What Causes High Estradiol Levels in Males?

Medically reviewed by Jillian Foglesong Stabile, MD, FAAFP on November 27, 2023. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Understanding Androgens, Estrogens, and Progesterones
• The Role of Estradiol in Men and People AMAB
• What Level of Estradiol is Normal in Men?
• Symptoms of High Estradiol Levels in Men
• What Causes High Estradiol Levels?
• Suggestions for Regulating Estradiol Levels in Men
• Find a Clearer Picture of Your Hormonal Health with Everlywell
• Related Content

Healthy hormone levels are a major marker of health no matter your sex. As the main “communicators” facilitating countless biological functions, hormonal imbalances can impact your health in both subtle and significant ways.

Both men and women produce estradiol, a type of estrogen, though the role the hormone plays manifests differently according to your biological sex. Numerous intrinsic and environmental factors can contribute to the overexpression of estradiol in men, resulting in a variety of symptoms and potential health risks that could compromise your quality of life.

Whether you’ve received feedback that your estradiol levels are imbalanced or you simply want to monitor your hormonal health, it’s helpful to know how high estradiol concentration is managed to benefit your overall health. Below, we identify symptoms of high estradiol in men and possible causes, as well as how to work toward regaining hormonal equilibrium.

Understanding Androgens, Estrogens, and Progesterones

The human endocrine system consists of several glands, which can produce many different kinds of endogenous hormones (those that can be produced by your body). [1]

Sex or reproductive hormones are some of the most fundamental of these chemical messengers, particularly as they relate to all things reproduction and sexual development. But they also serve a variety of other vital functions in your body. [2]

In humans, there are three main groups of sex hormones [3]:

• Progesterones
• Androgens
• Estrogens

In men and people assigned male at birth (AMAB), the dominant reproductive hormones are androgens. Healthy men and people AMAB tend to possess more androgens (e.g., testosterone) than women and people assigned female at birth (AFAB) do.

However, everybody’s body creates some level of estrogen, androgens, and progesterone—your biological sex largely determines which hormones dominate. Understanding androgen vs. estrogen vs. progesterone is critical in balancing these hormones correctly.

The Role of Estradiol in Men and People AMAB

Estrogens are responsible for various body maintenance processes that far exceed the domain of reproduction. From regulating blood glucose to supporting focus and concentration, these hormones play a critical role no matter your gender. [4]

There are three main types of estrogen hormones which typically dominate in women:

• Estrone (E1)
• Estriol (E3)
• Estradiol (E2)

In women, estradiol helps develop and sustain the female reproductive system, like facilitating ovulation and creating a hospitable environment for a fertilized egg. However, men also have estradiol in small amounts. [5]

In men, estradiol contributes to [5]:

• Maintaining strong, healthy bones
• Supporting healthy cognitive and brain function
• Supporting chemical processes, like the creation of nitric oxide

With that, it’s important to maintain a healthy balance of estradiol and other estrogens—not too much, but not too little. A low estrogen level has been associated with a lower-than-average libido; excess estrogens can contribute to [1,4]:

• Male fertility problems
• Erectile dysfunction (ED)
• Excess adipose (fatty) tissue, especially of the breasts (gynecomastia)
• Diminished bone density

In healthy men, estradiol synthesis is partly driven by the hormone aromatase. Aromatase converts androgens into estrogens (including E2). [1]

Estradiol production is divided into two general areas [1]:

• 80% is synthesized in the skin, brain, bone, and adipose tissue
• 20% is synthesized in the testes

For this reason, having extra body fat is one reason some men may express higher-than-average estradiol levels. [6]

What Level of Estradiol is Normal in Men?

For both men and women, “healthy” hormone levels fluctuate in response to the environment, illnesses, and the life cycle in general. Estradiol levels are typically negligible to the point of being undetectable in kids, but the levels tend to pick up following puberty.

Currently, the benchmark for healthy estradiol levels in adult biological males ranges between 14 and 43 pg/mL. [6]

However, estradiol reference ranges can differ depending on the laboratory conducting the test and the estradiol level charts and measurement methods they use. [6] This is a normal part of the lab testing process, so it’s best to interpret your estradiol test results using the reference ranges provided by the laboratory used for testing (as well as with the guidance of your healthcare provider).

Symptoms of High Estradiol Levels in Men

Symptoms of elevated estradiol levels or signs of high estrogen in men can vary, but some of the main symptoms you may experience include [6]:

Reduced libido – An elevated estradiol level in men could correspond to lowered testosterone. In combination, these influences may lower sexual desire and contribute to persistent erectile dysfunction.

Fertility challenges – Estradiol is a necessary hormone used in the production of sperm within the testes. However, excessively high estrogen levels can slow down sperm production by inhibiting spermatogenesis (the complex biological process by which sperm are created). When spermatogenesis is compromised, this can adversely impact sperm quality or motility, resulting in difficulty conceiving.

Excess breast tissue – Gynecomastia refers to a sudden increase in the development of fat tissue in the breasts. Elevated estrogen can contribute to this growth in breast fat tissue in men and people AMAB. Sometimes, this can also result in a swollen, tender feeling in the chest.

What Causes High Estradiol Levels?

Elevated estradiol levels men have can potentially stem from several causes [7]:

Advanced age – Age has an intrinsic impact on nearly all of your hormones. As men and people AMAB get older, their testosterone levels naturally decrease while their estrogen levels rise.

Body composition – As mentioned, aromatase is found in numerous areas throughout the body. The majority of it is produced by fat cells. In short, the more fat cells comprise your body composition, the more aromatase may flood your system. This may result in higher levels of estradiol.

Increased aromatase – Depending on lifestyle or underlying health factors, your body may be creating a higher concentration of the aromatase enzyme. This is called aromatase overexpression. [6] Higher amounts of this enzyme mean that more of your testosterone will get converted into estrogen, which both lowers testosterone levels and increases estradiol levels.

Chronic or elevated stress levels – Cortisol, produced in the adrenal gland, is the main hormone produced in response to stress. Chronic and consistent stress can lead to a constant flood of cortisol, which acts to suppress other body systems and hormones. In biological men, cortisol can suppress testosterone production. A low testosterone level can, in turn, raise estradiol production. [8]

Exposure to environmental estrogens – In the modern physical environment, both men and women are often exposed to excess estrogens. [6] Though research is still in its early stages, it’s thought that this exposure to a high E2 level can interfere with normal human reproductive development and sexual life. [6]

Finally, levels of estradiol high in males could result if they are currently being treated with testosterone replacement therapy. [9] Testosterone replacement therapy may be recommended for men with low testosterone or testosterone deficiency to assist with [9]:

• ED
• Low sex drive
• Low motivation or self-esteem

Because testosterone and estrogen levels are closely interlinked, a sudden increase in testosterone from testosterone replacement therapy could result in a rise in aromatase. In turn, this could spike estradiol levels.

However, if you are on T replacement therapy, your healthcare provider will likely carefully measure your hormone levels throughout treatment. If your hormones become imbalanced, they may prescribe controlled levels of aromatase inhibitors to ensure your body produces them in healthy amounts.

Suggestions for Regulating Estradiol Levels in Men

If you discover you have an overabundance of estradiol, it’s important to reach out to a healthcare provider for recommendations on how to bring your hormones back into balance. Pinpointing the precise cause of hormonal imbalances can be complex, as a variety of contributing factors are often present.

That said, there are some healthy habits to practice that may help support your endocrine health overall. For instance, maintaining a regular workout routine is one of the surest methods to support healthy hormone patterns. Working out can help keep your estradiol in check by:

Reducing adipose (fat) tissue – Reducing body fat may play a role in reducing your body’s production of aromatase, providing the conditions to slow the conversion of testosterone into estrogen.

Managing stress– If exercise provides stress relief, you may be able to bring your cortisol levels into balance. Aside from exercise, you might also consider other constructive coping methods for stress and anxiety. This may include meditation, breathing exercises, creative projects, or simply spending more time with friends.

In some cases, even consistent lifestyle changes may not be enough to manage high levels of estradiol. If you’re struggling to gain hormonal health independently, it’s a wise idea to reach out to a healthcare provider or schedule a telehealth consultation. They can help you assess if an underlying health condition could be contributing to hormonal dysregulation, as well as treatment options to help get your endocrine levels back on track.

Find a Clearer Picture of Your Hormonal Health with Everlywell

You might also find it helpful to evaluate your hormone balance by using an at-home Men’s Health Test from Everlywell. This test measures estradiol, testosterone, cortisol, and DHEA—the precursor to both testosterone and estrogen—to provide some insight into your hormonal levels and overall health. [10]

If your at-home test reflects a need for further care, Everlywell helps connect you with a vetted telehealth professional who can counsel you on treatment options and the next steps for regaining health. Find out more of how Everlywell can help make treatment more convenient and accessible by checking out the complete range of at-home tests online today.

Related Content

Understanding Estrogen Levels in Men

Estrogen vs. Progesterone: Key Points to Know

What Is Dehydroepiandrosterone (DHEA)?

References

1. Campbell M, Jialal I. Physiology, Endocrine Hormones. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan
2. Professional, Cleveland Clinic Medical. Endocrine System: What Is It, Functions & Organs. Cleveland Clinic, my.clevelandclinic.org/health/body/21201-endocrine-system. Accessed 26 Oct. 2023.
3. Reproductive Hormones. Endocrine Society, Endocrine Society, 24 Jan. 2022, www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones.
4. professional, Cleveland Clinic medical. Estrogen: Hormone, Function, Levels & Imbalances. Cleveland Clinic, my.clevelandclinic.org/health/body/22353-estrogen. Accessed 26 Oct. 2023.
5. “Reproductive Hormones.” Endocrine Society, Endocrine Society, 24 Jan. 2022, www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones.
6. Estrogens, Male Reproduction and beyond - Endotext - NCBI Bookshelf, www.ncbi.nlm.nih.gov/books/NBK278933/. Accessed 26 Oct. 2023.
7. “Understanding Aging and Testosterone.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 May 2022, www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056.
8. Solorzano, C. Reproductive Hormones. Endocrine Society. https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones. Accessed October 2, 2023. Last reviewed January 24, 2022.
9. Low Testosterone (Male Hypogonadism). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadism. Accessed October 2, 2023. Last reviewed September 2, 2022.
10. “DHEA.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 10 Aug. 2023, https://www.mayoclinic.org/drugs-supplements-dhea/art-20364199.