Male Menopause Has Roots in Estrogen

A new MGH study says men need more estrogen to avoid male menopause.

Male/female signs image via shutterstock

Male/female signs image via shutterstock

In a recent study published in the New England Journal of Medicine, researchers at Massachusetts General Hospital discovered that symptoms in middle aged men often attributed to “male menopause” may be caused, not by a decrease in testosterone, but by a decrease in estrogen.

Male hypogonadism — the medical term for the presentation of symptoms more commonly called “male menopause” — has thought to have been cause by a significant drop in production of testosterone. As a result, according to the study, prescriptions for testosterone supplements over the past twenty years have grown by 500 percent.

However, the study establishes a base testosterone level at which physical symptoms start to present themselves. This level may serve as a determinant for when patients should be treated with testosterone supplements. But the study also showed that not every male menopause patient will benefit from more testosterone.

Dr. Joel Finkelstein, corresponding author of the study, said in a press release:

“But the biggest surprise was that some of the symptoms routinely attributed to testosterone deficiency are actually partially or almost exclusively caused by the decline in estrogens that is an inseparable result of lower testosterone levels.”

While testosterone directly affects certain physical functions in men, a portion of the testosterone produced in men’s bodies is converted into estrogen. Men with lower testosterone levels therefore have lower estrogen levels which can now be linked to physical symptoms such as changes in body composition, energy, strength, and sexual function.

The study examined 150 male participants who were given both testosterone and estrogen blockers over the course of 16 weeks. Physical changes such as increases in body fat and lowered sexual desire were reported in patients with lower estrogen levels. The study concluded that testosterone levels directly affect lean body mass, and muscle size and strength, while estrogen levels directly affect fat accumulation. Sexual function, both desire and physical function, is regulated by a combination of both hormones.

The study’s findings seem to suggest that testosterone treatments should be reevaluated and estrogen treatments should be considered depending on the individual patients’ symptoms.