Risk of Hernia In Men Likely To Increase From Higher Estrogen Levels

Estrogen, or oestrogen, is the primary female sex hormone. It is responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens in females that have estrogenic hormonal activity: estrone, estradiol, and estriol.

Although it’s called the female hormone, a man’s body also makes estrogen. A healthy balance of estrogen and testosterone is important for sexual growth and development. When these hormones become imbalanced, your sexual development and function may be affected. One other consequence of aging in men is that a larger share of testosterone is converted to estrogen by a hormone called aromatase.

What Researchers Believe

An age-related increase in estrogen may be the culprit behind inguinal hernias, a condition common among elderly men that often requires corrective surgery, according to a Northwestern Medicine study published Oct. 15 [SCIENCEDAILY]

The study, led by Dr. Serdar Bulun, chair and the John J. Sciarra Professor of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, found the lower abdominal muscles of mouse models are particularly sensitive to estrogen, developing scar tissue in response to increases in estrogen levels that weakens the abdominal wall and eventually causes a hernia.

Bulun, whose chief scientific interests include breast cancer and gynecology, was investigating the effects of high estrogen in female mice. One experiment involved boosting estrogen levels by incorporating the human aromatase gene into the mouse genome, creating mice who would convert testosterone into estrogen throughout the body.

“We realized the lower abdominal muscle is extraordinarily sensitive to estrogen,” Bulun said. “Estrogen causes these fibroblasts to divide rapidly, at a much higher pace than the muscle cells. The proliferation of the fibroblasts weakens the integrity of the sphincter and it eventually gives way, causing a hernia.”

When the investigators reduced estrogen with a drug compound, it prevented the hernias, suggesting a therapy with preventive potential in humans.

“It may make sense to treat at-risk men with an aromatase inhibitor that could decrease estrogen and strengthen the muscle,” said Bulun, also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Inguinal hernias occur when tissue, such as the intestines, protrudes through the inguinal canal, a weak spot near the groin in the human abdominal wall. These hernias are the most common reason men undergo surgery. There are more than 700,000 inguinal hernia repair surgeries performed each year in the United States, according to the Food and Drug Administration. While the chances of an inguinal hernia increase as men age, the root cause remains unknown.

Symptoms of high estrogen in men

Some of the symptoms of high estrogen in men include:

  • Infertility : Estrogen is partly responsible for creating healthy sperm. When estrogen levels are high, sperm levels may fall and lead to fertility issues.
  • Gynecomastia : Estrogen may stimulate breast tissue growth. Men with too much estrogen may develop gynecomastia, a condition which leads to larger breasts.
  • Erectile dysfunction (ED) : Men with high levels of estrogen may have difficulty getting or maintaining an erection.

To manage high estrogen or estrogen dominance, your doctor might prescribe medications, recommend surgery, or encourage you to adjust your diet.

If you develop high estrogen while undergoing hormone therapy, your doctor might change your hormone therapy plan. This might help your body achieve a healthier hormone balance. If you have a type of cancer that’s sensitive to estrogen, high estrogen levels can make the cancer worse. Your doctor might prescribe medications to block cancer cells from binding to estrogen. For example, they might prescribe tamoxifen.

Alternatively, they might prescribe an aromatase inhibitor. This type of medication stops the enzyme aromatase from converting androgens into estrogen. This class of drug includes:

  • Anastrozole (Arimidex)
  • Exemestane (Aromasin)
  • Letrozole (Femara)

In addition, especially for women with high estrogen levels, the doctors may prescribe a medication that stops your ovaries from producing estrogen. For example, they might prescribe goserelin (Zoladex) or leuprolide (Lupron).

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