As you read this, over 50 hormones are cruising around your body. Each hormone is on its journey with a sole or combined purpose and destination. Hormones are responsible for maintaining essential systems within the body, such as metabolism, sexual activity, smooth muscle, and cardiac function. They also directly affect growth, sexual development, mood, stress, sleep, and blood pressure.
As men age, hormones like testosterone start to decline. Typically, when men reach their 40s, their hormone levels will have dropped enough for them to start noticing a difference. Weight gain, lethargy, difficulty losing weight, and lack of sexual desire are common symptoms.
Younger men usually have the 'correct balance' of hormones. Their bodies run like clockwork, and they feel on top of the world. But as your hormones dwindle with age, symptoms begin to set in. There is no natural way to increase testosterone levels, so men often use testosterone replacement therapy to maintain healthy levels.
Understanding Hormones
Sadly, most primary care doctors have very little training in hormone therapy. Many do not understand how hormone therapy can help avoid obesity, diabetes, cardiovascular disease, and depression. Not only a potent form of preventative medication, but hormone therapy can also improve many aspects of your life.
Many of our patients start on their HRT journey looking to lose weight, increase lean muscle, and regain their libido. Little do they realize a year or two later, they are converted for life. Many guys feel brighter, cope better at work and, most importantly, regain the body they had in their youth.
What are the Main Male Hormones?
Men and women share the same hormones, albeit at different concentration levels. Interestingly men and women at age 20s typically have the same estradiol level (a form of estrogen). Women tend to cycle their hormones depending on where they are in their period. Androgens are usually thought of as male hormones, but the female body produces a small amount too. Men and women both share estrogen and testosterone, for example.
The most well-known and influential of the androgens is testosterone; men have around ten times the levels of females. However, any imbalance in hormone levels can dramatically impact a man's or woman's life. Keeping abreast of your hormones should be a priority as you start to get older.
Which are the Most Important Androgens?
What is Testosterone? (Learn More)
Testosterone is considered the most important male hormone. It is involved in bone development and maintenance, muscle development, fat distribution, sperm production, and sex drive. Decreased testosterone levels can affect physical and mental health, causing low libido, depression, stress, poor body composition, and brittle bones. Several studies show that it protects against heart disease and prostate cancer via estradiol (estrogen) production.
Dehydroepiandrosterone (DHEA) and Dehydroepiandrosterone Sulphate (DHEA-S)
Dehydroepiandrosterone (DHEA) is the most abundant hormone in the human body, produced by the adrenal glands; it triggers male characteristics in men and women. DHEA and DHEA-S are what are known as precursor hormones. These hormones are converted into other hormones, such as testosterone and estradiol, via aromatase conversion.
DHEA converts in the adrenal glands and liver into the much longer-lasting DHEA-S. Doctors, therefore, test DHEA-S levels as an indicator of levels of DHEA in the blood. Raised DHEA-S levels can indicate Cushing's disease in both men and women. This rare condition can result from long-term steroid tablet use or, rarely, a benign tumor in the pituitary gland or one of the adrenal glands. These tumors are more common in young women but remain very rare.
Cushing's disease causes elevated cortisol, which can have many annoying side effects. DHEA is diametrically opposed to cortisol, so it is incredibly beneficial in helping with stress. In Cushing's disease, it is elevated to try to counter the overproduction of cortisol. If your DHEA-S levels are low, this may be due to an adrenal gland issue, which can often lead to fertility problems and reduced libido.
Dihydrotestosterone (DHT)
About 10% of the testosterone produced in a man's body converts into DHT in the testicles and prostate. The rest is either converted to more DHT at the base of the hair follicle by the 5-alpha reductase enzyme or converted to estradiol via the aromatase enzyme. DHT (being an androgen) is responsible for male characteristics such as body hair and a deeper voice.
Everybody has a different tolerance to DHT. Some guys can have high levels, and others can be hypersensitive to it. It is not the DHT amount that causes hair loss; it is the sensitivity of hair follicles to the DHT. Some men have high levels of DHT and never lose hair, but others are sensitive to it and can lose hair easily.
Women also can experience pattern balding, but this is far less common. In the USA, around 50 million guys suffer from male pattern balding compared to (a still significant) 30 million women.
DHT is derived from testosterone but is much more potent, 10 to 100 times more powerful. It also plays a role in some sexual functions and physiological processes. DHT also binds to androgen receptors but for longer than testosterone. This process increases the positive impact on the body.
Other Important Hormones
Estrogen (Learn More)
Estrogen is the umbrella term for the primary female hormone, estradiol, estriol, and estrone. As with testosterone, these hormones are present in both sexes. These hormones are required in men to maintain sexual function, libido, and fertility. Produced via aromatization, estradiol is the most influential and beneficial of the estrogen group of hormones. In fact, estriol and estrone have a negative or neutral effect on the body.
The aromatization process can derive estradiol from visceral fat (which is why obese people tend to have high levels) or testosterone. Estradiol derived from either source is not necessarily bad; however, the estradiol from fat tells the brain that you have enough estradiol. As a result, the body drops the production of testosterone. This is the negative effect, not because of estradiol but because of the fat. Guys with low testosterone levels tend to have low estrogen levels; however, estrogen levels will usually be high if they are overweight.
Estrogen gets a bad rep due to the assumption that these hormones are feminizing in men; this argument holds very little water. The health benefits of this vital hormone should be at the forefront of any hormone treatment. You see a decreased risk of heart disease, Alzheimer's, and osteoporosis. You see a reduced risk of prostate cancer, reduced belly fat, and improved sexual function.
Follicle Stimulating Hormone (FSH)
Follicle-stimulating hormone is a gonadotrophic hormone produced in the pituitary gland. It regulates the function of the ovaries and testicles. If hormone levels are too high or too low, it can cause infertility and difficulty conceiving.
In men, FSH helps the testicles produce molecules and nutrients that help regulate sperm production. If your testicles have too much FSH, this could be a sign of malfunction in the testicles instead of low levels, indicating an issue in the pituitary gland. In women, FSH stimulates ovarian follicle growth before the release of an egg (ovulation). It also increases estradiol production.
Luteinising Hormone (LH)
Luteinising Hormone (LH) is vital for male and female fertility. Produced in the anterior pituitary gland, LH stimulates the testes to produce testosterone by binding to Leydig cells in the testicles. This then releases testosterone, which is vital in sperm production.
In women, LH stimulates the ovarian follicle, causing an egg to grow and produce estrogen, which in turn tells the body to slow FSH follicle-stimulating hormone production, which starts the ovulation process.
Low levels of LH in men can signal a problem with the pituitary gland and cause infertility. LH is required to support testicular function. So, Low levels can be a response of the pituitary to high testosterone levels in the blood - a common effect of TRT.
What are Thyroid Hormones? (Learn More)
The thyroid gland regulates your metabolism and energy production on a cellular level, so any lack of function can profoundly affect your body. It controls heart, muscle, digestive function, brain development, and bone maintenance. It plays a vital role in extracting and absorbing iodine from your blood and incorporating it into the essential hormones it releases.
What is Cortisol? (Learn More)
Cortisol is a steroid hormone made in the adrenal glands and then released into the blood. Most cells have receptors for this hormone, which works in your body in several ways. Cortisol helps control blood sugar levels and metabolism. It also influences water and salt balance, blood pressure, memory, and the ability to fight infection. Like many other hormones, cortisol affects the sleep cycle, with the highest levels in the morning and the lowest around midnight.
Cortisol also is released in stressful situations. Hence why called the stress hormone. As the adrenal glands release cortisol into your bloodstream, your body produces a surge of insulin. Insulin helps push sugar into your muscles enabling you to jump into action. This surge in sugar can be harmful when you are not utilizing it, and your body stores the sugar as fat. For this reason, it is so important to exercise when you are stressed. Your body also produces another hormone called epinephrine (adrenaline), which increases your heart rate and awareness.
What is Oxytocin?
Oxytocin must be one of the most important hormones to humanity. This may be a bold statement, but it is one of the building blocks of emotional attachment, relationships, sexual reproduction, childbirth, and love.
It is usually associated with women, where oxytocin is vital in labor and milk production (lactation). Oxytocin is also present in men, where it helps with male reproduction and testosterone production in the testicles.
When you get that rush of excitement of attraction, your brain releases oxytocin into your bloodstream, organs, and spinal cord. It binds with receptors around your body, giving you that unforgettable euphoria. This shows how hormones influence your feelings towards that person and 'in love.'
What's fascinating is that the simple act of hugging signals your body to naturally release oxytocin, helping you both achieve a more loving bond. This response isn't surprising, especially when doctors and midwives encourage the skin to skin contact with newborns to promote bonding.
Sex Hormone-Binding globulin (SHBG)
Sex hormone-binding globulin (SHBG) is the transport molecule for major hormones like estradiol and testosterone. It is also a biologically active hormone that is vital in how hormones work. It binds tightly to the steroids testosterone, estradiol, and DHT and transports them in the blood in an inactive form, meaning they are unavailable for the body to use. Increased levels of SHBG are associated with a decreased risk of heart disease, strokes, and cancer.
