The appropriate prescribing of testosterone should entail monitoring and control of estradiol levels in men. Some of our circulating testosterone (natural or via medication) is converted to estradiol in our bodies. This natural process becomes much more impactful with men supplementing testosterone and could become problematic if not managed correctly. Unfortunately, a common treatment standardization of many “testosterone” clinics is to administer an estrogen blocker (aromatase inhibitor) to any patient using testosterone, regardless of need. We certainly know that increased estrogen conversion in men can cause excess fatty tissue in the chest, fluid retention, erectile dysfunction and emotional mood swings. However, there are multiple known benefits of estrogen even in a man’s body. Improved bone health, cardiac function, vascular integrity, libido, erectile quality, brain function and mood are all attributable to optimized estradiol levels in males.
If utilizing testosterone replacement, it is important for optimization of all hormone levels. Having far too little of many hormones is just as problematic as having far too much. When seeking appropriate care for hormone replacement therapy make sure your provider is optimizing treatment specifically for you.
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