Elevated Serum Estradiol Is Associated with Higher Libido

Discuss Elevated Serum Estradiol Is Associated with Higher Libido at the Men's Health Forum; Male ≤ 50 pg/mL; ≤ 200 pm/L Testosterone has always been considered to be a male hormone, whereas oestrogen has ...

Go Back   MESO-Rx > Medicine > Men's Health Forum


Like Tree5Likes
  • 2 Post By Michael Scally MD
  • 2 Post By idmd
  • 1 Post By Michael Scally MD

Reply
 
LinkBack Thread Tools Display Modes
  #1  
Old 02-03-2014, 06:10 PM
Michael Scally MD's Avatar
Doctor of Medicine
 
Join Date: Mar 2006
Location: Texas; Italy
Posts: 12,396
Default Elevated Serum Estradiol Is Associated with Higher Libido

Male ≤ 50 pg/mL; ≤ 200 pm/L

Testosterone has always been considered to be a male hormone, whereas oestrogen has typically been discussed in the context of being a female hormone. Conventionally, the goal of testosterone supplementation therapy (TST) in men was to raise serum testosterone levels and lower oestrogen levels.

A recent study by Finkelstein et al. highlighted an important role for oestrogen in regulation of sexual function in men on TST. In that study, dramatic declines in libido were observed in conjunction with decreased levels of serum oestrogen.

Although oestrogen is associated with male sexual behaviour, the distinct roles of testosterone and oestrogen on sexual function in men on TST are controversial. We thus sought to elucidate the associations between serum testosterone, estradiol, and libido in men undergoing TST for symptomatic hypogonadism (total testosterone <300 ng/dl and three or more symptoms on the Androgen Decline in Aging Male [ADAM] questionnaire).

Men on TST (injections or gels; n = 423) presenting to a large-volume, tertiary referral andrology clinic were asked to rate the quality of their libido using 5-point Likert scales (1 = terrible, 5 = excellent) as part of the validated, quantitative ADAM questionnaire.

Men were categorised as having low (0.5–5.0 ng/dl) or high (>5.0 ng/dl) estradiol and low (<300 ng/dl) or high (>300 ng/dl) testosterone. Serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH), serum testosterone, and sex hormone- binding globulin (SHBG) were collected on the same day that men completed their ADAM questionnaires. We subsequently performed univariate (t test, chi-square) and multivariate analyses (ordinal logistic regression) to evaluate factors that predicted libido.

• Men with serum testosterone levels >300 ng/dl reported greater libido than men whose levels were <300 ng/dl (3.46 vs 2.92; p < 0.01).
• Men with serum estradiol levels >5 ng/dl reported greater libido than men with estradiol levels <5 ng/dl (3.70 vs 3.23; p < 0.01).


In total, 60.4% of men with a serum testosterone level >300 ng/dl and estradiol level >5 ng/dl reported very good or excellent levels of libido (scored as 4 or 5) compared with 31.3% of men with testosterone levels <300 ng/dl and estradiol levels <5 ng/dl ( p < 0.01).

Univariate analysis noted associations between libido and age, and FSH, LH (analysed as continuous variables), estradiol, and testosterone levels (analysed as categorical variables, and which remained significant even when analysed as continuous variables) (Table 1). Interestingly, on multivariate analysis, only estradiol at serum levels >5 ng/dl (2.13; p = 0.04) was associated with greater libido (Table 2).

While this study highlights the importance of oestrogen in men on TST, the limitations include a lack of control group and no score comparisons before and after commencement of TST. Furthermore, a larger sample size may have unmasked a confounding relationship between testosterone and libido.

In summary, we have found that elevated serum levels of estradiol are associated with increased libido in men on TST. We recommend judicious use of aromatase inhibitors for indications such as gynaecomastia. Indiscriminate prescription for the sole purpose of reducing serum oestrogen may be met with poor libido-decreasing satisfaction and quality of life.

Carefully designed placebo-controlled trials to assess the risks and benefits of both testosterone and oestrogen are required.

Ramasamy R, Scovell JM, Kovac JR, Lipshultz LI. Elevated Serum Estradiol Is Associated with Higher Libido in Men on Testosterone Supplementation Therapy. Eur Urol. Elevated Serum Estradiol Is Associated with Higher Libido in Men on Testosterone Supplementation Therapy - European Urology

Attached Images
File Type: gif Estradiol-libido.gif (107.7 KB, 97 views)
Millard Baker and pittbox like this.
__________________
HPTA Restoration (PCT/AIH) & AAS Cycles Consultations Available.

Email for free copy (pdf), "Anabolic Steroids - A Question of Muscle: Human Subject Abuses in Anabolic Steroid Research."

Email - [email protected]
Twitter - https://twitter.com/#!/michaelscally
Blog - http://michaelscally.blogspot.com/
FaceBook - https://www.facebook.com/profile.php?id=100000559797692
Post Cycle Therapy (PCT)/ Androgen Induced Hypogonadism (AIH) - https://www.facebook.com/groups/609337655745437/

Last edited by Michael Scally MD; 02-03-2014 at 06:14 PM.
Reply With Quote
  #2  
Old 02-04-2014, 02:58 AM
Senior Member
 
Join Date: Mar 2011
Posts: 162
Default Re: Elevated Serum Estradiol Is Associated with Higher Libido

"Men were categorised as having low (0.5–5.0 ng/dl) or high (>5.0 ng/dl) estradiol and low (<300 ng/dl) or high (>300 ng/dl) testosterone."

Isn't their categorization of high and low estradiol relative? We are used to seeing estradiol in units of pg/mL with a reference range around 7.0 - 42.0. Wouldn't 5.0 ng/dL translate to < or > 0.05 pg/mL where "high" estradiol would more likely land within the supplied reference range?
Reply With Quote
Sponsored Links
  #3  
Old 02-04-2014, 05:55 AM
Veteran Member
 
Join Date: May 2012
Posts: 2,183
Default Re: Elevated Serum Estradiol Is Associated with Higher Libido

The following has been my experience and an observation I've made many times here. E2 too low and dick works but desire to have sex is low. E2 too high and desire to have sex is there but dick doesn't work. E2 in middle of range equals firing on a cylinders.
kawilt and pittbox like this.
Reply With Quote
  #4  
Old 02-04-2014, 07:52 AM
Michael Scally MD's Avatar
Doctor of Medicine
 
Join Date: Mar 2006
Location: Texas; Italy
Posts: 12,396
Default Re: Elevated Serum Estradiol Is Associated with Higher Libido

Quote:
Originally Posted by JOWS6 View Post
"Men were categorised as having low (0.5–5.0 ng/dl) or high (>5.0 ng/dl) estradiol and low (<300 ng/dl) or high (>300 ng/dl) testosterone."

Isn't their categorization of high and low estradiol relative? We are used to seeing estradiol in units of pg/mL with a reference range around 7.0 - 42.0. Wouldn't 5.0 ng/dL translate to < or > 0.05 pg/mL where "high" estradiol would more likely land within the supplied reference range?
5 ng/dL = 5,000 pg/dL = 50 pg/mL
Millard Baker likes this.
__________________
HPTA Restoration (PCT/AIH) & AAS Cycles Consultations Available.

Email for free copy (pdf), "Anabolic Steroids - A Question of Muscle: Human Subject Abuses in Anabolic Steroid Research."

Email - [email protected]
Twitter - https://twitter.com/#!/michaelscally
Blog - http://michaelscally.blogspot.com/
FaceBook - https://www.facebook.com/profile.php?id=100000559797692
Post Cycle Therapy (PCT)/ Androgen Induced Hypogonadism (AIH) - https://www.facebook.com/groups/609337655745437/

Last edited by Michael Scally MD; 02-04-2014 at 08:19 AM.
Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On



All times are GMT -4. The time now is 09:59 PM.



Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.