peripheral aromatase activity and Testosterone to Estradiol production have central HPA axis suppression resulting in decreased LH and FSH and low Testosterone.
A cross-sectional study of 1,458 men over a 13 years found an increase risk of diabetes incidence with elevated Estradiol and Estrone levels. The greatest association was found with Estrone. This should come as no surprise to anybody as type II diabetes is clearly associated with increasing weight and this is the source of 80% of estrogen production in men.
Sometimes I think medicine has lost its mind. Or at least, it is not thinking things through. To give IV estrogen to decrease Testosteorne in men with prostate cancer is devoid of the pathophysiology of prostate cancer and cardiovascular disease in men. Elevated Estradiol in men increases CRP, IL-1beta, and TNF-alpha to name a few cytokines. The proported purpose of the IV estrogen is to prevent the cardiovascular complications associated with ADT. Yet, elevated aromatase activity and low T in men are both shown to be associated with increased CVD in men.
increased estradiol and estrone levels in men associated with cognitive decline. This was distinct from age, CVD, and APOE genotype. This points to a clear association between increased aromatase activity and inflammation that contributes to cognitive decline in men.
Estradiol found to be associated with elevated CRP and fibrinogen with men. This association was not found between Testosterone and the same inflammatory markers. This points to the conversion of Testosterone to estrogen as a contributor to inflammation and CVD in men.
Total and free Estradiol associated with increased CRP in men. This study found that it also correlated with WBC count as well. Not new, but builds on the accumulative literature that high aromatase activity and estrogen production in men produces inflammation.
Significantly higher estradiol levels found in men with a history of MI. These men would likely have an increase in adverse effects associated with Testosterone therapy.
High aromatase activity and estradiol production in men was found to be associated with elevated total cholesterol, LDL, TC:HDL, and triglycerides. No association was found with Testosterone or SHBG. The 111 men in this study had "stable CAD"
Hypogonadism may be defined either as serum concentration of T (either total T, bioavailable T or free T) or as low T plus symptoms of hypogonadism
The Baltimore Longitudinal Study on Aging reported the incidence of total serum T < 325 ng/dL to be 20% for men in their 60s, 30% for men in their 70s and 50% for men over 80
The Massachusetts Aging Male Study reported that 12.3% of men aged 40 to 70 had a total serum T of < 200 ng/dL with 3 or more symptoms of hypogonadism
The Boston Area Community Health Study reported that 5.6% of men aged 30 to 70 were hypogonadal, as defined by total serum T < 300 ng/dL; or, free serum T < 5 ng/dL plus 3 or more symptoms of hypogonadism
In a health screening project among 819 men in Taiwan, the prevalence of hypogonadism (total serum T < 300 ng/dL) ranged from 16.5% for men in their 40s, 23.0% for men in their 50s, 28.9% for men in their 60s, and 37.2% for men older than 70 years of age
The prevalence of hypogonadism among men in Taiwan is higher than the prevalence reported in the Massachusetts Male Aging Study
CAG repeat sequence, within the androgen receptor (AR). Rajender et al[12] reviewed over 30 studies on the AR trinucleotide repeat and infertility
suggestion that CAG repeat length may determine androgen responsiveness, this issue is not clearly settled
reported prevalence of low T in older men range from 5.6% to 50%
Those in the hypogonadal group (n = 4269) had direct health care costs, that exceeded the eugonadal group (n = 4269) by an average of $7100 over the course of the observation window
higher economic burden and presence of co-morbidities for hypogonadism
minor to moderate improvements in lean mass and muscle strength
increased bone mineral density
modest enhancement in sexual function
reduced adiposity
lessening of depressive symptoms
Meta-analyses of clinical TRT trials as of 2010 have identified three major adverse events resulting from TRT: (1) polycythemia; (2) an increase in prostate-related events; and (3) and a slight reduction in serum high-density lipoprotein (HDL) cholesterol
polycythemia (> 3.5-fold increase in risk
TRT produced a 40% prostate enlargement in older hypogonadal male Veterans over 12 mo
no published analysis has reported measurable increases in prostate cancer risk or Gleason score in men undergoing TRT, or in hypogonadal men with a history of prostate cancer undergoing TRT
the prostate which highly expresses the type II 5α-reductase enzyme. Inhibition of this enzyme via finasteride (a type II 5α-reductase inhibitor) or dutasteride (a dual type I and II 5α-reductase inhibitor) reduces circulating DHT 50%-75% and > 90%, respectively[47], and reduces prostate mass[48] and prostate cancer risk
Normally estradiol partially regulates testosterone levels, at the hypothalamus, blunting LH and FSH release from the pituitary. As a selective estrogen receptor modulator, CC interrupts this pathway, and consequently there is a greater stimulation for the production of testosterone in Leydig cells
meta-analysis finds that low T associated with increased cardiovascular mortality in men. Additionally, higher Estradiol is associated with increased CVD and CV mortality
Fascinating difference in the sexes. High estradiol is found to be associated with depression in men and high Testosterone is found to be associated with depression in women. The exact mechanism or strength of association is unstated.
total and bioavailable Estradiol associated with increased hsCRP in men age 40-80. Bioavailable is calculated with serum calculated free Testosterone and albumin bound Testosterone.
aromatase inhibition in men to increase Testosterone:Estradiol ratio. Men with infertility have a low Testosterone:Estradiol ratio. Aromatase inhibitors inhibit Testosterone to Estradiol conversion