To a great degree, we are who we are because of the hormones produced in our body. From our sexuality to our physical and mental development to the state of our health—we are all dependent on our hormones working properly. When there is an overproduction or under-production of any of our hormones, we can experience a host of serious health disorders. The problem is few of us ever connect these issues with our hormones. And while men may be familiar with testosterone, there are others that are just as important. To address this lack of information, bestselling author Dr. Pamela Wartian Smith has written Maximize Your Male Hormones, a clear guide for men to understand, identify, and treat the many common sources of these ailments including:

Fatigue
Depression
Sexual Dysfunction
Headaches
Anger
Cancer
Nervousness
Weight loss/gain
Heart disease
Male menopause
Stress
Mood swings
Diabetes
Sleep apnea

And so much more

These are all serious disorders that, if left untreated, can be life-threatening. By first recognizing this problem and identifying the hormone most normally associated with it, you will learn there is a great deal that you can do to fix the problem. In her book, Dr. Smith not only provides the medical treatments available—she also includes the natural supplements that have proven to be helpful, as well as the lifestyle changes that can help bring a hormone back in balance.

If any of these problems sound familiar, maybe it’s time to do something about them. Don’t let your hormones ruin your life. With Maximize Your Male Hormones in hand, you will learn that there is a good deal that you can do to help control or even eliminate many of these disorders.

Pamela Wartian Smith, MD, MPH, is a diplomat of the American Academy of Anti-Aging Physicians and director of the Master's Program in Medical Sciences, with a concentration in Metabolic and Nutritional Medicine, at the University of South Florida College of Medicine. An authority on the subjects of wellness and anti-aging, Dr. Smith is also director of the Fellowship in Anti-Aging, Regenerative, and Functional Medicine. Currently, she is the owner and director of the Center for Healthy Living, with locations in Michigan and Florida. Dr. Smith is also the best-selling author of What You Must Know About Vitamins, Minerals, Herbs & More; What You Must Know About Women’s Hormones; What you Must Know About Memory Loss; and Why You Can’t Lose Weight.

"Exceptionally well written, organized and presented . . . an ideal and essential resource for the non-specialist general reader concerned about men's health issues ranging from Prostate Disease to Osteoporosis. Highly recommended for personal, professional, community, and academic library Health/Medicine collections . . . [will] help control or even eliminate many of these common male medical disorders as the body ages."

Introduction

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Part I

Testosterone

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Allan, C., et al., Androgen Deficiency Disorders. In DeGroot, L., Jameson, J., (Eds.) Endocrinology. 5th Ed. Philadelphia: Elsevier, 2006, p. 3159-91.

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Damassa, D., et al., “Sex hormone-binding globulin and male sexual development,” Neurosci Biobehav Rev 1995; 19:165-75.

Daniell, H., “Hypogonadism in men consuming sustained-action oral opioids,” Jour Pain 2002; 3:377-84.

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Ding, E., et al., “Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis,” JAMA 2006; 295:1288-99.

Dobs, A., et al., “Effects of high-dose simvastatin on adrenal and gonadal steroidogenesis in men with hypercholesterolemia,” Metabolism 2000; 49:1234-38.

Dong, Q., et al., “Circulating immunoreactive inhibin and testosterone levels in men with critical illness,” Clin Endocrinol 1992; 36:399-404.

Duncan, S., et al., “Antiepileptic drug therapy and sexual function in men with epilepsy,” Epilepsia 1999; 40:197-204.

English, K., et al., “Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms,” Eur Heart Jour 2000; 21(11):890-4.

Feldman, H., et al., “Age rends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study,” Jour Clin Endocrinol Metab 2002; 87:589-98.

Flood, J., et al., “Age-related decrease of plasma testosterone in SAMPS mice: replacement improves age-related impairment of learning and memory,” Physiol Behav 1995; 57:669-73.

Fukui, M., et al., “Bone and men’s health, association between serum testosterone and bone mineral density in patients with diabetes,” Clin Calcium 2010; 20(2):206-11.

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Hamalainen, E., et al., “Decrease of serum total and free testosterone during a low-fat high-fibre diet,” Jour Steroid Biochem 1983; 18:369-70.

Haring, R., et al., “Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20-79,” European Heart Jour 2010; 31(12):1494-1501.

Harman, S., et al., “Male menopause, myth or menace,” The Endocrinologist 1994; 4(3):212-217.

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Heikkonen, E., et al., “The combined effect of alcohol and physical exercise on serum testosterone, luteinizing hormone, and cortisol in males,” Alcohol Clin Exp Res 1996; 20:711-16.

Hyde, Z., et al., “Low free testosterone predicts mortality from CVD but not other causes: The Health in Men Study,” Jour Clin Endocriol Met 2012; 97(1):179.

Jankowska, E., et al., “Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival,” Circulation 2006; 114:1829-37.  

Kahn, S., et al., “Sex hormone-binding globulin is synthesized in target cells,” Jour Endocrinol 2002; 175:113-20.

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Laaksonen, D., et al., “Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-age men,” Diabetes Care 2004; 27:1036-41.

Lorigo, M., et al., “Vascular pathways of testosterone: Clinical implications,” Jour Cardiovasc Trans Res 2020; 13(1):55-72.

Ma, R., et al., “Erectile dysfunction predicts coronary heart disease in type 2 diabetes,” Jour Amer Coll Cardiol 2008; 51:2045-50.

Malkin, C., et al., “Low serum testosterone and increased mortality in men with coronary heart disease,” Heart 2010; 96:1821-25.

McKeever, W., et al., “Testosterone, dihydrotestosterone and spatial task performance of males,” Bull Psychon Soc 1990; 28:305-08.

Meikle, A., et al., “Quantitating genetic and non-genetic factors to determine plasma sex steroid variation in normal male twins,” Metabolism 1987; 35:1090-95.

Menta, P., et al., “The social endocrinology of dominance: basal testosterone predicts cortisol changes and behavior following victory and defeat,” Jour Pers Soc Psychol 2008; 94(6):1078-93.

Moffat, S., “Effects of testosterone on cognitive and brain aging in elderly men,” Ann NY Acad Sci 2005; 1055:80-92.

Morley, J., et al., “Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: progressive decreases in bioavailable testosterone, dihydroepiandrosterone sulfate, and the ratio of insulin-like growth factor 1 to growth hormone,” Proc Natl Acad Sci USA 1997; 94:7537-42.

Morley, J., et al., “Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: progressive decreases in bioavailable testosterone, dehydroepiandrosterone sulfate, and the ratio of insulin-like growth factor 1 to growth hormone,” Proc Natl Acad Sci USA 1997; 94:7537-42.

Pasquali, R., et al., “Effects of acute hyperinsulinemia on testosterone serum concentrations in adult obese and normal-weight men,” Metabolism 1997; 46(5):526-29.

Pines, C., et al., “Variations in the concentration of the sex hormone binding globulin is a major factor causing a variation in total testosterone values,” Endocrinol Nutr 2009; 56(4):209-12.

Pont, A., et al., “Ketoconazole blocks testosterone synthesis,” Arch Intern Med 1982; 142:2137-40.

Rettori, V., et al., “Role of nitric oxide and alcohol on gonadotropin release in vitro and in vivo,” Ann N Y Acad Sci 1998; 840:185-93.

Rizza, R., et al., “Androgen effect on insulin action and glucose metabolism,” Mayo Clin Proc 2000; 75(Suppl):S61-S64.

Rizza, R., et al., “Androgen effect on insulin action and glucose metabolism,” Mayo Clin Proc 2000; 75(Suppl):S61-S64.

Rommerts, F., Testosterone an overview of biosynthesis, transport, metabolism and non-genomic actions in Nieschlag, E., Behre, H, (Eds). Testosterone: Action, Deficiency, Substitution. Cambridge: Cambridge University Press, 2004, p. 1-37.

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Sarkola, T., et al., “Testosterone increase in men after a low dose of alcohol,” Alcohol Clin Exp Res 2003; 27:682-85.

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Stanton, A., Hormone Replacement in Men, In Rakel, D., Integrative Medicine. 3rd Ed., Philadelphia: Elsevier/Saunders, 2012, p. 321-34.

Stellato, R., et al., “Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study,” Diabetes Care 2000; 23(4):490-94. 

Stoffer, S., et al., “Digoxin and abnormal serum hormone levels,” JAMA 1973; 225:1643-44.

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Swerdloff, R., et al., “Androgen deficiency and aging in men,” West Journ of Med 1993; 159(5):579-585.

Torkler, S., et al., “Inverse association between total testosterone concentrations, incident hypertension and blood pressure,” Aging Male 2011; 14(3):176-82.

Troncoso, M., et al., “Testosterone activates glucose metabolism through AMPK and androgen signaling in cardiomyocyte hypertrophy,” Biol Res 2021; 54:3.

Turhan, S., et al., “The association between androgen levels and premature coronary artery disease in men,” Coronary Artery Dis 2007; 18(3):159-62.

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Vermeulen, A., “Androgen replacement therapy in the aging male---a critical evaluation,” Jour Clin Endocrinol Metabol 2001; 86:2380-90.

Vermuelen, A., et al., “Andorgens in the aging male,” Journ Clin Endocrin Met 1991; 73(2):221-224.

Wang, C., et al., “ISAm ISSAm, EAU, EAA, and ASA recommendations: investigation, treatment and monitoring of late-onset hypogonadism in males,” Aging Male 2009; 12:5-12.

Wang, C., et al., “The effect of heroin addiction on pituitary-testicular function,” Clin Endocrinol (Oxf) 1978; 9:455-61.

Weinbauer, G., et al., Physiology of Testosterone Function. In Neischlag, E., Behre, H., (Eds.) Andrology: Male Reproductive Health and Dysfunction. Berlin: Springer, 1997, p. 25-57.

Wright, J., “Endocrine effects of alcohol,” Clin Endocrinol Metab 1978; 7:351-67.

Yeap, B., “Testosterone and ill-health in aging men,” Nat Clin Pract Endocrinol Metab 2009; 5(2):113-21.

Estrogen

Abbott, R., et al., “Serum estradiol and risk of stroke in elderly men,” Neurology 2007; 68(8):563-68.

Abbott, R., et al., “Serum estradiol and risk of stroke in elderly men,” Neurology 2007; 68(8):563-68.

Bowen, R., et al., “An association of elevated serum gonadotropin concentrations and Alzheimer disease?” Jour Neuroendocrinol 2000; 12(4):351-54.

Celhay, O., et al., “Expression of estrogen related proteins in hormone refractory prostate cancer: association with tumor progression,” Jour Urol 2010; 184(5):2172-78.

Cooke, P., et al., “Estrogens in male physiology,” Physiol Rev 2017; 97(3):995-1043.

Dobbs, R., et al., “Estrogens and prostate cancer,” Prostate Cancer Prostatic Dis 2019; 22(2):195-94.

Dunajska, K., et al., “Evaluation of sex hormone levels and some metabolic factors in men with coronary atherosclerosis,” Aging Male 2004; 7(3):197-204.

Farnsworth, W., “Roles of estrogen and SHBG in prostate physiology,” Prostate 1996; 28:17-23.

Gibbs, R., et al., “Estrogen and cognition: applying preclinical findings to clinical perspectives,” Jour Neurosci Res 2003; 74(5):637-43.

Hess, R., et al., “Estrogen in the male: a historical perspective,” Biol Repro 2018; 99(1):27-44.

Hogervorst, E., et al., “Serum total testosterone is lower in men with Alzheimer’s disease,” Neuro Endocrinol Lett 2001; 22(3):163-68.

Lerchbaum, E., et al., “High estradiol levels are associated with an increase in mortality in older men referred to coronary angiography,” Exp Clin Endocrinol Diabetes 2011; 119(8):490-96.

Lerchbaum, E., et al., “High estradiol levels are associated with an increase in mortality in older men referred to coronary angiography,” Exp Clin Endocrinol Diabetes 2011; 119(8):490-96.

Mohamad, M., “Serum levels of sex hormones in men with acute myocardial infarction,” Neuro Endocrinol Lett 2007; 28(2):182-86.

Palaszynski, K., et al., “Estriol treatment ameliorates disease in males with experimental autoimmune encephalitis: implications for multiple sclerosis,” Jour Neuroimmunol 2004; 149(1-2 84-1.

Rubinow, K., “Estrogens and body weight regulation in men,” Adv Exp Med Biol 2017; 1043:285-313.

Shippen, E., The Testosterone Syndrome. New York: M. Evans & Co., 2001.

Sudhir, K., et al., “Cardiovascular actions of estrogens in men,” Jour Clin Endocrinol Metab 1999; 84(10):3411-15.

Sudhir, K., et al., “Cardiovascular actions of estrogens in men,” Jour Clin Endocrinol Metab 1999; 84(10):3411-15.

Tivesten, A., et al., “Circulating estradiol is an independent predictor of progression of carotid artery intima-media thickness in middle-aged men,” Jour Clin Endocrinol Met 2006; 91(11):4433-37.

Tivesten, A., et al., “Low serum testosterone and high serum estradiol associated with lower extremity peripheral arterial disease in elderly men. The MROS Study in Sweden,” Jour Amer Coll Cardiol 2007; 50(11):1070-76.

Tripathi, Y., et al., “Serum estradiol and testosterone levels following acute myocardial infarction in men,” Jour Physiol Pharmacol 1998; 42(2):291-94.

Tripathi, Y., et al., “Serum estradiol and testosterone levels following acute myocardial infarction in men,” Jour Physiol harmacol 1998; 42(2):291-94.

Ulloa-Aguirre, A., et al., “Clinical applications of gonadotropins in the male,” Prog Mole Biol Trans Sci 2016; 143:121-74.

Vermeulen, A., et al., “Estradiol in elderly men,” Aging Male 2002; 5(2):98-102.

Progesterone

Barnett-Conner E., et al., “A prospective study of dehydroepiandrosterone sulfate, mortality and cardiovascular disease,” NEJM 1986; 37(9):1035.

Barrett-Connor, E., et al., “A prospective study of dehydroepiandrosterone sulfate, mortality, and cardiovascular disease,” NEJM 1986; 315(24):1519-24.

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Brignardello, E., et al., “Dehydroepiandrosterone administration counteracts oxidative imbalance and advanced glycation end product formation in type 2 diabetic patients,” Diabetes Care 2007; 30(11):2922-27.

Buffington, C., et al., “Case report amelioration of insulin resistance in diabetes with dehydroepiandrosterone,” Amer Jour Med Sci 1993; 306(5):320-24.

Buford, T., et al., “Impact of DHEA(S) and cortisol on immune function in aging: a brief review,” Appl Physiol Nutr Metab 2008; 33(3):429-33.

Bumke-Bogt, C., et al., “Expression of the progesterone receptor and progesterone-metabolizing enzymes in the female and male human kidney,” Jour Endocrinol 2002; 175(2):349-64.

Butcher, S., et al., “Raised cortisol: DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity,” Aging Cell 2005; 4(6):319-24.

Cameron, D., et al., “The use of dehydroepiandrosterone therapy in clinical practice,” Treat Endocrinol 2005; 492):95-114.

Cekic, M., et al., “Traumatic brain injury and aging: Is a combination of progesterone and vitamin D hormone a simple solution to a complex problem?” Neurotheropeutics 2010; 7(1):81-90.

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Cooke, P., et al., “Estrogens in male physiology,” Physiol Rev 2017; 97(3):995-1043.

De Bruin, V., et al., “Cortisol and dehydroepiandrosterone sulfate plasma levels and their relationship to aging, cognitive function, and dementia,” Brain Cogn 2002; 50(2):316-23.

Hua, F., et al., Progesterone and vitamin D: Improvement after traumatic brain injury in middle-aged rats,” Human Behav 2012; 1(4):642-51.

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Napoli, N., et al., “Estrogen metabolism modulates bone density in men,” Calcif Tissue Int 2007; 80(4):227-32.

Oettel, M., et al., “Progesterone: the forgotten hormone in men,” Aging Male 2004; 7(3):236-57.

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Schumacher, M., et al., “Progesterone: therapeutic opportunities for neuroprotection and myelin repair,” Pharmacol Ther 2007; 116(1):77-106.

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DHEA

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Farr, S., et al., “DHEAS improves learning and memory in aged SAMP8 mice but not in diabetic mice,” Life Sci 2004; 75:2775-85.

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Feldman, H., et al., “Low dehydroepiandrosterone sulfate and heart disease in middle-aged men: cross-sectional results from the Massachusetts Male Aging Study,” Ann Epidemiol 1998; 8(4):217-28.

Fitzpatrick, J., et al., “Metabolism of DHEA by cytochromes P450 in rat and human liver microsomal fractions,” Arch BIochem Biophysics 2001; 389(2):278-87.

Gordon, G., et al., “Reduction of atherosclerosis by administration of dehydroepiandrosterone. A study of the hypercholesterolemic New England white rabbit with aortic internal injury,” Jour Clin Invest 1988; 82:712.

Hazeldine, J., et al., “Dehydroepiandrosterone as a regulator of immune function,” Jour Steroid Biochem Mol Biol 2010; 120(2-3):127-36.

Herbert, J., “Neurosteroids, brain damage, and mental illness,” Exp Gerontol 1998; 33(7-8):713-27.

Huerta-Garcia, E., et al., “Dehydroepiandrosterone inhibits the activation and dysfunction of endothelial cells induced by high glucose concentration,” Steroids 2012; 77(3):233-40.

James, K., et al., “IL-6, DHEA and the ageing process,” Mech Ageing Dev 1997; 93(1-3):15-24.

Khorram, O., et al., “Activation of immune function by dehydroepiandrosterone (DHEA) in age-advanced men,” Jour Gerontol A Biol Sci Med Sci 1997; 52(1):1-7.

Khorram, O., et al., “Activation of immune function by dehydroepiandrosterone (DHEA) in age-advanced men,” Jour Gerontol A Biol Sci Med Sci 1997; 51(1):M1-M7.

Krysiak, R., et al., “Current views on the role of dehydroepiandrosterone in physiology, pathology and therapy,” Pol Merkur Lekarski 2008; 24(139):66-71.

Legrain, S., et al., “Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamics studies in healthy elderly subjects,” Clin Endocrinol Metab 2000; Clin Endocrinol Metab 2000; 85(9):3208-17.

Leowattana, W., “DHEA(S): the fountain of youth,” Jour Med Assoc Thai 2001 84(Suppl 2):S605-S612.

Li, M., et al., “Adrenal androgen dehydroepiandrosterone sulfate inhibits vascular remodeling following arterial injury,” Atherosclerosis 2009; 206(1):77-85.

Luppi, C., et al., “Growth factors decrease in subjects with mild to moderate Alzheimer’s disease (AD): potential correction with dehydroepiandrosterone-sulphate (DHEAS),” Arcch Gerontol Geriatr 2009; 49(Suppl 1):173-84.

Martina, V., et al., “Short-term dehydroepiandrosterone treatment increases platelet cGMP production in elderly male subjects,” Clin Endocrinol (Oxf) 2006; 64(3):260-64.

Mitchell, L., et al., “Evidence for an association between dehydroepiandrosterone sulfate and nonfatal, premature myocardial infarction in males,” Circulation 1994; 89(1):89-93.

Morales, A., et al., “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age,” Jour Clin Endocrinol Metab 1994; 78(6):1360-67. Erratum in: Jour Clin Endocrinol Metab 1995; 80(9):2799.

Morgan, C., et al., “Relationships among plasma dehydroepiandrosterone sulfate and cortisol levels symptoms of dissociation and objective performance in humans exposed to acute stress,” Arch Gen Psychiatry 2004; 61(8):819-25.

Morgan, C., et al., “Relationships among plasma dehydroepiandrosterone and dehydroepiandrosterone sulfate, cortisol, symptoms of dissociation and objective performance in humans exposed to underwater navigation stress,” Biol Psychiatry 2009; 66(4):334-40.

Morley, J., “Hormones and the aging process,” Jour Amer Geriatr Soc 2003; 51(Suppl 7):S333-S337.

Muller, M., et al., “Endogenous sex hormones in men aged 40–80 years,” Eur Jour Endocrinol 2003; 149:583–89.

Ponholzer, A., et al., “Vascular risk factors and their association to serum androgen levels in a population-based cohort of 75-year-old men over 5 years: results of the VITA study,” World Jour Urol 2009; 28(2):209-14.

Ponikowska, B., et al., “Gonadal and adrenal androgen deficiencies as independent predictors of increased cardiovascular mortality in men with type II diabetes mellitus and stable coronary artery disease,” Int Jour Cardiol 2010; 143(3):343-48.

Rutkowski, K., et al., Dehydroepiandrosterone (DHEA): hypes and hopes,” Drugs 2014; 74(11):1195-207.

Samaras, N., et al., “A review of age related dehydroepiandrosterone (DHEA) decline and its association with well-known geriatric syndromes. Is treatment beneficial? Rejuvenation Res 2013; May 7.

Savineau, J., et al., “Role of DHEA in cardiovascular disease,” Biochemical Pharmacol 2013; 85(6):718-26.

Schmidt, P., et al., “Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression,” Arch Gen Psychiatry 2005; 62:154-62.

Straub, R., et al., “Dehydroepiandrosterone in relation to other adrenal hormones during an acute inflammatory stressful disease state compared with chronic inflammatory disease: role of interleukin-6 and tumour necrosis factor,” Eur Jour Endocrinol 2002; 146(3):365-74.

Straub, R., et al., “Replacement therapy with DHEA plus corticosteroids in patients with chronic inflammatory diseases—substitutes of adrenal and sex hormones,” Zeitschrift fur Rheumatologie 2000; 59(uppl2):108-18.

Straub, R., et al., “Serum dehydroepiandrosterone (DHEA) and DHEA sulfate are negatively correlated with serum interleukin-6 (IL-6), and DHEA inhibits IL-6 secretion from mononuclear cells in man in vitro: possible link between endocrinosenescence and immunosenescence,” Jour Clin Endocrinol Metabol 1998; 83(6):2012-17.

Straub, R., et al., “Serum dehydroepiandrosterone (DHEA) and DHEA sulfate are negatively correlated with serum interleukin-6 (IL-6), and DHEA inhibits IL-6 secretion from mononuclear cells in man in vitro: possible link between endocrinosenescence and immunosenescence,” Jour Clin Endocrinol Metabol 1998; 83(6):2012-17.

Talaei, A., et al., “The effect of dehydroepiandrosterone on insulin resistance in patients with impaired glucose tolerance,” Hormones (Athens) 2010; 9(4):326-31.

Tannenbaum, C., et al., “A longitudinal study of dehydroepiandrosterone sulphate (DHEAS) change in older men and women: the Rancho Bernardo Study,” Eur Jour Endocrinol 2004; 151:717–25. 

Traish, A., et al., “Dehydroepiandrosterone (DHEA)—a precursor steroid or an active hormone in human physiology,” Jour Sexual Med 2011; 8(11):2960-82.

Van Hollenhoven R., et al., “Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months,” Jour Rheumatol 1998; 25(2):285-89.

Villareal, D., et al., “Effect of DHEA on abdominal fat and insulin action in elderly women and men,” JAMA 2004; 292:2243-48.

Wang, Y., et al., “Dehydroepiandrosterone indirectly inhibits human osteoclastic resorption via activating osteoblastic viability by the MAPK pathway,” Chin Med Jour (Engl) 2012; 125(7):1230-35.

Watson, R., et al., “Dehydroepiandrosterone and diseases of aging,” Drugs Aging 1996; 9(4):274-91.

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