In the early 90s, a book called Men Are From Mars, Women Are From Venus was a huge sensation. And while there were some cute parts to it, it was a sort-of scientific extension of bad standup comedy: hey, did you know that men and women are different?
There’s truth to that, but that kind of thinking does a few things. For one, it erases complexity of sex and gender. For another, it promotes dangerous thinking about health. If women and men are so different—indeed, dimorphic—then hormones that are more prevalent for women must be bad for men.
Of course, such logic is scientifically inaccurate, but that hasn’t stopped people from thinking that estrogen is something men should avoid. This, in turn, has spurred the growth of over-the-counter estrogen blockers for men, which can be harmful and confuse the sometimes-genuine need for estrogen moderation.
Estrogen modulators—selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs)—have legitimate therapeutic uses, particularly for men with low testosterone. These can have meaningful benefits, including increasing testosterone and even reversing infertility. But the problem is some men take unregulated OTC supplements marketed as estrogen blockers for men to ostensibly boost testosterone to increase muscle mass, workout abilities, and energy. The thinking is that estrogen inhibits them from being stronger, leaner, and more virile. Not only is this wrong-headed, it is also potentially dangerous. At best, these supplements are ineffective and at worst, they put you at risk of serious health problems.
The truth is that estrogen is an important hormone for men’s health, and artificially blocking it is usually unnecessary or ill-advised. Often, there are better, healthier, and more effective ways to improve the symptoms of low testosterone.
What Estrogen Does For Men
We all know that estrogen plays a pivotal role in a woman’s body, regulating the reproductive cycle, protecting bone density, and even regulating mood. But it also does similar things, to different levels, in a man’s body. In fact, estrogen is found throughout a man’s body. It is produced in a man’s skin, brain, bones, and testicles—so we can already guess that it is pretty important.
Much like in women, estrogen is important to bone health in men. As one study on estrogen inhibitors pointed out, “Men with estrogen deficiency caused by a mutation in the CYP19 gene suffer from low bone mineral density (BMD) and unfused epiphyses.” (The latter part is the rounded part of a long bone; not having it fused can lead to serious mobility issues.) This does not mean that estrogen inhibitors will necessarily hurt bone density, but it is an example of the importance of estrogen to structural health.
Equally interesting is the role estrogen plays in the brain, where it works as a neuroregulator, helping to promote impulse control and curb anti-social behavior. Essentially, they modulate reactions. Of course, the brain is also a vital part of sexual health, and estrogen levels in both the brain and the testicles are instrumental in the functioning of the libido, sexual performance, and reproductive capacity. As noted in a 2016 study:
Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in brain, penis, and testis, organs important for sexual function. In the brain, estradiol synthesis is increased in areas related to sexual arousal.
In myriad ways, estrogen is vital for men’s health, and low estrogen in men could be more dangerous than you think. Blocking it unnecessarily is not just dangerous, it can produce effects that are counterproductive to your goals.
When Estrogen Blockers for Men Are Appropriate
While estrogen is indeed essential for healthy physiological function, excess estrogen can also be disruptive. When your body has disproportionately high levels of estrogen, you might have these symptoms:
- Erectile dysfunction
- Gynecomastia (swelling of breast tissue)
What we see here is that symptoms usually associated with low T could also be the symptoms of low estrogen. Indeed, infertility, erectile dysfunction, and other common symptoms shouldn’t be assumed to be caused by low testosterone levels alone.
In cases where estrogen is elevated, estrogen modulators may be used to regain balance. It must be emphasized that these are legitimate, prescription estrogen blockers, not unregulated over-the-counter products. With the guidance of an experienced health care practitioner, estrogen modulators can play a vital role in restoring healthy estrogen levels and alleviating disruptive symptoms.
Additionally, these medications can increase testosterone production, as a small but groundbreaking study discovered as early as 2004. According to this study, “aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism.” The researchers also found that while estrogen levels dropped, they remained within the normal range. This approach to treating low testosterone is known as testosterone restoration, as opposed to testosterone replacement.
For some men, there are well-founded reasons to choose testosterone restoration. Chief among them is the desire to preserve fertility; evidence that shows that testosterone therapy can dramatically lower sperm count. This infertility is different than sex drive, of course; one can be aroused and have a full sex life without the production of sperm. But for men who wish to have children, estrogen modulation treatment might be more productive than exogenous testosterone. In fact, research indicates that estrogen modulation might actually increase sperm count. As researchers from the David Geffen School of Medicine at UCLA write:
In a certain subset of infertile men, particularly those with hypogonadism, or those who have a low serum testosterone to estradiol ratio, there is some evidence suggesting that SERMs and AIs can reverse the low serum testosterone levels or the testosterone to estradiol imbalance and occasionally improve any associated infertile or subfertile state.
Here, we see that there are some very good reasons for some men to take estrogen modulators. But if high relatively high estrogen is accompanied by low testosterone, there are likely better and more sustainable methods of getting your body back in balance.
Finding the Best Way Forward
When your hormone levels are unbalanced, there is a certain logic to blocking one of them. After all, won’t that get things back where they should be? There are also deeply illogical reasons: if estrogen is for women, won’t I be manlier without it? Both of these approaches can keep you from getting what you need to feel your best.
If you’re experiencing symptoms of high estrogen and/or low testosterone, the right place to start is by asking, “Do I have what I need in the amounts at which I need it?” You need estrogen in your body. You also need testosterone. It’s crucial to work with experts to determine what your personal hormone levels are, correctly identify any imbalances, and determine the best treatment—or combination of treatments—to reduce, reverse, or eliminate symptoms. If your primary issue is low testosterone, the best approach is usually to raise testosterone levels using testosterone replacement therapy (TRT), which can begin alleviating low T symptoms in as little as six weeks.
It is far healthier to get into the right kind of balance rather than suppress everything to a low level. With the right treatment plan and the right health care practitioner, you can ensure that you receive the best possible treatment for your needs today and for a healthy future.
If you want to know more about estrogen blockers for men, BodyLogicMD can help. The practitioners in the BodyLogicMD network are top medical professionals specializing in hormone health and hormone replacement therapy. A BodyLogicMD-affiliated practitioner can assess your hormone levels and design a personalized treatment plan to help you feel your best. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz to learn more about how hormones may be affecting your daily life.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.