How can men lower high estrogen?

The single most effective way for a man to lower high oestrogen is to lose excess body fat. Fat tissue acts as an oestrogen factory, so the more you carry, the more testosterone it quietly converts.

In men, an enzyme called aromatase turns testosterone into oestrogen, and aromatase lives largely in body fat. That sets up a self-feeding loop: more fat means more aromatase, which means more testosterone lost to oestrogen, which means lower testosterone, which makes it easier to gain more fat. Break the loop and the oestrogen problem usually takes care of itself. Alcohol deserves its own mention here, because it hits oestrogen from two directions at once: it can raise aromatase activity, and it burdens the liver that is supposed to clear used oestrogen out of the body.

• Lose excess body fat, especially around the middle, which is the biggest lever by far
• Cut back on alcohol, which raises oestrogen and loads the liver that has to clear it
• Lift weights and stay active, since muscle improves the whole hormonal picture (see how lifting affects testosterone)
• Eat fibre and cruciferous veg such as broccoli, cauliflower and sprouts to support oestrogen clearance through the gut
• Fix sleep and dial down chronic stress

Notice what is missing: aromatase-inhibitor drugs and "estrogen blocker" supplements. The popular supplement versions, such as DIM and calcium-d-glucarate, have far less evidence than their marketing suggests, and the real drugs are powerful prescription medicines that can crash your oestrogen too far. Low oestrogen in men wrecks libido, mood, joints and bone, so this is not a case where lower is always better. The same habits that lower oestrogen also raise testosterone, so you are rarely choosing between the two.

One distinction worth drawing: true gynaecomastia, a firm disc of breast tissue under the nipple, is different from the soft chest fat that comes with general weight gain. Gynaecomastia is more closely tied to the oestrogen-to-testosterone balance and is worth showing a doctor, particularly if it appears quickly, is tender, or affects one side only.

When to see a doctor: if you have genuine high-oestrogen symptoms such as breast tissue growth, low libido or mood changes, get measured with a blood test before doing anything. Find the cause, usually body fat or alcohol and occasionally a medication or medical condition, rather than self-prescribing blockers off the internet. Fix the cause and the numbers tend to follow.