What causes high estradiol levels in males?

Medically reviewed by Neka Miller, PhD on August 15, 2021. 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.

Humans can produce over 50 different hormones via their endocrine systems. Sex hormones comprise some of the most important of these chemicals. While these hormones are involved in all things related to reproduction, including libido, sperm production, and menstruation, they also serve various other roles in other parts of your body.

This is also why a hormonal imbalance of any kind can affect your overall health in both small and significant ways. Keeping your hormones balanced is essential to good health, but your hormones can fluctuate based on lifestyle, medication, or underlying health conditions.

One of these hormones is estradiol. If you know about the DHEA hormone, then you’ll see that it is a hormone precursor to estradiol. In cis men, estradiol levels are typically low, but they can become elevated for different reasons. Learn more about estradiol and how it can get high below.

Easily check your estrogen levels from the comfort of home with the at-home Men’s Health Test.

Understanding Androgens and Estrogens

Reproductive hormones are typically categorized as androgens (male sex hormones) or estrogens (female sex hormones). Cis men generally have more androgens, just like testosterone, which is an important part of the development of typically male sex characteristics during puberty and supports other aspects of health in adulthood. Cis women generally have comparatively high estrogen, which contributes to the development of typically female sex characteristics during puberty and also supports health in adulthood. Progesterone is the other main sex hormone in cis women.

Despite the gendered nature of these hormones, everyone has both testosterone and estrogen in some amount. It’s easy for most people to think of these two categories as opposites. In reality, these hormones have a complex, balanced relationship that contributes to your overall health, even beyond your reproductive system.

What is Estradiol?

There are three estrogen hormones: estrol, estriol, and estradiol. Estradiol is the most prominent form of estrogen in both males and females, and it is the most potent of the three estrogen hormones. In cis men, estradiol is likely the only type of estrogen that you need to worry about.

Cis men produce estradiol with help from the enzyme aromatase. Aromatase essentially breaks down and converts free testosterone in the blood into estrogen in men. Estradiol is a byproduct of this process. Aromatase is found in the brain, adrenal glands, testicles, and some fatty tissue.

Functions of Estradiol in Men

Estradiol plays an extensive role in your overall health, even your reproductive function. In cis men, estradiol modulates sex drive, supports regular erectile function, and regulates healthy spermatogenesis (the production of sperm).

Outside of the reproductive system, estradiol has numerous applications and functions, including:

• Maintaining bone health
• Regulating the balance of lean muscle mass and fat mass
• Supporting regular brain function
• Metabolizing lipids (fats and fatty acids)
• Supporting healthy skin
• Producing nitric oxide (a molecule that has an important part in vasodilation)

What is a Normal Estradiol Level in Men?

Estradiol levels are typically negligible to the point of being undetectable in kids, but the levels tend to pick up following puberty. Normal estradiol levels in adult cis men vary depending on who you ask, but they can be anywhere between 10-40 picograms per milliliter to 20-55 picograms per milliliter.

There’s one key thing to keep in mind when it comes to normal levels: estradiol reference ranges can differ depending on the laboratory conducting the test. 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.

Symptoms of High Estradiol Levels

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

Infertility

Estradiol is a necessary hormone used in the production of sperm within the testes. However, excessively high estrogen levels can slow down sperm production, affect sperm quality or motility, or cease sperm production entirely.

Erectile Dysfunction

Getting and maintaining an erection requires a fragile balance of testosterone and estrogen. An elevated estrogen level can tip this balance, resulting in erectile dysfunction. This can be even more prominent if you also have reduced testosterone levels.

Gynecomastia

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, resulting in swollen, tender breasts.

Other Symptoms

Other general signs of high estrogen may include:

• Mood swings
• Reduced libido
• Depression and/or anxiety
• Physical fatigue
• High blood pressure
• Insomnia and other sleep disorders
• Reductions in muscle mass
• Osteoporosis (a loss of bone density)
• Hot flashes

What Causes High Estradiol Levels?

Elevated estradiol levels can potentially come from several sources.

Aging

Age has an intrinsic impact on nearly all of your hormones. As cis men get older, their testosterone levels naturally decrease, while their estrogen levels increase.

Increased aromatase

Depending on lifestyle or underlying health factors, your body may have a higher concentration of the aromatase enzyme. 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.

Body composition

As mentioned, aromatase is found in numerous areas throughout the body. Some of it comes from fat cells. This means that if your body composition comprises more fat cells, you may end up with more aromatase in your system. This may result in higher levels of estradiol production.

Stress and cortisol

Cortisol is the main hormone produced in the stress response. DHEA and cortisol are also both the most common adrenal hormones. Chronic and consistent stress can lead to a constant flood of cortisol, which acts to suppress other body systems and hormones. In cis men, cortisol can suppress testosterone production, which can allow for increased estradiol production.

Testosterone replacement therapy

Some men experience low testosterone levels or testosterone deficiency, resulting in erectile dysfunction, a low sex drive, and other issues. Doctors can prescribe a form of hormone therapy known as testosterone replacement therapy to support healthy testosterone levels. Testosterone levels typically correlate with your estrogen levels, but a sudden increase in testosterone may contribute to an increase in aromatase.

If you do go through with hormone replacement therapy, your healthcare provider will carefully measure your hormone levels throughout the hormone therapy process. You may also receive controlled levels of aromatase inhibitor to keep your aromatase production at a minimum.

How to Keep Estradiol Levels Down

Regular exercise is one of the surest methods to rebalance your hormones and keep your estradiol in check. Exercise may help to increase testosterone levels in both the short- and long-term. Strength training and lifting weights are believed to have a more significant effect on testosterone as increased muscle mass results in increased testosterone production, but all forms of exercise count.

Maintaining a regular workout routine can also help to reduce fat cells. This can reduce the amount of aromatase enzyme, which may then help to reduce the amount of testosterone that gets converted into the estrogen hormone.

Exercise is also a good way to manage stress and reduce cortisol levels. Along with or aside from exercise, consider other constructive methods of coping with your stress. This may include meditation, yoga, breathing exercises, having sex, or simply spending more time with friends.

You may also find it helpful to check in on your hormone balance using a simple at-home Men’s Health Test from Everlywell. This test measures estradiol, testosterone, cortisol, and DHEA to provide some insight into your hormonal balance and overall health. It is also important to learn more about what are the benefits of DHEA.

Lifestyle changes alone may not be enough to manage high levels of estradiol. If hormonal issues continue to be a problem, consult your doctor to determine if there is an underlying health issue contributing to your hormonal imbalances.