High Estrogen and Low Testosterone: How to Manage levels on TRT

Low testosterone and high estrogen levels can be a dangerous combination. If you are suffering from low testosterone, chances are your estrogen levels are also out of balance.While men’s testosterone gradually declines with age, estrogen levels might rise, causing unpleasant side effects if the imbalance is not corrected. Because high estrogen levels are linked to diabetes and cancer, it’s critical to keep estrogen levels in check through diet, exercise, and medicine. This is especially significant for males on testosterone replacement treatment (TRT), as testosterone might impact your body’s estrogen production.

Estrogen and the brain

In men, estrogen is produced in the brain by the action of an enzyme called aromatase. This enzyme converts testosterone into estradiol, which is the most potent form of estrogen in the human body. The amount of estradiol produced by aromatase is directly proportional to the amount of testosterone that is available for conversion.Estradiol regulates hunger, resting energy use, mood and motivation, and body weight in the central nervous system and the hypothalamus region of the brain. The aromatase enzyme should produce just enough estrogen to ensure optimal performance in bed and mental clarity, which are both goals for most men on testosterone therapy.Estradiol also has a role in fat metabolism, notably in the synthesis and burning of fat, and it also influences how fatty acids respond to and interact with other body activities.The body uses estrogen to break down fat cells through lipolysis in the immune system, and skeletal muscles then activate the oxidation or burn away process. The hormone also aids in the correct movement of energy cells via the liver by regulating glucose levels.

What happens when you have excess estrogen?

An estrogen imbalance can cause a number of problems, including weight gain, fatigue, low libido, and erectile dysfunction. Estrogen dominance can also lead to an increase in anxiety and depression.

·         Erectile Dysfunction

An erection is a complex movement of nerves, vessels, and activities in the hypothalamic-pituitary-adrenal axis area that work together to direct blood flow to the penis. If there is a mismatch between testosterone and estrogen, at least one of these will cause a trigger that will misfire, resulting in dysfunction.When estrogen levels rise, and testosterone levels fall, erectile dysfunction is more likely to occur. Low testosterone and high estrogen are linked to weaker and less frequent erections.

·         Production of Sperm

Estrogen influences sperm production, concentration, migration, and formation. The presence of too much estrogen in the testes might have a negative impact on fertility. Estrogen also governs the cells that line and protect the testicular lining, but if the cells are saturated with estrogen, it can have a negative impact on the amount and quality of sperm.

·         Weight Gain

Estrogen and testosterone are abundant in fat reserves throughout the body. Simply put, if testosterone naturally begins to drop with age, then men are more vulnerable to estrogen dominance. High estrogen levels also have an effect on liver function. The liver’s ability to handle fatty acids will be determined by normalizing testosterone to estrogen ratios. This is why men with diabetes or obesity often have low testosterone and high estrogen levels resulting in weight gain.Further, estradiol regulates hunger and energy regulation in the hypothalamic-pituitary-adrenal axis, regulating mood and motivation in men. These abnormalities could cause changes in hunger and willpower, affecting total energy balance and, as a result, body weight if excessive estrogen levels are present. High estrogen levels can also produce negative mood swings and depression, which can interfere with a man’s desire to stay fit and healthy, resulting in weight gain and obesity.

Treatment of High Estrogen

If necessary, clinicians may prescribe medications or assist you in making dietary changes to treat elevated estrogen or imbalances.Providers may also modify your dose or prescribe an aromatase inhibitor if diet alone isn’t adequate to control elevated estrogen levels while on testosterone replacement therapy. The most common prescription is anastrozole (Arimidex), which prevents testosterone from being converted into estrogen by the enzyme aromatase.If estradiol is excessively high, anastrozole with TRT at 0.1mg per week is commonly prescribed. Anastrozole is an oral tablet that inhibits the enzyme aromatase. Men’s diets could be tweaked slightly to normalize estrogen aromatization. Natural phytochemical herbs derived from vegetable extracts can also be used to jumpstart the metabolization of estrogen levels.
If you have any additional questions, please do not hesitate to reach out to our clinic.

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