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The Role of Estradiol in Men

Estradiol is mainly produced by aromatization of testosterone. Its role is misunderstood in males as some anti-aging clinics aim at suppressing it with the use of anastrozole. This presentation shows the benefits of estradiol in men to raise awareness about it. For more information visit ExcelMale.com and DiscountedLabs.com

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The Role of Estradiol in Men

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  1. Role of Estradiol in Men

  2. The HPTA & Its Modulators

  3. Estradiol , Fat and Sexual Function Low blood level of estradiol was associated with significant increases in the percentage of body fat (P<0.001), subcutaneous fat area (P<0.001), and intra abdominal fat area (P = 0.002), and relative less improvement in sexual desire (P<0.001) and erectile function (P = 0.022) Reference:Gonadal Steroids and Body Composition, Strength, and Sexual Function in MenN Engl J Med 2013;369:1011-22.

  4. Estradiol and Cardiovascular Mortality A prospective observational study at 2 cardiology centers (Poland) of 501 men (mean 58 years old) with chronic heart disease who were recruited between January 1, 2002, and May 31, 2006 (3 years). Cohort was divided into quintiles of serum estradiol (Avg TT 320 ng/dl. Not on TRT)quintile 1, < 12.90 pg/mL;  44.6% 3-year survival ratequintile 2, 12.90-21.79 pg/mL; 65.8%quintile 3, 21.80-30.11 pg/mL; 82.4% (Control group)quintile 4, 30.12-37.39 pg/mL; 79.0 %and quintile 5, > or = 37.40 pg/mL.65.9 %Reference:Circulating estradiol and mortality in men with systolic chronic heart failure.JAMA 2009 May 13;301(18):1892-901.

  5. Estradiol and Sex Drive in Men In a study of 423 men on TRT, Dr RanjithRamasamy at Baylor College of Medicine measured subjects' testosterone and estradiollevels and asked the men to rate the quality of their libido using a five-point Likertscale (1= terrible, 5 = excellent). The researchers categorized the men as having low or high testosterone (below or above 300 ng/dL, respectively) and low or high estradiol (below 5 and above 50 pg/ml, respectively).Men with high serum testosterone levels reported significantly greater libido than men with low level and those with high serum estradiol levels had significantly greater libido than subjects with low levels.  From the March 2014 Issue of Renal And Urology News

  6. Testosterone/Estradiol Ratio and Fertility

  7. Testosterone Enthanthate Injections and Estradiol (Doses- Young and Old Men) J ClinEndocrinolMetab. 2010 Aug; 95(8): 3955–3964.

  8. Symptoms of Estradiol Excess Nipple sensitivity Fluid retention? Elevation of blood pressure? Decreased libido Can educate patient to take extra dose of anastrozole if nipple tenderness/sensitivity occur. Prescribe anastrazole is estradiol by sensitive test is over 40 pg/mL at follow up. 0.5-1 mg/week is a good starting dose to be readjusted at second follow up visit

  9. Age Obesity Efavirenz Alcohol over-consumption (incl HOPS in beer!) Liver Disease Zinc deficiency (50mg Zn/2mg Cu QD) Vitamin C deficiency Excessive DHEA supplementation (100mg QD) Xenoestrogens (incl Vinyl IV bags!) Lavender, Tea Tree Oil Soy Flax seed Factors that Increase Estradiol

  10. Side Effect: Gynecomastia (breast enlargement in men) Treatment: Estrogen Blocker Medications or surgery (in worst cases)

  11. Anastrozole (Arimidex) To Control EstradiolLevels in Testosterone Treatment Breast cancer drug used off label in men to control E2 levels Anastrozole is the best single, reliable way to control E2 levels. Other supplements Zinc 50mg/Copper 2-3 mg, Chrysin 1000mg, work well in some patients but not as reliable as the gold standard of anastrozole. Compounded anastrozole available 1 , 0.5 and 0.25 mg capsules Dose range – 0.5 to 1.0 mg per week in men with over E2 of 40 pg/mL at 6 week follow up. Adjust dose based on second follow up Many men may not need anastrazole treatment Patients can be instructed to take as needed if sensitivity develops in the chest and/or nipples.

  12. Anastrozolein Testosterone Treatment Emphasize to patients the goal of testosterone treatment is to optimize T levels and control estradiol levels between 20 and 40. It is recommended to not let estradiol levels fall below 20 pg/mL. This may be linked to low bone density, higher fat content and lower sex drive. Estradiol may also have a role in cognitive function. Usually, higher fat mass will increase estradiol. Many men can taper down dosage of anastrozole after a period of time during treatment due to fat loss. Less fat means less aromatization of testosterone to estradiol. Insurance doesn’t cover anastrozole for a male indication as it is gender specific for women with breast cancer. Compounding pharmacies sell it cheaply.

  13. DHEA Supplementation and Estradiol

  14. What Effect Does HCG Have on Estradiol Blood Levels?

  15. HCG and Estradiol Left column: mean of plasma estradiol (upper panel) and testosterone levels (lower panel) in normal men (group I) in response to the injection of vehicle alone (⧫) or 50 (▵), 500 (□), and 5000 IU (▪) hCG. Right Column: 5000 IU (black box) and 6500 IU (white box) Cailleux-Bounacer A et al. Eur J Endocrinol 2008;159:171-178 © 2008 European Society of Endocrinology

  16. For More Information, Visit ExcelMale.com

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