Hormone Regulation in Men – Alternatives to Potency Enhancers

Hormonal Imbalances in Men – A Neglected Topic

QS24 [0:00–0:49]:

Welcome, dear viewers, to our health television today. I'm speaking today with our physician Dr. Isabella Wilden, expert in bioidentical hormones, about a significant topic. Sometimes men suffer from hormonal imbalances, and rarely anyone takes notice of this.

Especially when erectile dysfunction occurs, potency enhancers are often used to help. These, however, can have strong consequences, both on the brain and the heart. And these are the topics we're talking about today. What holistic solution approaches exist? I'm discussing this with our guest. Stay tuned.

Hello dear Isabella. Nice to have you with us.

Dr. Isabella Wilden [0:49–0:54]:

Thank you very much for the invitation. I'm pleased to be here.

QS24 [0:54–0:57]:

I'm pleased too. The last time you were with us was in 2018.

Dr. Isabella Wilden [0:57–0:58]:

Yes, exactly.

QS24 [0:58–1:36]:

You offer individual consultations on bioidentical hormones online, which is fantastic. It's great that you dedicate over an hour to each patient to look at their entire system individually.

It's interesting that we women are generally familiar with the topic of hormones. We're proactive about it and go for screenings. But men don't really have the same access to information about their hormones and are often left in the dark, aren't they?

Dr. Isabella Wilden [1:36–5:15]:

Yes, generally, the medical community needs to pay more attention to this topic. But they don't, they treat the topic often very superficially. Today we will talk about how these processes work. It's also the case that our society offers no education, no medical education in this direction.

That means, this critical point comes for a man, sometimes earlier or later, depending on what kind of lifestyle he has had. And at this critical point it's similar to Perimenopause in women, the man needs help. Then he simply goes first to the family doctor or directly to the urologist, and these topics are simply not addressed there. No proper diagnosis is made. It's simply something, yes okay, erectile dysfunction, as it's called medically. And immediately prescribes a potency enhancer. No hormone status is done, they simply don't listen to what kind of problem might be underlying. The person inside the man, is also not looked at, that he already has a few kilos too much and has accumulated visceral fat, so belly fat, and various other weaknesses or circulatory disorders.

Erectile dysfunction isn't just a sexual symptom; it's a sign of a person's overall health. When symptoms like this appear, it indicates a general weakness in the body, not just a sexual one. To identify the root cause, you need a therapist or an expert with extensive experience in this area. Typically, couples over 50 come to my practice with this issue, but recently, I've seen many younger people with these problems as well. I take an integrative approach to find the underlying cause.

Diagnostics: The Right Way to Hormone Analysis in Men

QS24 [5:16–5:27]:

How do you make a diagnosis? I heard conflicting information—some say hormones should be tested via saliva, others say blood. What do you consider the gold standard?

Dr. Isabella Wilden [5:27–8:15]:

For men, the gold standard in my treatment is a blood test. First thing in the morning.

And there are a few rules, yes. Before blood collection, you may not have sex, you may not do sports, not come to the practice by bicycle, also not be stressed. The man must choose a day, a morning, where he comes to the practice at 8, 9, 10 o'clock, and we test all the hormones, including estradiol, progesterone, testosterone, the hormones of the pituitary gland, so that I can simply connect the dots.

Where is the problem? Is the problem above? Is the problem below? Is the problem with the enzymes? And we already know that men and women all have the same hormones, just in different proportions. Thus, this blood collection in men is relatively simple compared to women. Women have a different cyclicity, as long as they have bleeding, it's more complicated. So with men it's simple.

QS24 [8:15–8:22]:

If now a man would like to be treated from a distance or would like to be advised, could he theoretically also go to his family doctor?

Dr. Isabella Wilden [8:22–8:23]:

Yes.

QS24 [8:23–8:25]:

And that's good?

Dr. Isabella Wilden [8:25–9:13]:

Generally, men prefer online consultations. I like to start with an initial patient history, and my approach is to do a comprehensive review, from head to toe. I ask about everything, very directly and openly, and take detailed notes. After this initial assessment, I order a blood test, or I create a list of necessary tests based on his specific situation, which sometimes includes non-hormonal markers.

Note: Because of the thoroughness, an initial consultation takes about 60 minutes with Dr. Wilden.

QS24 [9:13–9:14]:

For example, HbA1c?

Dr. Isabella Wilden [9:14–10:39]:

Yes, exactly. Or insulin resistance or homocysteine, or how thick the blood is. An inflammation marker, to check for underlying or chronic inflammation. Uric acid, urea, so small things, liver values, these values show me a little where we stand. So it's not only hormones, it's also the other things, depending on the situation.

I practically put these two things together. The information from the initial anamnesis, where he also expresses his wishes to me, then the results from the laboratory, and then we practically create a plan also according to my opinions and my results and also according to his wishes. And a second conversation is simply conducted and in this second conversation, as previously discussed, we create a therapy and see how it works. Disadvantages, advantages. Everything is discussed.

Examples of Patients: Who Seeks Help and Why?

QS24 [10:39–10:51]:

Do couples actually come to you for consultations together? Please give us some examples so we can get a better feel for the process and the kinds of problems your patients are facing.

Dr. Isabella Wilden [10:51–13:44]:

There are two classic situations I see in my consultations. The first involves a younger woman and an older man. The woman might ask, "How can I help my partner feel more vital?" or the man himself says, "I have a new partner, and I want to be able to keep up with her." That's a classic scenario.

Then there are simply also couples, he works in a large company, somewhere where he has a lot of stress, and you can already tell from the first conversation that he is generally exhausted. That it's not necessarily about a sexual problem or a relationship problem. Rather, he is generally exhausted.

Then there are these other life projects, new child or new house. He is not only stressed in the professional area, but stress comes through the new woman or the younger woman. She doesn't have to be much younger, but the new woman, new projects, new expectations, new things, quite great, luxurious, but comfortable holidays. Every day a bottle of champagne, lots of food and so on.

Psychosomatic stories, that means, these men carry stories from childhood within themselves. Some men really identify only with the erection because they learned it that way in the family and in society. You are a strong male, only that characterizes you as a man. And that's also a situation.

There are perfectly normal men in long-term marriages... they come to me and say: 'I've lost all my drive. So, I love my wife, we are simply a sweet, beautiful couple, I've had her for decades, but it doesn't work anymore, I simply have no desire anymore, and I would like to try ways to regain this desire."

Problematic Potency Enhancers: Forced Erections

QS24 [13:44–14:08]:

There's also the category that goes to the urologist, immediately takes a potency enhancer and all is well. What happens there on a biological level in the body with the potency enhancers? That's also difficult to dose, you always have side effects that can happen there.

Dr. Isabella Wilden [14:08–14:55]:

There are, of course, different dosages and also different other agents. When using these agents, a forced or coerced erection is produced. So the blood is practically sucked from the body and goes to a different specific place.

QS24 [14:56–15:10]: Doesn't that also happen when it's a normal erection without potency enhancers? Then the body decides from a safe source where the blood comes from. It's not sucked from the brain or from the heart.

Dr. Isabella Wilden [15:10–15:57]:

The chemical compounds in these potency enhancers have a very rapid effect, which isn't how a natural erection works. This forced erection diverts blood from either the brain or the heart—or from the central circulatory system in general. And for those few minutes, even if it's not for long, there is reduced blood flow to the brain.

QS24 [15:57–16:01]:

Yes, well, but some take doses where it then goes on for hours.

Dr. Isabella Wilden [16:01–17:04]:

So they all start with a quarter, with a small dose, then with a half, then with three quarters and so on. Then patients try several potency enhancers. Where does the information come from the circle of friends? They also talk to each other. "What do you take for that?" and so on.

This is also not communicated within the family. The woman initially also doesn't know what it's about. She possibly notices at some point some differences but doesn't know what exactly changed. In any case, men also exchange information among themselves. And then at some point, depending on what kind of situation it is, you take these potency enhancers regularly and have an effect for a certain time, then again sometimes no effect anymore.

QS24 [17:04–17:08]:

You also become resistant.

Dr. Isabella Wilden [17:08–17:38]:

Yes, therse is also a resistance. You simply see that these affected people always need more again to get the same results. Because for many it's important to have this symbol, to have this erection. And we as doctors must also understand this.

QS24 [17:38–18:00]:

Are there healthy possibilities, if now someone says, I notice I really have erectile dysfunction and am also stressed by myself, or maybe it's also simply due to circulation? That I say, I take things punctually simply where I know that these support, but don't damage the body. Ideally, perhaps still supply with nutrients.

Dr. Isabella Wilden [18:00–18:26]:

So in a detailed hormone analysis, I can identify at which level the patient is located. And we can always start with naturopathy. With arginine, with circulation problems.

Visceral Fat: How Belly Fat Converts Testosterone

QS24 [18:27–18:53]:

I have cared for many Type 2 diabetes men in corporations for many years, and therefore this topic is extremely familiar to me. And I have also really seen in consultations that testosterone is always low with Type 2 diabetes. If you then work with L-arginine, then it also goes up relatively quickly, where you really also experience success.

Dr. Isabella Wilden [18:54–21:07]:

It's like this. Testosterone, L-arginine, also all the vitamins or minerals that support this circulation, they all work well and relatively quickly. There are also plants with testosterone effect. But there is also simply a condition for this, namely the musculature.

So if his muscle mass is very low and has been ignored for years, because of years of no strength training or high intensity training because he only walked the dog. Or when he has become a bit of comfortable, a bit of cycling during the weekends or holidays and that's it. That's not enough training.

So it doesn't go so quickly any more because to restore the whole system and the circulation and the system hormonally. It is possible for the man, it's more difficult for women. But with a condition like this, the man should simply change his lifestyle. He should eliminate his alcohol or at least massively reduce it, he should get his weight in order.

It's like this in biology, that this visceral fat produces an enzyme here, that's called aromatase. And this aromatase unfortunately transforms this testosterone into estradiol or other things. And this estrogen is also not a good quality. That's an estrogen.

So as long as this belly fat or fatty liver is there, you simply shouldn't solely use testosterone. I still recommend taking it, but immediately going to strength training so that this testosterone can be used properly for the musculature as well.

QS24 [21:07–21:51]:

I've seen cases of men—and this really bothered me—where their doctors just weren't knowledgeable in this area. They had Type 2 diabetes for years, and they'd enter a wellness program, start strength training, and change their diet. But they already had developed breast tissue and belly fat, and they couldn't build any muscle. They were trying so hard, but their hormone levels needed to be addressed first. That's the key to starting the engine.

But they already had breasts, belly fat and no muscle grows there. They tried, they really tried hard, and the hormone level needed to increased here.

Effects of Testosterone: More Than Just Sexual Function

Dr. Isabella Wilden [21:51–24:36]:

With hormonal support, with parallel support, you can add what's still missing. That works. That definitely works. Because: "What does testosterone do?" Now let's have a look at the effect. Courage. Musculature. They can simply do new projects. They can follow through. Those affected can then think again. They start thinking: I'm not out of the game yet. I'm simply still capable of starting new projects.

So testosterone also brings mathematical thinking, mood is improved again, the affected person is no longer so half-depressed. "I can't anymore, I don't do anything anymore." That also has an enormous effect on the musculature. That means, he can get going, immediately do strength training, start running again, etc.

And the man becomes less verbal. This is another example from my practice: men are generally less talkative when they have adequate testosterone. The man is often the person in the family who is characterized by his quiet presence. 'Quiet' might not be the right word; 'stable' and 'balanced' is better.

When this testosterone level goes down, then men start to verbalize more, then the partners are also more involved and then there often happen more arguments.

It's simply also too annoying for women who come to me and say: "Yes, he's somehow not there anymore, doesn't have so much energy anymore, no desire to undertake anything, not even to go to a restaurant or anything to do with eating and drinking. He becomes very argumentative, starts to complain, and is critical of everything." That's also a sign that testosterone is no longer so high.

QS24 [24:36–24:50]:

I always thought that was due to the blood pressure lowering medication. The women notice that massively too.

Dr. Isabella Wilden [24:50–25:56]:

Exactly, but there are also cases where they don't use blood pressure lowering medication yet. Maybe there's a connection here. It would be interesting to see whether blood pressure lowering medications also determine behaviour in this direction.

But these are such typical situations that repeatedly occur during our consultations. Situations where I think, yes, that's our approach to help. And when from the diabetologist or from the internists, as you say, the train has already left, I'm still of the opinion that we don't have to directly use potency enhancers or other treatments, but can change something with hormone balancing. Supplement everything that the patient might need.

Objectively conduct an initial anamnesis, regular analysis of laboratory values and a 6-month therapy → doesn't hurt.

QS24 [25:56–26:23]:

Maybe we should emphasize once more that it's important to put yourself in expert hands because the hormones are so complex and can have so many opponents. Not that someone now listens and thinks: "Well, then we'll just smear testosterone on the skin and then something will work.

"So maybe you can once again clearly say that you should under no circumstances apply this to the skin uncontrolled in self-application.

Dr. Isabella Wilden [26:23–26:34]:

Yes, well, all these hormones are prescription only. So, you need a doctor to get them.

QS24 [26:34–26:37]:

Yes, that's certain too.

Dr. Isabella Wilden [26:38–26:49]:

But from my perspective, the patients who are with me have to reorder hormones. That means, I have a control that takes place regularly.

QS24 [26:49–26:55]:

What would happen if you used too much testosterone?

Dr. Isabella Wilden [26:55–28:12]:

Yes, so if the man is young and his testicles, so genital organs still have their own production, then these applications will cause the body's own testosterone production to decrease.

For older men who are in the final stage, when production is no longer there, that doesn't play such a big role anymore. You then take the agents simply as a supplement. Also, for women who are in menopause, where hormone production doesn't take place, it's supplemented.

But the body's own production is always inhibited when, let's say, these hormones are served on a silver platter. Therefore, you must regularly check, you must take breaks and be careful that the hormone level doesn't increase or decrease too far. And, of course, carry out the parallel therapy. So naturopathy, sports and all other topics that play a role: blood sugar etc.

Risks of Uncontrolled Hormone Intake and Importance of Regular Controls

QS24 [28:12–28:24]:

So I also always see it in bodybuilding, when they then take their artificial hormones, sexually nothing was possible any longer.

Dr. Isabella Wilden [28:24–28:34]:

Yes, you can see in the blood whether these athletes take these androgens in the gym, and then you can draw conclusions.

QS24 [28:35–28:42]:

Is that regulated again? So if now someone says he has done bodybuilding for years and wants to again...

Dr. Isabella Wilden [28:42–29:44]:

Not always, but an attempt is possible. But I have had examples of such men in my consultations who were able to turn things around with the help of a little testosterone. So that there's simply still a bit of impulse in the body.

Because otherwise yes, these androgens that they take in the gym go in a biological direction, the dihydrotestosterone, but many get baldness or lose hair because of it, in favour of the musculature. It's very individual, and it's worth an attempt, in my opinion, to balance the hormone level again.

Dr. Wilden's Online Consultation Approach

QS24 [29:44–29:52]:

If people now feel addressed, couples or men, where does the possibility exist to read in and have a look?

Dr. Isabella Wilden [29:53–31:06]:

hormonexperten.de/en, that's my homepage. I basically handle all these hormonal problems rather online because I want to conduct a good anamnesis, undisturbed from the practice, to speak with the person for a full hour.

After the blood collection, patients get a list from me by email of what should still be done, at the family doctor, at the urologist or at naturopaths. Depending on who can do blood collections. And then this list is also discussed online afterwards.

QS24 [31:06–31:08]:

Thank you very much, Isabella.

Dr. Isabella Wilden [31:08–31:16]:

I thank you too. I thank you for the opportunity to pass on this information.

QS24 [31:16–31:18]:

We're pleased too. Dear viewers, wonderful that we could also talk about this topic "Hormones and also the possibilities of regulation for men." I hope you could take something away. Thank you for watching. See you soon. Bye.