The FDA announced a label revision for the 5-alpha reductase inhibitor (ARI) prostate and hair loss drugs, including finasteride (Proscar) and dusteride (Propecia). The revision follows the results of two large studies that looked at using these drugs for preventing prostate cancer. Both studies found that while the ARIs lowered the risk of low grade prostate cancers, they also slightly increased the risk of higher grade, more aggressive prostate cancers. The label revisions warn men of the increased risk of high grade prostate cancer.
Alpha reductase is an enzyme that blocks the conversion of testosterone to the more potent dihydrotestosterone (DHT), which can stimulate prostate growth and is associated with prostate cancer. ARIs can also cause sexual dysfunction, including low libido and impotence.
What does all this have to do with estrogen levels in men? Testosterone can also be converted to estrogen, via the aromatase enzyme. Aromatase inhibitors are used to treat breast cancer patients, but have been largely ignored, until recently, for the treatment of prostate disease. In Hormone Balance for Men, Dr. John Lee postulated that in addition to DHT, it was estrogen dominance that causes prostate enlargement and prostate cancer. He pointed out that men start having prostate problems when their testosterone levels are dropping and estrogen levels are rising.
A 2010 editorial in The Journal of Steroid Biochemistry and Molecular Biology commenting on data on estrogen and prostate disease points out that, “Overall, these data reveal that homeostasis in the normal prostate involves a finely tuned balance between androgens and estrogens. This has identified estrogen, in addition to androgens, as integral to maintaining normal prostate health, but also as an important mediator of prostate disease.”
The good news is that men do not need to wait for research on estrogen and prostate disease to trickle down to the doctor’s office in a decade or two; they can reduce their estrogen levels starting now:
1) Build muscle (without steroids). Muscle promotes the production of testosterone, and testosterone opposes the effects of estrogen.
2) Lose the belly fat. Testosterone specifically converts to estrogen in belly fat. The fact that man boobs go hand-in-hand with belly fat is not a coincidence.
3) Avoid xenoestrogens, or environmental estrogens such as pesticides, plastics, fragrances (e.g. found in laundry soap, fabric softeners, shaving cream, cologne, air fresheners etc). Do not microwave food in plastic!
4) Try to eat organic meat. Livestock used for food is treated with estrogens before slaughter to increase weight, both via fat and water retention.
5) Avoid drugs that increase estrogen levels or decrease testosterone levels, such as H2 blockers (Tagamet, Zantac), benzodiazepines (Valium, Xanax), some heart medications (Lanoxin, Norvasc), and some antibiotics (ketoconazole, metronidazole).
For more information about how to prevent prostate problems read Update on the Prostate.
Carruba G, “Estrogen and prostate cancer: an eclipsed truth in an androgen-dominated scenario,” J Cell Biochem. 2007 Nov 1;102(4):899-911.
Ellem SJ, Risbridger GP, “Aromatase and regulating the estrogen:androgen ratio in the prostate gland,” J Steroid Biochem Mol Biol. 2010 Feb 28;118(4-5):246-51.
Nakajima Y, Akaogi K, Suzuki T et al, “Estrogen regulates tumor growth through a nonclassical pathway that includes the transcription factors ERβ and KLF5,” Sci Signal, 12 April 2011 Vol. 4, Issue 168, p. ra22.