We spend so much time working with women’s hormone issues we sometimes neglect the role hormone balance plays in men’s health. Without the years of cycling changes women routinely experience and generally without overt short term changes in later life, most men take their hormones for granted (if they think about hormones at all). Much of what we desire for our lives, especially as we grow older, such as healthy cardiac function, healthy prostate and sexual function, sharp minds and good memory, maintenance of strength and energy for life, and yes, even desire itself depends on adequate levels, proper balances, and normal cellular responses to the hormones we produce. Sound important? Absolutely! So let’s take a few minutes to explore how they do what they do…
Although the equipment is somewhat different (thank goodness) men and women produce the same hormones, just different balances. That should give us a clue as to how important balance is to hormone activity. Hormones are biochemical messengers produced by endocrine glands that control and regulate metabolic activity. The term includes agents secreted by the hypothalamus, pituitary, adrenals, thyroid, testes, and islet cells of the pancreas. All are critical, all are interrelated, and through sometimes complex feedback systems even regulate each other. To simplify this discussion we’ll focus on the hormones associated with the most common health issues men experience: insulin, cortisol, DHEA, progesterone, testosterone, DHT, estradiol, and estrone.
Probably the most common hormone issue affecting men’s health is insulin resistance. Characterized by excessive insulin production coupled with impaired insulin response, this imbalance is a primary underlying cause of obesity, hypertension, hyperlipidemia (high cholesterol), heart disease, and Type II diabetes. Insulin resistance is the direct result of our western “civilized” diet, high in grains, starches, dairy products, and sugars. It appears that with adequate dietary control over a long enough time insulin resistance can be reversed, and a number of published studies have demonstrated safety and efficacy of agents such as chromium, alpha lipoic acid, cinnamon, and vanadium in improving insulin response.
Cortisol is a stress response hormone produced by the adrenal glands which works in tandem with insulin to regulate blood glucose levels. Low cortisol levels (weakened adrenal response) lead to hypoglycemic responses, or low blood sugar symptoms. Elevated cortisol levels (high stress response) lead to central weight gain, irritability, reduced muscle and bone mass, and decreased libido. Dietary changes, increased intake of the B vitamins, vitamin C, and pantothenic acid, regular exercise, and stress reduction techniques all help stabilize cortisol production.
Dehydroepiandrosterone, or DHEA for short, is also produced by the adrenal glands and is active in several areas. DHEA improves immune response, mental outlook and energy, assists in maintaining muscle and bone mass, helps regulate the conversion of thyroid hormone into its active form, and serves as a precursor in the production of testosterone. DHEA is converted into androstenedione (remember Mark Maguire?) which is converted into either estrone or testosterone.
Progesterone, often overlooked in men, may have greatest service in reducing risk of prostate cancer by inhibiting the cellular proliferation caused by estrogens. A low progesterone to estradiol ratio has been established as a marker for breast cancer risk in women and is considered equally significant in men relative to prostate cancer. Progesterone is also a precursor to several hormones including cortisol, aldosterone, androstenedione, testosterone, and estrone.
Testosterone, the hormone that makes men men, seems to get all the press (both good and bad). It is a primary agent in increasing heart health, increasing bone mass and muscle mass, increasing energy, improving mental outlook and performance, improving sexual desire and performance, and maintaining healthy prostate function. Too much testosterone (inappropriate supplementation) leads to aggressive behavior and increased prostate cancer risk; too little (poor diet, lack of exercise, stress, aging) leads to declining muscle tone and mass, increased fat gain, depression, dementia, reduced sex drive and performance, and increased risk of heart disease. Testosterone can be converted into dihydrotestosterone (DHT) or into estradiol.
DHT may be more active than testosterone, at least in certain tissues. It is linked to male pattern baldness and to prostate health. Although it has been blamed as a prostate risk, recent published studies demonstrated that DHT supplementation prevented and even controlled existing prostate cancer.
Estradiol and estrone are the primary estrogens in men and women. In men they are produced in the normal process of breaking down testosterone and androstenedione. Current functional medicine literature views these agents as culprits in the development of prostate cancer as well as benign prostatic hyperplasia (BPH). As men age and testosterone levels decrease, estrogen levels increase relative to testosterone. Remember that healthy testosterone levels offset estrogen effects, progesterone regulates and inhibits estrogen effects, and both indole-3-carbinol and di-indolylmethane speed the breakdown of estrogens.
Two final comments...if you elect to explore hormone testing, don’t settle for testosterone levels as a measure of health. We should always explore the full pathway- how we make testosterone as well as how we break it down- so that any intervention we choose not only adds benefit but also reduces risk. And remember, we don’t have to accept gradual declines in hormones and health as inevitable. Managing our hormone balances, along with proper diet, nutritional therapy, regular exercise, and frequent mental stimulation, can keep us younger and healthier for years to come.