Why Estrogen Balance is Critical to Aging Men

By William Faloon

We tested estrogen based on published data indicating that when estrogen levels are unbalanced, the risk of degenerative disease in aging men skyrockets.1-7 Of concern to us 14 years ago were reports showing that excess estrogen contributes to the development of atherosclerosis.  Human clinical studies conducted more than a decade later confirmed our suspicions. Men with even slightly elevated estrogen levels doubled their risk of stroke and had far higher incidences ofcoronary artery disease.10-12 Our early observations also revealed that men presenting with benign prostate enlargement or prostate cancer had higherblood estrogen levels (and often low free testosterone blood levels). Insufficient estrogen, on the other hand, predisposes men to osteoporosis and bone fracture. The fact that 99% of men today have no idea what their blood estrogen levels are helps explain the epidemic of age-related disease that is bankrupting this nation’s medical system. New Study Published in the Journal of the American Medical Association Conventional doctors tend to ignore hard science until it appears in their own medical journals. A study published in the Journal of the American Medical Association (JAMA) measured blood estradiol (a dominant estrogen) in 501 men with chronic heart failure. Compared to men in thebalanced estrogen quintile, men in the lowest estradiol quintile were 317% more likely to die during a 3-year follow-up, while men in the highest estradiol quintile were 133% more likely to die.24 The men in the balanced quintile—with the fewest deaths—had serum estradiol levels between 21.80 and 30.11 pg/mL. This is virtually the ideal range that Life Extension® has long recommended male members strive for. The men in the highest quintile who suffered 133% increased death rates had serum estradiol levels of 37.40 pg/mL or above. The lowest estradiol group that suffered a 317% increased death rate had serum estradiol levels under 12.90 pg/mL. The dramatic increase in mortality in men with unbalanced estrogen (i.e., estradiol levels either too high or too low) is nothing short of astounding. It uncovers a gaping hole in conventional cardiology practice that is easily correctable. This study revealing the lethal dangers of estrogen imbalance was published in conventional medicine’s Bastille of knowledge—the Journal of the American Medical Association. Low Estradiol and Testosterone Predict Mortality in Aging Men Sales of testosterone replacement drugs have surged more than 20-fold in response to studies linking low testosterone to a host of common maladies. In a recent study of 3,014 men aged 69-80 years, serum levels of testosterone and estradiol were measured during a mean follow-up of 4.5 years. Men with low testosterone had 65% greater all-cause mortality, while men with low estradiol suffered 54% more deaths.25 Those men low in estradiol and testosterone were almost twice as likely to die (a 96% increase in mortality) compared to men in the optimal ranges.25 This large study of aged men corroborates prior published reports linking imbalances of testosterone and/or estradiol with greater incidences of degenerative disease and death.26-36 How Do Men Naturally Make Estrogen? Women synthesize most of their estrogen in their ovaries and other reproductive tissues. Since men lack this female anatomy, they need to produce estrogen through a process involving an enzyme called aromatase that transforms testosterone into estradiol. Aging men sometimes have too much aromatase activity, which causes their testosterone to convert to excess estradiol. This results in depletionof vital testosterone while spiking estradiol to unsafe ranges. Some men lack aromatase and suffer an estrogen deficit. Other men produce so little endogenous testosterone that there is not enough to convert into estrogen, which causes low levels of both free testosteroneand estradiol. Fortunately, no matter what the underlying cause, aging men can easily achieve optimal free testosterone and estradiol serum levels. Free testosterone is the unbound form that is biologically available to cell receptor sites throughout the body. Measuring free testosterone blood levels is the most accurate way of assessing testosterone status in aging men. How Aging Men Can Control Their Estrogen Levels An epidemic problem in aging male members is insufficient free testosterone, i.e., less than 15-20 pg/mL of serum. When accompanied by excess estradiol (over 30 pg/mL of serum), this can signal excess aromatase enzyme activity. Excess aromatase robs men of their testosterone while exposing them to higher than desirableestradiol.37 Aromatase can be suppressed with absorbable forms of chrysin (a plant flavonoid) and/orlignans such as those extracted from the Norway spruce tree (HMRlignan™).38-42 If these nutrients fail to reduce estradiol adequately, then we suggest that men ask their doctor to prescribe an aromatase-inhibiting drug like Arimidex® in the very low dose of 0.5 mg twice a week. When aromatase is properly suppressed, estradiol levels are reduced to safe ranges, while free testosterone often increases, since less testosterone is being aromatized into estradiol.

Vaginal estrogen linked to improved sexual health for some women

Among women who don’t take hormonal replacement therapy (HRT) after menopause, and even some who do, vaginally applied estrogen may help ease dryness and painful intercourse, a small U.S. study suggests. Women were most likely to use the vaginal estrogen if they reported pain during sex, and if they had stopped HRT, the study found.

Among the women who abandoned HRT and never went back, the participants using vaginal estrogen reported significantly higher satisfaction with their sex lives, the study published in Menopause also found.

“We would expect that the women with the most severe symptoms would show the greatest benefit and the group that stopped estrogen/hormone use after the WHI would be expected to develop symptoms and benefited the most,” senior study author Dr. Michelle Warren, of Columbia University Medical Center and the Center for Menopause, Hormonal Disorders and Women’s Health in New York, said by email.  Women go through menopause when they stop menstruating, which typically happens between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterwards, women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia.

Vaginal dryness and painful intercourse are symptoms thought to result from atrophy of vaginal tissues because of falling estrogen levels. HRT has been shown to improve these symptoms by rebuilding vaginal walls.

For the study, Warren and colleagues studied vaginal estrogen use and sexual health in 310 women in New York City who were born between 1938 and 1953 and had used HRT for at least five years.

While about 36 percent of women who stopped HRT used vaginal estrogen, so did around 17 percent of women who continued HRT, the study found.

Overall, roughly a quarter of women in the study used vaginal estrogen.

The researchers acknowledge that the study is limited by its small size and the fact that participants were generally healthy, highly educated women with normal weight, so the results may not generalize to other groups.

Even so, the findings suggest that some women may benefit from vaginal estrogen whether or not they use HRT, the authors conclude.

“Vaginal estrogen is safer because very little if any estradiol gets into the blood stream,” Dr. Michael Thomas, a researcher in reproductive endocrinology and infertility at the University of Cincinnati Medical Center, said by email.

Lubricants may help make sex less painful for women after menopause, but this alternative can’t work like estrogen to improve the mucous lining of the vagina and make bleeding and abrasions or tearing less likely during intercourse, added Thomas, who wasn’t involved in the study.

BP Health Lab Work and Why We Do Them - Testosterone

Testosterone

The Test

How is it used? When is it ordered? What does the test result mean? Is there anything else I should know?

How is it used?

Testosterone testing is used to diagnose several conditions in men, women, girls, and boys. Examples of some of these conditions include:

• Delayed or precocious (early) puberty in boys
• Decreased sex drive in men and women
• Erectile dysfunction in men
• Infertility in men and women
• Testicular tumors in men
• Hypothalamus or pituitary disorders
• Hirsutism and virilization in girls and women

Typically, a test for total testosterone is used for diagnosis. The total testosterone test measures testosterone that is bound to proteins in the blood (e.g., albumin and sex-hormone binding globulin [SHBG]) as well as testosterone that is not bound. However, a test for free or bioavailable testosterone may be used if, for example, the level of SHBG in the blood is abnormal.

When is it ordered?

In boys with delayed or slowly progressing puberty, the test is often ordered with the FSH and LH tests. Although there are differences from individual to individual as to when puberty begins, it is generally by the age of 10 years. Some symptoms of delayed puberty may include:

• Delayed development of muscle mass
• Lack of deepening of the voice or growth of body hair
• Slow or delayed growth of testicles and penis

The test also can be ordered when a young boy seems to be undergoing a very early (precocious) puberty with obvious secondary sex characteristics. Causes of precocious puberty in boys, due to increased testosterone, include various tumors and congenital adrenal hyperplasia.

In men, the test may be ordered when infertility is suspected or when a man has a decreased sex drive or erectile dysfunction. Some other symptoms include lack of beard and body hair, decreased muscle mass, and development of breast tissue (gynecomastia). Low levels of total and bioavailable testosterone have also been associated with a greater presence of visceral fat (midriff or organ fat), insulin resistance, and increased risk of coronary artery disease.

In females, testosterone testing may be done when a woman has irregular or no menstrual periods (amenorrhea), is having difficulty getting pregnant, or appears to have masculine features, such as excessive facial and body hair, male pattern baldness, and/or a low voice. Testosterone levels can rise because of tumors that develop in either the ovary or adrenal glandor because of other conditions, such as polycystic ovarian syndrome (PCOS).

What does the test result mean?

Males:  The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline starting in the third decade of life. The rate may increase in men who are obese or chronically ill and with the use of certain medications.

A low testosterone level (hypogonadism) may be due to:

• Hypothalamic or pituitary disease
• Genetic diseases that can cause decreased testosterone production in young men (Klinefelter, Kallman, and Prader-Willi syndromes) or testicular failure and infertility (as in myotonic dystrophy, a form of muscular dystrophy)
• Impaired testosterone production because of acquired damage to the testes, such as from alcoholism, physical injury, orviral diseases like mumps

Increased testosterone levels in males can indicate:

• Testicular tumors
• Adrenal tumors that are producing testosterone
• Use of androgens (also called anabolic steroids)
• Early puberty of unknown cause in boys
• Hyperthyroidism
• Congenital adrenal hyperplasia

Females:  In women, testosterone levels are normally low. Increased testosterone levels can indicate:

• PCOS
• Ovarian or adrenal gland tumor
• Congenital adrenocortical hyperplasia

Is there anything else I should know?

Alcoholism and liver disease in males can decrease testosterone levels. Drugs, including androgens and steroids, can also decrease testosterone levels.

Prostate cancer responds to androgens, so many men with advanced prostate cancer receive drugs that lower testosterone levels.

Drugs such as anticonvulsants, barbiturates, and clomiphene can cause testosterone levels to rise. Women taking estrogen therapy may have increased testosterone levels.