The aromatase enzyme is responsible for converting androgens into estrogens by a process called aromatization. More specifically this enzyme can convert Androstenedione into estrone and/or Testosterone into estradiol.
Elevated levels of these circulating estrogens can cause some issues. Firstly they signal the pituitary gland to reduce production of LH, a hormone which signals the testes to produce testosterone, thus reducing testosterone production. In addition high estrogens can also stimulate SHGB (sex hormone binding globulin) production which is a protein which binds to free testosterone creating a bound and inactive form which is no longer available to bind to testosterone receptors thus reducing active testosterone levels.
The aromatase enzyme is found in higher concentrations in fat tissue so if your overweight you may be more likely to have high estrogen levels. Experts have also estimated that approximately 60% of men genetically have overactive aromatase enzymes which also can contribute towards high estrogens.
Symptoms of High Estrogens
These symptoms include: water retention, puffiness, bloating, sensitive nipples, Poor erections and moodiness.
Men with high estrogen is usually the result of insulin resistance and viseral body fat. It is very important that diet, exercise and lifestyle (reduce alcohol consumption) and weight loss are addressed to treat these issues which in effect will naturally reduce excessive estrogen levels. In addition men with high estrogen also tend to have low testosterone and this imbalance increases risks of chronic disease. If this is the case we recommend you address the low testosterone. Raising testosterone levels can help reduce SHGB which is often elevated due to high estrogens.
The normal estradiol range is 70 – 220pmol/L and practitioners often tried to maintain levels at the low-mid end of this range. Recent evidence shows levels up to 290pml/L show no symptoms in men and can be beneficial for cardiovascular and bone health. We recommend estrogen reduction only if symptoms are present and/or if estradiol exceeds this range.
Many practitioners routinely use an aromatase inhibitor (AI) to reduce estradiol levels. The danger of reducing estrogens is you may negate their benefits such as protecting the cardiovascular system and preventing osteoporosis. Apart from the symptoms mentioned above the scientific literature shows not only is there is no harm caused by elevated estrogens but they can actually be beneficial.
For men on testosterone therapy it has long been believed by hormone experts that if aromatization occurs it should be controlled with an AI. This theory has been challenged and some now argue that the research suggests AI’s should not be used if your on testosterone therapy as it may actually be causing you harm. Our position lies somewhere in between. For men on Testosterone therapy if estrogens increase yet remain below 290pmol/L we do nothing unless symptoms occur whereas previously we aimed to maintain levels at the low to mid end of the normal range with an AI. In addition we now recommend using natural over the counter compounds like Indol-3-carbinol or DIM Cream to keep symptoms at bay instead of using an AI. See video below for more detail.
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