Today, we’re diving deep into a topic that affects many aspects of both men’s and women’s health: Dihydrotestosterone (DHT). This powerful sex hormone that is much stronger than testosterone is created from testosterone by an enzyme called 5 alpha reductases. It and its precursor androgen testosterone have widespread effects that go beyond sex and reproduction. Just like any hormone, too much or too little can have negative effects. 

In men DHT, it plays a pivotal role in developing masculine characteristics, such as body hair, muscle growth, and a deeper voice. In women, muscle DHT levels correlate with strength and power. While most studies have been done in males, testosterone deficiency and low DHT can have an effect in females. But its influence extends far beyond just these traits.

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The Dual Nature of DHT

DHT is instrumental in the development of the penis and prostate and activates androgen receptors essential for sexual differentiation and changes during puberty. It’s also vital for maintaining a healthy sex drive in men and women. Women with higher free testosterone and DHT had more sexual desire.

A  low DHT to Testosterone ratio may be responsible for excess body hair growth and metabolic disorders in women with PCOS. 1Women with high DHT may also develop male pattern baldness. However, like any good story, there’s a twist. DHT is also the main character in less desirable narratives, such as male-pattern baldness in men and women and, in some cases, prostate enlargement. This duality presents a challenge: how do we maintain the balance?

The Positive Effects of DHT or Testosterone Replacement Therapy

  1. Blood Sugar Control: Studies done in rats showed DHT may play a role in regulating glucose metabolism, offering potential benefits for those at risk of diabetes.
  2. Memory: Depletion of sex estrogen and progesterone at menopause in women and testosterone in aging men is the most significant risk factor for the development of Alzheimer’s disease. Studies show that DHT is involved in the regulation of learning and memory.
  3. Sexual Function: DHT is crucial for a healthy sex drive and preventing erectile dysfunction.
  4. Cardiovascular Disease: Higher Testosterone was associated with reduced Carotid Intima-Medial Thickness (thick, narrow arteries) and lower prevalence of carotid plaque. Higher DHT and estradiol were associated with reduced carotid plaque except men with a coronary artery disease had worse thickening with higher estradiol levels.
  5. Strength and Muscle Mass: DHT may contribute to increased muscle mass, particularly in postmenopausal settings.
  6. Bone Growth: Total bone calcium was greater with DHT and estrogen combined with DHT in rat studies. DHT increased skeletal mass by promoting bone growth and formation with concomitant increases in total body mass. DHT is an important determinant of Bone Mineral Density in men and low DHT to Bone Mineral Density is associated with osteoporosis in men.

Addressing the Challenges

While DHT contributes to many aspects of health, its elevation can lead to male pattern baldness in men and women and prostate enlargement in men. Understanding how to manage DHT levels is crucial for maintaining health without tipping the balance towards these negative outcomes.

How to Increase DHT

For those looking to boost their DHT levels for health benefits, engaging in regular exercise, optimizing body fat levels, and consuming a diet rich in healthy fats and zinc can be beneficial. Supplements like creatine and DHEA may also support this goal. Testosterone replacement therapy may also but not always boost DHT levels.

How to Decrease DHT

On the flip side, managing high DHT levels is essential for preventing hair loss and prostate enlargement. Utilizing natural strategies such as consuming foods rich in lignans (flaxseeds), antioxidants (green tea, curcumin), and taking supplements like saw palmetto can be effective. Finasteride is a prescription medication that blocks the 5 alpha reductase enzymes effectively lowering DHT levels. 

Takeaway

DHT is a powerful hormone derived from testosterone with significant impacts on many aspects of our health. Understanding its effects and how to manage its levels can help us navigate the challenges it presents, ensuring we harness its benefits while mitigating its drawbacks.

In our journey towards optimal health, acknowledging and addressing the role of hormones like DHT is a step towards a balanced, healthy life. Let’s continue to support each other in this journey, embracing the knowledge and tools available to us.

P.S. Remember, while the information provided here is grounded in research and expertise, always consult with a healthcare professional before making significant changes to your health regimen. Your unique health context matters, and personalized advice is key to achieving the best outcomes.

  1. Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels. Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
  2. Riley A, Riley E. Controlled studies on women presenting with sexual drive disorder: I. Endocrine status. J Sex Marital Ther. 2000;26(3):269-283. doi:10.1080/00926230050084669
  3. Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009;5:427-448.
  4. Navarro G, Xu W, Jacobson DA, et al. Extranuclear Actions of the Androgen Receptor Enhance Glucose-Stimulated Insulin Secretion in the Male. Cell Metab. 2016;23(5):837-851. doi:10.1016/j.cmet.2016.03.015
  5. Pan W, Han S, Kang L, Li S, Du J, Cui H. Effects of dihydrotestosterone on synaptic plasticity of the hippocampus in mild cognitive impairment male SAMP8 mice. Exp Ther Med. 2016;12(3):1455-1463. doi:10.3892/etm.2016.3470
  6. Sartorius GA, Ly LP, Handelsman DJ. Male sexual function can be maintained without aromatization: randomized placebo-controlled trial of dihydrotestosterone (DHT) in healthy, older men for 24 months. J Sex Med. 2014;11(10):2562-2570. doi:10.1111/jsm.12550
  7. Chan YX, Knuiman MW, Hung J, et al. Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease. Endocr J. 2015;62(9):777-786. doi:10.1507/endocrj.EJ15-0196
  8. Coxam V, Bowman BM, Mecham M, Roth CM, Miller MA, Miller SC. Effects of dihydrotestosterone alone and combined with estrogen on bone mineral density, bone growth, and formation rates in ovariectomized rats. Bone. 1996;19(2):107-114. doi:10.1016/8756-3282(96)00135-4
  9. Ilangovan R, Sittadjody S, Balaganesh M, et al. Dihydrotestosterone is a determinant of calcaneal bone mineral density in men. J Steroid Biochem Mol Biol. 2009;117(4-5):132-138. doi:10.1016/j.jsbmb.2009.08.004

Lorraine Maita, MD, CEO & Founder of The Feel Good Again Institute and Vibrance for life and widely known as “The Hormone Harmonizer”, has helped thousands of people ditch fatigue, brain fog, mood swings, lose weight, and achieve balanced hormones so they Feel Good Again.
She is a recognized and award-winning triple board certified, holistic, functional, integrative and anti-aging physician, speaker and author, and has been featured in ABC News, Forbes, WOR Radio and many media outlets to spread the word that you can live younger and healthier at any age.

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