MALE HORMONAL HEALTH

Let’s not forget about male hormones and endocrine health!

Although not typically as complicated as women’s hormones, male endocrine health is equally susceptible to either excess or deficiency in hormones such as testosterone and oestrogen. While men also produce LH and FSH (needed to communicate with the gonads for testosterone and sperm production), here I will discuss the roles of testosterone and oestrogen.

Testosterone:

95% of testosterone is produced in the testicles, but is affected by LH in the brain, reminding us that testing for LH/FSH can indicate whether the problem stems from the brain or the testes. ie. Is FSH is elevated it is a testes issue, if its low it means it’s brain issue. Elevated LH indicates a testes issue, while low LH indicates we need to look at the brain. Did you know it takes approximately 74 days for sperm to fully develop (and in women it typically takes 90 days for an egg to fully mature, ready for ovulation), which is why a minimum of three months pre-conception care is advised for all couples. It is also worth noting there that roughly 30% of infertility is due to problems with the male’s sperm.

Common presentations of low testosterone include fatigue, weight gain, sexual dysfunction or loss of libido, low motivation, low mood, loss of muscle strength, male pattern baldness, enlarged prostate and fertility issues.

So why does testosterone decrease?

Well, naturally it decreases with age (typically from ages 50-60 onwards, as sex hormone binding proteins (SHBG) also increases), but it is also affected by excess fat tissue (causing what is known as “aromatisation” where testosterone is actually converted to oestrogen), nutritional deficiencies especially in zinc, vitamin A and vitamin D, low cholesterol (the backbone of hormones), decreased blood flow (think constriction and abdominal surgeries), steroid use (this is a big one!), opioid use, diabetes, hypothyroidism, environmental chemicals (especially plastics which increase oestrogen and SHBG, and decrease testosterone), alcohol (which is oestrogenic), EMFs (think mobile phones, wifi) and excess heat (such as saunas). Phew! That’s a long list!

Want to know one of the best ways to increase testosterone (other than addressing the above factors)? Weight training (but not over-training – isn’t it all a delicate balance?)

Similar to women (see my previous post), men also run into problems with the 5a-reductase pathway, where testosterone is converted to DHT, a more potent metabolite. This pathway is up-regulated with stress, insulin resistance, excess weight and inflammation (the drivers for most chronic conditions). Excessive DHT may present as male-pattern baldness, anger and irritation, acne and prostate problems. The main concern is the viscous cycle that can occur with stress/inflammation/excess weight, all driving more DHT or oestrogen, making their stress, inflammation, insulin issues and weight gain worse. How can we reduce DHT? Certain herbs such as saw palmetto, nettle root, Reishi mushroom, green tea and zinc.

Oestrogen in men? Yes, men need a small amount of oestrogen too. It is mainly made in fat tissue via aromatisation of testosterone. Increased oestrogen is commonly caused by excess insulin/blood sugar dysregulation, excess fat tissue, increased stress and alcohol, which all also decrease testosterone, another viscous cycle! Symptoms also mimic those of low testosterone.

How can functional medicine support men’s health? Firstly, by addressing the causes of hormone dysfunction, making lifestyle, diet and environmental changes. It is important to test LH/FSH/testosterone/DHT/oestrogen – check out the DUTCH test which provides a comprehensive analysis of testosterone/DHT and oestrogen, plus cortisol, neurotransmitters, nutritional markers and detoxification pathways. You will need to see your GP for LH/FSH. (Note: testosterone is best tested in the morning when it’s at its highest) We can also support testosterone with herbs, zinc, intermittent fasting, weight training, improving blood flow and brain/gonad communication. It is also important to support the adrenals, reduce stress, optimise sleep and support liver function for hormone detoxification.