Male hormone imbalances are becoming more and more prevalent in society. Symptoms can include impotence (erectile dysfunction), andropause (male menopause) and infertility are occurring more often and at much younger ages than ever before. Determining if this is due to hormone deficiencies and imbalances can be extremely helpful.
Four hormones make up the Male Hormone Panel: testosterone, estradiol, DHEA-S and cortisol. Interactions between these hormones are fundamental to health and imbalances can have a negative effect on health.
- Production of testosterone is stimulated by lutenizing hormone (LH).
- Low testosterone levels may be a result of decreased hormone production or due to increased conversion of testosterone to estrogen (estradiol) via the aromatase enzyme.
- The brain regulates LH output via estradiol levels. If estradiol is high, LH shuts down and testosterone production declines.
- Excess estradiol can compete with testosterone at gene response sites, and thus interferes with the message testosterone is trying to deliver reducing its effectiveness in the body.
Testosterone / Estradiol Ratio
- The ratio of testosterone to estradiol (T/E2) for a 20 year old man is between 20 and 40. A decrease in the T/E2 ratio is associated with an increased risk of cardiovascular disease.
- The aromatase enzyme that converts testosterone to estradiol is found in adipose fat cells. Men with central adiposity or high cortisol levels may have more aromatase activity and therefore convert more testosterone to estradiol.
- Cortisol and testosterone hormones deliver opposing messages to the body. Consequently, when testosterone levels are high, men with normal testosterone levels may have symptoms of testosterone deficiency because the elevated cortisol interferes with the testosterone message. This results in a “functional” deficiency; where the system has normal levels of testosterone, but functions as if there is not enough.
- High cortisol can induce aromatase enzyme which speeds the conversion of testosterone to estrogen (estradiol) resulting in elevated estradiol levels.
- Excess cortisol supports break-down of bone and also opposes the action of testosterone, which supports bone formation. Thus, significant bone loss bay occur with elevated cortisol levels.
- Over time, high cortisol levels may exhaust the adrenal glands and result in decreased cortisol output.
- DHEA is stored in the blood mainly in its sulphate form, DHEA-S
- Cortisol and DHEA have opposite effects on the immune system and blood sugar regulation via the action of the hormone – insulin.
- High cortisol levels require more DHEA to be released to balance the effects of cortisol. Thus, chronically elevated cortisol can result in a deficiency of DHEA.
- The ratio of cortisol to DHEA-S increases with age, mostly due to declining DHEA.
- Low DHEA-S levels may be associated with hypothyroidism and chronic illness such as, hypothyroidism, depression and chronic fatigue.