Estrogen imbalance health risk

[Carolynn]

I am putting this here because we do not have a section that seems more approbriate, like a health page or something. This is an article on unusual levels of estrogen in an otherwise normal male body. Note that the person asking the question is in their 60s. These effects can show up as early as the early 50's and are usually due to decreased testosterone that comes with aging.

Estrogen: Not Just for Females
What causes elevated estrogen levels in men?
By Dr. Rob for MSN Health & Fitness
Q. I am a male in my 60s and was recently evaluated for enlarged breasts. Blood tests came back indicating unusually high levels of estrogen. What does that mean?
A. The results may indicate your levels of estrogen are higher than what is considered "normal" due to a variety of factors that include obesity, alcoholism and liver disease. Or, they may point to an imbalance of the male hormones known as androgens (testosterone, androstenedione, etc.) relative to the amount of estrogen in your body. Unusually low levels of androgens (from pituitary gland disease, testicular tumor, older age, a genetic abnormality known as Klinefelter's syndrome, or other reasons) amplify the effects of estrogen in your body. Either way, it's best to follow up with your primary care doctor or endocrinologist.
Not just your mother's hormone
Many men are surprised to hear their bodies produce and circulate small amounts of estrogen that help to provide hormonal balance and healthy body function. However, it's important to note that estrogen represents a group of hormones composed of three main types:
 Estrone (E1)–This is found in women and men (in small amounts). It's obtained from the adrenal gland and is also made, as well as stored, in fatty (adipose) tissue.
 Estradiol (E2)–The most active form of estrogen, it's mainly produced by the ovaries in women and by the testes and adrenal glands in men.
 Estriol (E3)–This is the major type of estrogen during pregnancy with large amounts produced in the placenta. The level of this hormone continues to rise until just before delivery.
While your question didn't mention why your estrogen levels were elevated, a key clue may be linked to the increasing size of your breasts. Once physicians note these female-like physical characteristics in men, laboratory tests to check your levels of thyroid-stimulating hormone (or TSH), luteinizing hormone (LH), testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), as well as estrone and estradiol would be recommended as part of a complete evaluation.
Estrogen rising
Abnormal results are only part of the puzzle. It's also important to know the reason for your "estrogen" excess, so as to correct the cause (if possible) and minimize its potential effects (higher voice, loss of body hair, decrease in muscle mass, increase in fatty tissue, prostate enlargement, change in sex drive, difficulty in losing weight, etc.) on your body systems. That said, factors with the potential to temporarily (or chronically) elevate these levels include, but aren't limited to the following:
 Older age–Aging can lead to decreased levels of testosterone and increase in estrogen levels, especially if you're obese.
 Medications–This includes estrogen-containing drugs, steroids, ulcer medications such as cimetidine, some antibiotics (tetracycline, ampicillin, etc.), anti-fungal medications and antidepressants. Since there are more medications that can cause this effect, it's best to check with your pharmacist.
 Obesity–Fat cells, especially those in the abdominal region, have the ability to produce an enzyme known as aromatase. This plays a role in converting testosterone into estrogen, thus changing the hormonal balance.
 Illness–Certain tumors of the testes, adrenal and pituitary glands, liver and lung, cirrhosis (liver disease), kidney and thyroid disease may elevate estrogen levels.
 Drugs–The use of anabolic steroids, marijuana, cocaine and other drugs can affect hormone levels.
 Alcohol–Drinking excessively can increase the body's conversion of testosterone into estrogen, especially in fat cells. It can also block the liver from effectively eliminating excess estrogen.
 Environmental exposure–The breakdown products from certain pesticides, chemicals and herbicides have the potential to cause estrogen-like effects in the body. There is even some concern regarding hormone-enhanced food products; people with elevated estrogen levels may be wise to choose hormone-free foods.
Lastly, it's important you see a physician experienced in breast health. I say this not to alarm you, but because you are a male in your 60s with high estrogen levels and changes in your breasts. (The condition of enlarged breasts in males is known as gynecomastia.) Those factors alone put you at an increased risk for male breast cancer. While rare, it's best for you to be on the safe side and be checked rather than ignore the possibility.
For further information, please speak with your physician. Visit the American Association of Clinical Endocrinologists, the Hormone Foundation, or Breastcancer.org for more information.

I am also adding this again for those who might be thinking of playing with estrogen or other forms of feminizing hrt.

Summary of risks and possible side effects of MTF hormone therapy
General risks • increased strain on liver Þ increased risk of liver disease
• harassment, discrimination, violence, and rejection by
people who do not support your decision to take hormones

Estrogen Risks Possible side effects
• increased risk of blood clots • increase in blood pressure
(risk of death or permanent • nausea or vomiting
damage) • increase in frequency or severity
• increased risk of diabetes and of headaches/migraines
heart disease • milky discharge from nipples
• increased risk of gallstones
• may be increased risk of noncancerous
tumour of pituitary
gland
• not known if breast cancer
risk is increased

Spironolactone Risks Possible side effects
• low blood pressure • skin rash
• changes to heart rhythm due
to high levels of blood
potassium

[Lydia]

Hi Carolynn,

This is just to support the cautions you detailed. Years ago, I taught a course in endicrinology, which gives me some license to contribute to this topic. The main feature of this endocrine system is the complex interplay and balance among the various glands; pituitary, gonads, adrenals, etc., etc. The moral of all this is: "don't fool with the system." All sorts of unexpected and seemingly unrelated things can happen. The application of any hormones, topical or internal, natural or plant-derived, is potentially dangerous -- even when supervised by a physician.

The widely used phyto-estrogen Black Cohosh can have adverse effects on blood clotting time, and increase the possibility of stroke. This is only one example of many. Besides, there is virtually no control over dosage and advertising claims for these OTC drugs.

There is no harm in repeating these cautions on the forum. Maybe these
comments of ours should be maintained as "sticky" posts.

Hugs, sisters - please be careful with your body - it's the only one you'll ever have.

Lydia

[Carla L]

Carolyn and Lydia,

Although I have not use any estrogen I see your comments regarding the side effects. In my mind I start to think of every prescription I've ever had and every advertisement on prescription medicines I've ever seen. Not to take away from the possible effects of estrogen, but many prescriptions have a full list of side effects. My wife has asthma and takes a number of prescriptions. The side effects are immense and like most of the medicines she and I have used in the past, we usually don't see the 'bad effects'. I try to refrain from any drug, using natural foods as much as possible instead. However, I have thought of estrogen many times.

So I have to wonder... Are the side effects on the very few?

Don't get me wrong, I'm not trying to condone the use of estrogen, but like any other prescrip or drug, is it really that bad or risky to a healthy person?

[Carolynn]

Hi Carla. Generally speaking, if one is healthy, side effects are not as likely as with someone who has other health issues if the dosages are safe, but there are also issues not mentioned in the initial post above. Among them is the fact that after between 6 months and a year on estrogen, a male taking it will likely be near irreversibly sterile or have a much reduced and damaged sperm count. At 3 to 4 months on low dose estrogen with a T suppressor such as Spirolactone, the temperary reduction in libido and sperm count will naturally and gradually reverse when the medication is stopped. It's side effects are so low that some therapist use this as a means of diagnosis, looking for depression and other things that show up with people who are not actually TS.

But after 6 months, the physical side effects are pretty much permanent, and there are mental effects from estrogen, possibly including some physical changes in neuron density in some areas of the brain that may not reverse. There is some disagreement with that, as it has not been seen in males taking estrogen for other health issues. There is pretty good indication that the neuron differences and thickness of the connection between the two halves of the brain are present in trans women already along with a female brain lobe pattern and not affected by estrogen.

As far as health goes, NO ONE should take contra-gender hormones without consulting a doctor during the process for blood tests, at the beginning and every 4-6 months. Self medication or DIY as some have tried is the most dangerous. Too high a dose of estrogen can damage your liver, even if you are otherwise healthy, but I have no idea about how long you have to be taking it to do so. Spirolactone is potassium sparing and you can easily wind up with too much potassium, and heart arrythmias, and some people can find their feet swelling due to water retention, and frequent "charley horses" and muscle spasms. Salt is usually flushed along with excess water, but you need a proportion of salt in your system to rid yourself of excess water and maintain optimum health. Spiro is a diuretic primarily used to decrease blood pressure by removing salt and excess fluid. The suppression of testosterone is a happy side effect that increases the effectiveness of estrogen.

In addition to the lower libido, even 3 - 4 months on contra gender hormones can result in depression if you are not psychologically and perhaps physically in need of them. And yes, even if you are otherwise healthy, there is always the risk of Deep Vein Thrombosis, and this even includes young, healthy, cisgendered women on birth control. Generally the risk is realtively low, but does anyone wanting to "try" estrogen really want to chance that or the sterility/impotency side effects? That's the question. The DVT may not happen to your pal, but it may happen to you. After a year, you will be effectively sterile.

The same goes for all prescription drugs and their side effects. You have to be aware of the crap shoot, and hope you don't turn up snake eyes one week. You pays your money and you takes your chances.

The main thing with hormones is simply that they are not something to just play with like some "recreational" drug.

If anyone wants to take hormones then see a doctor, and if you are too embarrassed or uncommitted to that course of action, then just forget it. If you just gotta have breasts to play dress up with, then get implants. You can even get them removed if you change your mind, unlike the ones you grow yourself.

[Jabbela]

So I have to wonder... Are the side effects on the very few?

Hi to everyone,

it been a while since the last post here. But I want to share my thoughts to this topic.

First about the question: I can't really answer it, but in general everyone is an individual and therefore both - effects and side effects - are individual as well. Also women have different side effects, when taking the pill - even these are not contra-gender hormones.

Please do not blame me on this and I agree, that taking hormones can have bad side effects and everyone, who intends to take them, should be aware of them. On the other hand, everyone who is aware of the risks, shouldn't be blamed for it. It is similar with smoking or drinking: everyone know about the risks, but the can decide to start smoking or drinking. That's the freedom of choice - even others consider it as a bad choice.

Well I made my experience on that without a doctor - but with knowledge about the risks. I can share them in case someone is interested...

[Kyra]

Thanks ladies! Very good article Carolynn. Thanks for posting.

I know a person who "tried" hormones before consulting a doctor. She told me while she was married, she didn't want her spouse to know. Buying things of this nature from online stores (apparently) is not difficult. She was very lucky nothing adverse happened!!!
These days, she's under the care of a physician and transitioning very well. It scares me to think of people trying the self-medicating approach. As Lydia stated, we only have one body. Be very careful with it!

Hugs,
Kyra