What are hormones and why should men care about them? Oftentimes we associate hormones with PMS and hot flashes in women, but is that the only reason we should care? Men really only need to know about testosterone and growth hormone, right? Thyroid problems only affect women, right?
Wrong, wrong, wrong, wrong. Men have all of the very same hormones as women. We just have significantly different amounts of each. Men have estrogen and progesterone, and women have testosterone—we just have different levels than our counterparts.
Why should men (and women) care about their hormones?
Hormonal imbalances can be at the root of numerous problems plaguing many men like acne, mood swings, fatigue, and lack of energy, weight gain and fat accumulation, hair loss and male pattern baldness, decreased sex drive and erectile dysfunction... Do I have your attention yet?
Hormones are the body's most potent chemical messengers. They are produced in organs called endocrine glands and affect your cells at the level of DNA, literally working to instruct the cells of each system in the body. They're not just important—they're imperative. They keep us functioning, adapting, and thriving, or not, as an imbalance or fluctuation in our hormones can cause some pretty unpleasant and undesirable side effects.
1. Hormones can be making you (or keeping you) fat.
Weight gain is often associated with thyroid problems in women. And it's true that women are more likely to experience thyroid issues, but men can be affected too. More than 12 percent of the population will be affected by thyroid issues in their lifetime. That might seem like a low percentage, but when you're talking about the entire population—that's a lot of people, and a lot of men suffering from thyroid problems. Women are five to eight times more likely to develop thyroid issues, and that leads to many cases of thyroid disorder in men going undiagnosed or misdiagnosed. Men are also less likely to present to the doctor if they feel run-down, depressed, or are gaining weight. So if you feel like you just need to exercise more but it's difficult because you're so tired all the time, it might be your thyroid.
Even more commonly, however, being tired and run-down are symptoms of an issue with the adrenal glands. Cortisol is a stress hormone that's secreted by the adrenal glands in response to any kind of stress whether it's physical (e.g., exercise), emotional (e.g., relationship), or mental (e.g., work). You need cortisol to function under the most stressful of conditions, but when chronic stress of any kind is persistent, so is the cortisol production. High levels of cortisol raise your glucose and insulin levels, which tell your body to hold on to fat. They tell your body that, under all this stress, you may need that energy someday. So to lose the fat, you have to lose the cortisol, which means you have to lose the stress.
At Parsley Health, specialized testing helps to identify cortisol and insulin issues. The physicians work with all of our patients to identify, address, and reduce the stress in their lives. It's part of a comprehensive, whole approach to health. We work with our health coaches to help implement special anti-inflammatory diets, less stressful fitness plans, and relaxation techniques that fit your style.
2. Hormones may be the reason you're not sleeping and always tired.
Hormone imbalances are often responsible for sleep disturbances. Cortisol may be the culprit here, and stress can cause high cortisol levels at night, which can keep you up or make your sleep restless. Ideally, cortisol peaks in the early morning even before you awaken, getting your body revved up and prepared for the long day ahead. It drops to a low point in the evening while another hormone (melatonin) rises to make you calm and sleepy. Exercising in the evening or working late with the bright overhead lights on can trick your body into producing cortisol at the wrong times or delay or decrease melatonin production because your body thinks it's still daytime.
To solve this hormonal issue you may need to consider exercising in the morning or early afternoon at the latest. Reduce overhead lights after sunset to allow melatonin to start accumulating in your brain. Try stress-reducing techniques (like yoga or meditation) in the afternoon or early evening to reduce cortisol and prevent its stunting effect on melatonin production. A word of caution: While it seems like a simple solution to take melatonin at night as so many people do, this might be detrimental in the long term. Any time you take a hormone from outside the body (exogenous hormone), you reduce your body's ability to make that hormone from inside the body (endogenous hormone). This could potentially further upset your natural abilities and balance, perhaps making you dependent on pills and causing more significant or prolonged sleeping disturbances.
3. Hormones may be affecting your mood.
Hormone balance has a lot to do with whether you are happy or sad, angry or content. In fact, some hormones actually function as neurotransmitters in the brain, directly affecting your thoughts and feelings. Progesterone, for example, has a calming effect1 in the brain. Excesses of testosterone can lead to aggression and irritability, while low levels can make you feel sluggish and fatigued. Low thyroid levels (hypothyroidism) can lead to depression whereas high levels (hyperthyroidism) can cause anxiety.
As there are many potential causes of mood disorders or generalized fatigue and decreased energy, it's essential to work with a physician who takes the time to hear your story in order to find the clues that reveal the true underlying problem, then the problem can be addressed by correctly rectifying the root cause rather than reducing the symptoms. It's also important to work with a physician with expertise in cutting-edge diagnostic testing that evaluates hormone levels and neurotransmitter (brain chemicals) function.
4. Hormones are affecting your sex, in one way or another.
Hormones affect not only your libido (sex drive) but also your sexual function. An appropriate level of testosterone, for example, is necessary for a healthy interest in sexual activity. An imbalance in hormones may be why you or your partner have a reduced interest in sexual activity or a preoccupation with it. Testosterone levels are associated with erectile function and dysfunction. With age (or increased stress at any age), erections can become less frequent, less responsive, or less "erect." Testosterone levels typically start to decline by the age of 35 and often can be found to be low much earlier in the presence of significant or numerous stressors.
Of course, there can be other factors affecting your sex drive, and your doctor should have a detailed discussion with you about the potential underlying issues. Hormones and other factors should be thoroughly evaluated before a doctor just prescribes a pill for use before sex. Although these signs and symptoms can be disturbing enough to the man, woman, or couple, perhaps more importantly they can be an early (or not so early) warning sign of a hormone or vascular problem that is affecting you on a more systemic level.
Men should take their hormone health seriously (and so should their doctors).
These are only some of the ways that hormones affect men physically, emotionally, and mentally. Many common signs and symptoms experienced by men of all ages deserve consideration of how hormone levels and function might be affecting them. Unfortunately, primary care doctors often don't feel comfortable with hormone issues due to their complexity. Make sure that your hormone health is not only considered but adequately and appropriately tested by a provider who is comfortable creating a safe and effective treatment plan.
Dr. Egler is board certified by the American Board of Family Medicine and has completed the certification training with the Institute of Functional Medicine. Currently, Dr. Egler serves as the Medical Director of Parsley Health Los Angeles. He graduated from Drexel University School of Medicine in Philadelphia and completed his residency training at the University of Colorado in Denver. He subsequently completed a fellowship in Academic Medicine/Faculty Development at UCLA before practicing the full spectrum of family medicine in a group practice in South Lake Tahoe for five years. Dr. Egler then returned to academics as an assistant clinical professor and residency director of health information technology at the University of Southern California for the next five years. During this time he obtained a master’s degree in spiritual psychology, which bridged the gap for him from conventional medicine to a more integrative health practice.