrenal glands all produce male hormones.

 

Your PSA test has been credited with detecting 70% of all prostate cancers, which is a very slow growing and one of the most curable cancers.  PSA is a protein made by your prostate gland which leaks into your bloodstream.  Many cases of increased PSA indicate BPH or Prostatitis (inflammation of the prostate).   A high PSA can also indicate the need for a workup to rule out Prostate Cancer.

 

Yet the PSA, like many of our tests, is not a perfect gauge as some men with Cancer have normal PSA levels, and most men with mild or moderately elevated PSA levels do not have cancer.  Studies have been done showing that only 25 percent of men who had biopsies turned out to have Prostate Cancer (Surviving Prostate Cancer Without Surgery, by Bradley Hennenfent, MD; Roseville Books, 2005). My thoughts — have a digital rectal exam, and work with someone qualified, who will look at the entire picture, and refer  you to a Urologist when panoramic Integrative Medicine is truly being practiced.

 

Eugen Shippen, MD wrote The Testosterone Syndrome.  Dr. Shippen is my favorite author regarding male hormones.  When men’s Testosterone levels go down, he gains weight.  Then the increased weight increases his Estrogen level even more, then the Estrogen stimulates SHBG (Sex Hormone Binding Globulin) which binds Testosterone, which then causes more weight gain, then Estrogen increases even more………..you see the problematic cycle of events.

 

Speaking of weight gain,  portions and knowledge of what a healthy diet entails are of paramount importance.  And Zinc prevents Testosterone from converting into Estrogen, right up there with losing that belly fat.

 

My patients get the following labs: PSA,  Free Testosterone,  Estradiol, Estrone (Estrogen in fat),  SHBG,  Thyroid and Adrenal labs, and measurement of thier abdomens — and the suggestion to read the Testosterone section of my website.  Even better, read The Testosterone Syndrome by Eugene Shippen, MD.

 

Entered by Roberta Foss-Morgan, DO, November ll, 2007