Estradiol (E2), the most potent estrogen form, primarily arises from testosterone aromatization in men. Although men’s estradiol levels are lower compared to women, the hormone significantly impacts health. According to a comprehensive 2023 review in Frontiers in Endocrinology, estradiol plays a fundamental role in maintaining men’s health and preventing age-related diseases (source).
Researchers emphasize, “Estradiol is essential for men’s bone health, and deficiency heightens the risk of osteoporosis and fractures.”
Cardiovascular and Metabolic Benefits
Additionally, estradiol is vital for cardiovascular and metabolic health. A 2022 study from The Journal of Clinical Endocrinology & Metabolism showed that men with either low or excessively high estradiol levels had a higher risk of metabolic and cardiovascular disorders. Maintaining optimal estradiol levels—typically between 20–40 pg/mL—may promote healthier fat distribution and reduce risks of type 2 diabetes and heart disease. Furthermore, University of Washington researchers concluded that estradiol supports vascular function and endothelial health due to its anti-inflammatory properties, protecting arterial integrity (source).
Estradiol and Sexual Health
Moreover, estradiol significantly influences sexual health in men. Low estradiol levels can negatively impact libido, erectile function, and sexual satisfaction, particularly in men on testosterone replacement therapy (TRT). A landmark 2013 study published in The New England Journal of Medicine confirmed the importance of both testosterone and estradiol for optimal sexual function in men (source).
Consequently, hormone specialists now closely monitor estradiol during TRT to avoid inadvertently suppressing this crucial hormone.
Expert Recommendations for Estradiol Monitoring
Dr. Jonathan Ross, a leading hormone therapy researcher, emphasizes, “Estradiol isn’t just a testosterone byproduct—it’s a vital hormone in its own right. Clinical practices must evolve to educate men on the importance of estradiol screening, especially during hormone therapy.”
New guidelines from hormone health organizations recommend routine estradiol testing as part of male hormone evaluations, particularly for aging men, those undergoing TRT, or individuals with metabolic or bone health concerns.