The human body is a finely tuned, chemically run and controlled machine. Everything is controlled and mediated via the production of hormones, the chemical messenger substances produced by the glands of the endocrine system.
Amongst the most complex of the human biochemical processes are the processes mediated by the so called sex hormones.
Even mild changes to the normal production of these chemical messenger substances can throw the body into a potentially catastrophic state of dis-ease and eventually disease.
The sex hormones that we are talking about are estrogen, progesterone, and testosterone.
Testosterone
Testosterone, the dominant male hormone, but also found in women, is one of the steroid family of hormones derived from the parent compound cholesterol and manufactured in the testes.
As with all the hormones, fluctuating and, ultimately, declining levels will precipitate varying symptoms, syndromes, and potentially, disease states.
The aging process is a major contributor to declining hormone levels, and declining testosterone levels begin as early as age 25.
Testosterone is responsible for many physiological changes and developments in the male, including :
- enlargement of the penis and testis
- growth of facial and pubic hair
- increase in muscle mass and strength
- growth in height
- development of the male secondary sex characteristics
Then, throughout adult life, testosterone helps with:
- maintaining sex drive
- stimulating the production of sperm cells
- controlling male hair patterns
- maintaining bone mass
- maintaining muscle mass
All of the above are very important to the male species! In fact, for many, their whole identity is intimately intertwined with maintaining all of the above.
Conversely, therefore, declining testosterone levels are known to cause :
(Ref 1)
- Loss of sexual desire and responsiveness
- Chronic fatigue
- Muscle weakness
- Osteoporosis
- Erectile dysfunction
And there is ample research evidence to support the fact that declining testosterone may well be responsible for, or contribute to :
(Ref 2)
- Type II diabetes (Ref 3)
- Coronary artery disease (Ref 4)
- Peripheral vascular disease
- Depression
- Senile dementia (Ref 5)
- Prostate cancer
- Congestive heart failure
- Reduced life
Under normal conditions testosterone’s decline is a slow process, often thought of as the process of maturing! However, lifestyle, including high intakes of carbohydrates, too much ‘good living’, alcohol, smoking and high stress levels speed up declining testosterone levels by stimulating the production of an enzyme called Aromatase, which causes the conversion of testosterone to estrogen, thereby increasing male estrogen levels.
This imbalance, potentially, can throw a man into a state of panic. His vitality and virility seem threatened, crucial parts of our anatomy begin to function less than optimally, hair starts falling out and often his ‘get up and go, just seems to have got up and gone’.
Management of Declining Testosterone
Lifestyle Modification, something each individual has under their direct control, is, without doubt, the place to start, and should include:
- active stress management
- adoption of the ‘Mediterranean Type’ dietary lifestyle (balanced intake of low GI carbohydrate, high quality protein including plant protein, ample vegetables, fruits, nuts, seeds, legumes etc. and sufficient amounts of essential fatty acids)
- adequate rest and relaxation
- exercise
- avoiding smoking
Natural supplementation to enhance the function of all the metabolic pathways contributing to the conversion of cholesterol to testosterone is important. This includes multivitamins, multi-minerals and phytonutrient supplementation.
Tribulus terrestris, a herb that has been used in the traditional medicine of China and India for centuries is credited with having significant testosterogenic effects and may well assist with improving the effects of testosterone deficiency.
Estrogen
The dominant female hormone, but also found in men, is also derived from cholesterol. Estrogen includes a group of chemically similar hormones: estrone, estradiol (the most abundant in women of reproductive age) and estriol. Estrogen is produced in the ovaries, adrenal glands and fat tissues.
In women, estrogen circulates in the bloodstream and binds to estrogen receptors on cells in targeted tissues, affecting not only the breasts and uterus, but also the brain, bone, liver, heart and other tissues.
Estrogen is responsible for the optimal functioning and maintenance of many physiological processes, including:
- Promoting the formation of female secondary sex characteristics
- Accelerating metabolism
- Increasing fat stores
- Stimulating endometrial growth
- Increasing uterine growth
- Increasing vaginal lubrication
- Thickening of the vaginal wall
- Maintenance of vessels and skin quality
- Reducing bone resorption and increasing bone formation
- Reducing muscle mass
And has been found to play a role in :
Coagulation
- Increase circulating level of factors 2, 7, 9, 10, plasminogen
- Decrease antithrombin III
- Increase platelet adhesiveness
Lipid metabolism
- Increase HDL and triglycerides
- Decrease LDL and fat deposition
Fluid balance
- Salt (sodium) and water retention
- Increase cortisol, SHBG
Gastrointestinal tract function
- Reduce bowel motility
- Increase cholesterol in bile
Cancer
- Support hormone-sensitive breast cancers (see section below)
Conversely, declining estrogen levels is responsible for the ‘condition’ known as menopause, characterized by the deterioration and reduced function of the above.
Typically, during the early stages of estrogen depletion, referred to as peri-menopause, the symptoms are more irritating than serious, and include:
- Hot flushes
- Irregular menstrual cycles
- Breast tenderness
- Exacerbation of migraines
- Mood swings
As the state continues however, more sinister conditions may present, including:
- Various aspects of cardio vascular disease (hypertension and even heart attack)
- Severe mood swings and even depression
- Breast and uterine cancer
Management of declining estrogen levels
As with declining testosterone, as estrogen declines, lifestyle modification will go a long way to managing estrogen balance. In addition, the incorporation of foods from the Brassica family and soy isoflavones may be of benefit.
Supplementation with clinically proven, estrogen balancing natural supplements will often prove very successful in managing the symptoms of estrogen decline.
However, I would caution against ‘self diagnosis and prescription’, and would rather recommend consultation with a clinician well versed in the many and varied products which would suit each individual patient’s symptom profile.
Progesterone
Progesterone is an important female reproductive hormone that works in conjunction with estrogen during the menstrual cycle and is produced in response to ovulation.
Progesterone is necessary for the survival of the fertilized ovum and resultant embryo and the fetus throughout gestation. Functions of progesterone include:
- Precursor of other sex hormones, including estrogen and testosterone
- Protects against fibrocystic breasts disease
- Is a natural diuretic
- Helps use fat for energy
- Natural anti-depressant
- Helps thyroid hormone function
- Normalizes blood clotting action
- Restores sex drive
- Helps normalize blood sugar levels
- Helps protect against endometrial and breast cancer
- Helps build bone and protect against osteoporosis
- Preparing the body for possible pregnancy
- Maintaining the lining of the uterus to facilitate implantation of the fertilized egg
- Preventing the onset of uterine contractions of the uterus
- Stimulating the breast tissue to grow when fertilization takes place
- Development of milk ducts and glands to prepare the breasts for lactation
The resultant effects of modern day lifestyles, however, and the bombardment by synthetic and xenoestrogens, often causes non ovulation, in spite of having a monthly menstrual cycle. Anovulatory cycles result in disruption in progesterone production affecting progesterone levels and consequent abnormal physiological management of all of the above.
Management of abnormal progesterone production
Anovulatoy states, and thus disrupted progesterone levels, are closely linked to heightened stress levels and the resultant hyper-production of stress hormones, including cortisol, adrenalin, and noradrenalin which affects the steroid pathways and the production of the sex hormones.
Once again, therefore, as is the case with testosterone and estrogen, lifestyle management comes out as the number one initial management protocol.
Supplementation with natural progesterone products does offer a way of balancing progesterone levels, however stimulating the bodies natural ability to produce progesterone must be the primary consideration.
So, over time, with the overarching effects of modern day lifestyle, including poor nutritional status and high stress levels, the intimate ‘dance of the sex hormones’ becomes disturbed.
Many of the on going visits to general practitioners, including fatigue, depression, digestive disorders, waning libido, infertility, weight gain, headaches, sleep disorders etc. may well be attributed to the disruption to the balance of the sex hormones.
Considering hormonal fluctuations, as a cause of so many of these ‘everyday’ symptoms affecting so many people, is often foreign to orthodox medicine. Even for clinicians well versed in the implications of hormonal imbalances, establishing hormonal equilibrium is perhaps one of the major challenges because of individual patient hormone specificity.
However, an integrated lifestyle modification program, together with a coordinated and targeted supplementation regime will, more often than not, provide significant results in symptom improvement.
- Int J Clin Pract. 2007 Mar 1; [Epub ahead of print] Testosterone and ageing: what have we learned since the institute of medicine report and what lies ahead? Miner MM, Seftel AD. Department of Family Medicine, Brown University School of Medicine, Providence, RI, USA
- J Sex Med. 2007 May;4(3):558-66. Canadian Society for the Study of the Aging Male: response to health Canada’s position paper on testosterone treatment. Bain J, Brock G, Kuzmarov I. International Consulting Group.Department of Medicine, Division of Endocrinology and Metabolism, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
- Clin Endocrinol Metab. 2005 May;90(5):2618-23. Epub 2005 Feb Endogenous sex hormones and metabolic syndrome in aging men. Muller M, Grobbee DE, den Tonkelaar I, Lamberts SW, van der Schouw YT
- J Cardiol. 2005 Dec 26;96(12B):67M-72M. Epub 2005 Dec 19 Cardiovascular issues in hypogonadism and testosterone therapy. Shabsigh R, Katz M, Yan G, Makhsida N..
- Eur J Endocrinol. 2006 Dec;155(6):773-81. Testosterone and cognitive function: current clinical evidence of a relationship. Beauchet O. Department of Geriatrics, Saint-Etienne University Hospitals, 42055 Saint-Etienne Cedex 2, France. olivier.beauchet@univ-st-etien
- Textbook of Functional Medicine: The Institute of Functional Medicine, Gig Harbour, WA. 98335, USA
- Passage to Power, Leslie Kenton, Edbury Press, Random House, 20 Vauxhall Bridge Road, London, SW1V 2SA
- Nutritional Medicine, A Drug Free Guide to Better Family Health, Dr Stephen Davies & Dr Alan Stewart, Pan Books, 1987
- The Optimum Nutrition Bible, Patrick Holford, Judy Piatkus Publishers, 5 Windmill St, London W1P 1HF