By Mike Kocsis | 7 minutes read | Last updated: July 15, 2025 Categories: Menopause Testosterone
Medically Reviewed by Dr. George Touliatos
It is known that testosterone converts into oestrogen (estradiol) via the aromatase enzyme. Because of this, many men are worried that having Testosterone Replacement Therapy (TRT) will raise their oestrogen levels leaving them with distasteful symptoms.
The truth is that some men can experience increased levels of oestrogen from TRT but if you have a good TRT doctor, the chances of this happening are very slim.
Oestrogen contributes a lot to the overall health of the body in both men and women and your Oestrogen and Testosterone levels need to be balanced in order for proper sexual, mental and physical functioning.
Now let’s get into how abnormal oestrogen levels may present itself in men – what symptoms you should look out for and what you can do about it!
What are the common symptoms of high oestrogen in men?
Some of the main symptoms of high oestrogen in men include:
- Infertility
- Erectile dysfunction (ED)
- Stunted growth during puberty
- Gynecomastia
High oestrogen, particularly in the form of estradiol, affects libido, erectile function, and the sperm production within the male reproductive organ.
This is partly due to the fact that oestrogen receptors are prevalent not only in a man’s sexual organs but in his brain as well. In theory, when oestrogen is high, there’s a greater chance of erectile dysfunction (ED).
High oestrogen levels are also linked to higher chances of developing breast cancer in males, an international research collaboration participated in by Cancer Research UK reveals.
Although the risks are low in the first place, men with the highest levels of oestrogen are 2 ½ times more likely to develop breast cancer than those at the bottom of this scale.
Despite the bad rap it has been getting, female hormone oestrogen is a necessary hormone for the male body as well.
It aids in boosting the sexual function (libido) and keeps the bones and muscles strong as well. And since oestrogen helps in keeping your hormones balanced, it helps in regulating one’s weight.
The problem arises when there is either too much or too little of this hormone in men.
Ironically, the prospect of testicular shrinkage or reduced sperm count from TOT doesn’t seem to bother most men. But the thought of high oestrogen side effects from testosterone makes most men want to run for the hills.
In fact, so many are scared of elevated estrogen levels that they will avoid testosterone therapy altogether – even though they desperately need it.
Other symptoms of high oestrogen in men
I get questions on a daily basis from men fretting about the high oestrogen side effects of testosterone therapy.
Let’s get one thing straight: Undergoing TRT does not automatically mean you will suffer from increased estrogen levels!
Nevertheless, it pays to be vigilant because high oestrogen side effects in men can be nasty.
Typical symptoms of high oestrogen in men on testosterone therapy can vary, but these are some of the most common:
Water retention
Water retention, and puffiness or colloquially known as ‘moon face’ can sometimes occur as a side effect of testosterone therapy but it is up to debate if high oestrogen is the direct cause.
Androgens and their metabolites may disturb the electrolyte balance as well as the angiotensin pathway which may be the true cause of water retention in men from TRT.
Oestrogen sometimes gets the blame but it’s still uncertain if it’s a direct cause or only an association.
It’s also important to note the ratio of oestrogen to androgens as it’s an important factor in determining the source of symptoms.
Tiredness
Feeling tired all the time? Your oestrogen levels may be to blame.
High oestrogen can cause fatigue by inhibiting thyroid conversion which can make it difficult for you to sustain your energy throughout the day.
Low estrogen hormone levels may also be to blame. Some men using aromatase inhibitors have complained of tiredness for 3-4 days which may correspond with the half-life of these drugs which should be used sparingly if at all.
Belly fat
Can’t seem to shake off that fat around your abdomen? It might be a sign of high oestrogen. Elevated oestrogen levels can increase body fat, with the most prevalent being in the belly area.
Poor erection quality and low libido
Too much oestradiol can cause weak erections and lower your sex drive.
Moodiness
Too much estrogen has historically been blamed as the cause of mood swings and emotional outbursts. Crying spontaneously can become common.
Low mood is usually seen in men with low levels of testosterone or oestrogen, or low testosterone to elevated oestrogen ratio.
Gynaecomastia
Gynaecomastia or ‘man boobs’ is an unsightly side effect of high oestrogen in men. This involves the growth of excess fat and glandular tissue around the breast fat tissue. But this breast tissue grwoth is not an overnight phenomenon and tends to occur in stages.
Loss of lean muscle mass
Feel a little weaker than usual? Notice a jiggle in the parts of your body that used to be firm? This is another symptom of low testosterone that you should watch out for.
Depression
Estrogen dominance in men can also cause depression, regardless of one’s weight, according to a scientific study.
What are the normal oestrogen levels in men?
Oestrogen levels in adult males are typically 10-60 pg/ml (oestrone or E1) or 10-40 pg/ml (oestradiol or E2) depending on which oestrogen type is being measured.
However, what is considered “normal” levels of testosterone or oestrogen may vary depending on factors like men age and health conditions such as diabetes.
How to treat high oestrogen in men on TRT?
If you already have high estradiol levels prior to testosterone therapy, it is more likely the introduction of testosterone will elevate your oestradiol levels further compared to an individual with normal oestrogen levels.
This is due to the aromatisation of testosterone into oestradiol.
The side effects of high estrogen levels can be mitigated and avoided altogether by diligent blood work and proper oestrogen management. Your TRT doctor may suggest increased injection frequency to mitigate the conversion of testosterone into estradiol or the use of an aromatase inhibitor.
Here is how you can treat high oestrogen in men:
Manage testosterone dose
If your oestrogen levels are high because of TRT, the first thing your healthcare provider will most likely do is manage your testosterone injection dose and frequency.
They may ask you to lower your testosterone dose and take smaller, more frequent testosterone doses.
Consider aromatase inhibitor
Sometimes healthcare professionals prescribe aromatase inhibitors (AIs) medication that block aromatase enzyme, preventing conversing of testosterone into oestrogen.
The use of an aromatase inhibitor should be considered when there is a clinical need – i.e. your oestradiol levels are high and you have the symptoms of high oestrogen.
Remember that AIs come with potential side effects so discuss this method with your doctor in detail before opting for it.
Try natural methods
If you think your testosterone or estrogen levels are off, natural ways of balancing testosterone such as switching to a healthier diet, changing your mindset, and engaging in regular exercise can help.
Not only are these beneficial in raising your testosterone levels, but they also result in a better quality of life in the long run.
Here are a few effective natural methods for balancing hormones:
- For starters, you can start by avoiding too much alcohol. Unknown to many, excessive alcohol consumption can cause your body to produce more oestrogen.
- Likewise, you may also switch to an organic diet that includes more cruciferous vegetables. This will give you the assurance that there won’t be hormone-altering chemicals in your food.
- Also, avoid BPA and heating food in the microwave using plastic containers. BPA disrupts the body’s delicate, healthy balance of hormones, so avoid it if you can.
- Lastly, you may also resort to resveratrol supplementation to keep your oestrogen levels in check.
FAQs about TRT and high oestrogen in men
Does high oestrogen in men cause weight gain?
Yes, higher amounts of oestrogen in men can cause weight gain, especially around the belly. Oestrogen promotes fat storage and inhibits fat burning.
How to know if you have high oestrogen?
If you think you have high oestrogen levels, get yourself by an endocrinologist or a general practitioner.
They will examine your symptoms and conduct a few blood tests to make sure whether you actually have a hormonal imbalance.
Does high estrogen cause anxiety in men?
Yes, high oestrogen can lead to anxiety and other mood-related issues development in men.
What are the possible causes of high oestrogen in men?
Men can have high oestrogen levels for multiple reasons. Here are the most common risk factors of high estrogen in men:
- Obesity
- Stress
- Alcohol consumption
- Liver problems
- Certain medications (anabolic steroids, anti-androgens, etc.)
- Exposure to xenoestrogens
- Dietary factors
- Thyroid disorders
Conclusion
Oestrogen plays a pivotal role in the male body. Among other things, it’s responsible for modulating libido, erectile strength and bone mineral density.
Homeostasis is a finely tuned system of checks and balances. So, if you’re chasing lab numbers after having read about it on some online forum, you’re doing yourself no good!
If one guy feels good at X level, doesn’t necessarily mean you will too, it’s about finding your optimal levels!
Not sure whether your hormonal levels are balanced or not? Go to a doctor and get evaluated. They will then ask you to undergo oestrogen testing.
This blood test can measure three types of oestrogen: estrone (E1), estradiol (E2), and estriol (E3). The type you’ll be tested for will depend on your symptoms.
After which, you’ll be prescribed the most suitable treatment plan for your situation.
Blood work is critical in evaluating your response to treatment. But remember – with testosterone replacement therapy how you FEEL is foremost and lab numbers are secondary.
If you feel you’re suffering from a hormone imbalance and want to get in touch with a doctor, don’t hesitate to contact us.
Our experienced doctors and team will work closely with you to identify a diagnosis and come up with an HRT treatment that’s tailored to your specific needs.
BONUS:
If you would like to know more about TRT, testosterone and estrogen, I recommend you listen to this podcast. In this podcast, Jay Campbell and Dr John Crisler really dive deep into the subject.
Dr John Crisler, one of the best in the TRT game, gives a very high-level overview of estrogen control methods.
https://www.youtube.com/watch?v=0ZyptAoqnJw
References
Diaz, P.A.R., Ortiz, C.P. and Delgado, D.R., 2021. The crucial role of estrogen/androgen hormones and their receptors in male infertility risk. Central Asian J Med Pharm Sci Innov, 1(1), pp.35-43.
Schulster, M., Bernie, A.M. and Ramasamy, R., 2016. The role of estradiol in male reproductive function. Asian journal of andrology, 18(3), pp.435-440.
Tan, R.S., Cook, K.R. and Reilly, W.G., 2015. High estrogen in men after injectable testosterone therapy: the low T experience. American Journal of Men’s Health, 9(3), pp.229-234.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: July 15th, 2025
