How male hormones affect mood, obesity, insulin resistance, infertility, libido, male pattern baldness and prostate cancer risk
Almost everyone has heard of the hormone testosterone, we associate it with being a more male hormone although it is also vital for women’s libido and health, being associated with polycystic ovarian syndrome. But there are many more hormones involved in men’s health.
Testosterone is a hormone produced primarily in the testicles and helps maintain men’s:
- Bone and muscle strength/mass
- Fat distribution
- Sex drive
- Sperm production
A small percentage of testosterone is produced by adrenal glands (glands associated with stress response located above the kidneys). This is one of the reasons high stress can suppresses testosterone production and it is integral to support the adrenal glands when treating hormone dysregulation.
Testosterone production peaks at about age 25 and decreases 1% per year. By age 75 men have half the amount of testosterone than did at age 25.
This hormone decrease is more gradual than when women enter menopause but the symptoms of low testosterone are called andropause.
Symptoms of low testosterone are:
- Loss of libido
- Erectile dysfunction
- Decreased memory and ability to concentrate
- Reduced muscle mass and strength
- Gynecomastia (male breasts)
5 alpha-Reductase (5AR) is an enzyme that converts testosterone to 5 alpha-dihydrotestosterone (DHT). When 5AR is elevated it is associated with prostate enlargement and the primary factor in premature male baldness.
Prostate cancer is the most common cancer in Canadian men and is the second largest cause of male cancer deaths in Canada. 1 in 7 men will develop prostate cancer during his lifetime and 1 in 28 will die of it.
The prostate is a gland that is part of the male reproductive system, producing fluid that nourishes and protects sperm. It surrounds the tube that urine and sperm pass through in the penis. The nerves that control erections surround the prostate. Thus when the prostate becomes enlarged men often have difficulty/pain urinating, painful erections and blood in the urine or semen.
The growth of cells in the prostate, both healthy and cancerous, is stimulated by testosterone.
Testing is recommended for men aged 40-75 and for those with increased risk of prostate cancer. Along with the standard tests of PSA (prostate specific antigen) and a digital rectal exam (the prostate is felt for any abnormalities), there are other tests that measure testosterone metabolites to add in the accuracy of diagnosing prostate cancer risk.
5-alpha reductase (5AR) converts testosterone to a hormone called DHT (the primary factor in male pattern baldness) and contributes to prostate cancer. You would think it would be as simple as blocking 5AR to solve prostate cancer risk.
There are medications that block 5AR, a study found they did help prevent prostate cancer but if you did get prostate cancer on these drug you were more likely to get an aggressive form of cancer and die from it. That is because DHT can also convert into something (3b-Adiol) that helps prevent prostate cancer.
Guerini, V., D. Sau, et al. The androgen derivative 5alpha-androstane-3beta,17beta-diol inhibits prostate cancer cell migration through activation of the estrogen receptor beta subtype. Cancer Res. 2005;65(12): 5445-53.
Medications that block 5AR also have common side effect of impotence, decreased libido and decreased ejaculation volume all affecting infertility.
The interplay of hormones is complicated with genetics, estrogen, the thyroid and adrenal glands affecting this as well, along with diet and lifestyle. You can measure all of these factors with an individualized prevention and treatment program working with your physician.
Things you can take that help prevent prostate cancer are adequate zinc and gamma linoleic acid as well as a high fiber, low inflammatory diet. Men should eat 30-40 grams of fiber per day.