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Can Functional Medicine support Male Hormone Imbalance?

Hormone Imbalance in males is becoming more and more common. Read below how Functional Medicine may be able to help you.

Functional Medicine may help with Male Hormone Imbalance

Although hormone imbalance is often thought of as mainly affecting women, hormone disturbances in males are becoming more and more common.

Hormones are chemical messengers influencing cellular function. The most widely recognised male hormone is testosterone, but men also produce oestrogen, although in much smaller amounts than do women.

The commonest type of male hormone imbalance is low testosterone, often in combination with high levels of oestrogen.

Testosterone production naturally reduces with age, starting in your early 30’s. This has led to the age-related drop in testosterone being nicknamed the andropause or the male menopause.

Sometimes, however, your body converts your testosterone into oestrogen, resulting in very low testosterone and increased oestrogen levels.

Symptoms of Male Hormone Imbalance

Testosterone is often thought of in relation only to libido. However, it plays many more roles in your body, including motivation and mood, brain health, energy and heart health.

Symptoms of low testosterone include:

  • Muscle weakness and wasting, poor recovery from exercise; fatigue and lack of energy
  • Mood disturbances and depression
  • Weak bones, osteoporosis
  • Decline in brain cell function
  • Hair loss
  • Difficulty in maintaining an erection; low semen volume


Symptoms of high oestrogen include:

  • Excess fat especially around your breast area (‘man boobs’), hips and tummy
  • Low libido, infertility, erectile dysfunction
  • Increased risk of stroke and heart attack
  • Increased risk of prostate cancer
  • Skin problems like acne or rosacea
  • Fatigue
  • Infertility


Sometimes, testosterone levels appear normal, but your body converts it into a substance called dihydrotestosterone (DHT). This is stronger than testosterone and less likely to be made into oestrogen. Although this may sound like a good thing, high levels of DHT are linked to prostate enlargement and cancer, as well as male pattern baldness.

Causes of Male Hormone Imbalance

  • Ongoing stress – this can increase the activity of the enzyme converting testosterone to oestrogen, called aromatase. 1
  • Environmental oestrogens from pollutants, personal care and household chemicals, as well as plastics, can increase oestrogen levels. 2
  • Alcohol encourages the conversion of testosterone to oestrogen. 3
  • Lack of sleep can reduce the quantity of testosterone released – the majority of your testosterone is released during the night.
  • If your liver is struggling or the balance of bacteria living in your gut is disturbed, you’ll be less efficient at processing used hormones. This can cause oestrogen levels to rise. 4
  • Low testosterone is frequently seen alongside insulin resistance and Type 2 diabetes, in themselves connected with diets high in refined carbohydrates. 4 5
  • Obese men are more likely to have low testosterone, while reduced levels of testosterone encourage fat to be deposited. There is a particular link with fat lodging around your belly, known as visceral fat. This is because fat cells change testosterone into oestrogen, and obesity reduces the amount of a protein which carries testosterone around your body. 5

Hormone imbalance can be a side effect of some medications. 

Conventional Medicine and Male Hormone Imbalance

You may have had your hormone levels tested and been told they are normal, despite still experiencing symptoms connected to hormone imbalance.

Bear in mind the reference ranges used in conventional tests are very broad, meaning your level might not be optimal for you, even though it appears to be in the normal reference range for the general population.

Testosterone replacement therapy may be offered, however, this does not address the reasons behind your hormone imbalance.

Functional Medicine and Male Hormone Imbalance

The first thing to do is to become aware of your personal hormonal picture.  A saliva test can measure the amount of testosterone available to your body, your level of oestrogen and how your body is metabolising testosterone by measuring substances such as DHT.

Further tests can evaluate your personal nutrient levels, and discover how your gut and liver health are influencing your hormone levels.

Therapy will concentrate on replacing nutrients such as zinc, crucial for your body to make enough testosterone, supporting your body’s natural detoxification processes and encouraging good gut health to ensure excess oestrogen is expelled from your body. 6

Lifestyle interventions such as exercise can be incredibly useful in restoring testosterone levels, particularly strength exercises involving large muscle groups such as the glutes. Likewise, sufficient quality sleep is important to promote testosterone release if your levels are low. 7

Stress management techniques can reduce the activity of the enzyme used to convert testosterone to oestrogen. Natural nutrients and herbs to inhibit aromatase and to encourage healthy testosterone metabolism may also be recommended. 8


  1. Xiong X, Wu Q, Zhang L, Gao S, Li R, Han L, Fan M, Wang M, Liu L, Wang X, Zhang C, Xin Y, Li Z, Huang C, Yang J. Chronic stress inhibits testosterone synthesis in Leydig cells through mitochondrial damage via Atp5a1. J Cell Mol Med. 2022 Jan;26(2):354-363. doi: 10.1111/jcmm.17085. Epub 2021 Dec 10. Erratum in: J Cell Mol Med. 2023 Oct;27(20):3213-3214. PMID: 34894202; PMCID: PMC8743653.
  2. Carruthers M. Time for international action on treating testosterone deficiency syndrome. Aging Male. 2009 Mar;12(1):21-8. doi: 10.1080/13685530802699067. PMID: 19326293; PMCID: PMC2670553.
  3. Smith SJ, Lopresti AL, Fairchild TJ. The effects of alcohol on testosterone synthesis in men: a review. Expert Rev Endocrinol Metab. 2023 Mar;18(2):155-166. doi: 10.1080/17446651.2023.2184797. Epub 2023 Mar 7. PMID: 36880700.
  4. Liu S, Cao R, Liu L, Lv Y, Qi X, Yuan Z, Fan X, Yu C, Guan Q. Correlation Between Gut Microbiota and Testosterone in Male Patients With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne). 2022 Mar 25;13:836485. doi: 10.3389/fendo.2022.836485. PMID: 35399957; PMCID: PMC8990747.
  5. Wittert G, Grossmann M. Obesity, type 2 diabetes, and testosterone in ageing men. Rev Endocr Metab Disord. 2022 Dec;23(6):1233-1242. doi: 10.1007/s11154-022-09746-5. Epub 2022 Jul 14. PMID: 35834069; PMCID: PMC9789005.
  6. Te L, Liu J, Ma J, Wang S. Correlation between serum zinc and testosterone: A systematic review. J Trace Elem Med Biol. 2023 Mar;76:127124. doi: 10.1016/j.jtemb.2022.127124. Epub 2022 Dec 23. PMID: 36577241.
  7. Vingren JL, Kraemer WJ, Ratamess NA, Anderson JM, Volek JS, Maresh CM. Testosterone physiology in resistance exercise and training: the up-stream regulatory elements. Sports Med. 2010 Dec 1;40(12):1037-53. doi: 10.2165/11536910-000000000-00000. PMID: 21058750.
  8. Nielsen AJ, McNulty J. Polyphenolic natural products and natural product-inspired steroidal mimics as aromatase inhibitors. Med Res Rev. 2019 Jul;39(4):1274-1293. doi: 10.1002/med.21536. Epub 2018 Sep 1. PMID: 30171625.



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