Having conducted population-based studies on the relationship of sex steroid levels to bone mass in Rochester,Minnesota for many years, I have been struck by just how often male members of the medical staff at our institution who participate in these studies inquire about their testosterone level. Discovering that they happen to be in the top 10th percentile is often a cause for celebration; conversely, being told that they happen to be “average” or, most distressingly, “below average,” generally leads to at least temporary anguish. Not surprisingly, despite the numerous publications from our group and others regarding the key role for estrogen in bone metabolism in men (summarized in Ref. 1), none of my colleagues inquire or seem to care one way or another about their estradiol level. At least based on this anecdotal experience, it seems that even in the minds of well-informed male medical professionals, more testosterone is clearly “better,” whereas estrogen is largely irrelevant.
