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Fifty Shades of Low Testosterone by Virginia Hopkins, MD

I’ve been trying to figure out why EL James’ Fifty Shades of Grey trilogy is a runaway bestseller among women from twenty to seventy. (It’s been close to a year on the NY Times bestseller lists.) When I first started listening to it, I thought for sure it must be a sendup of the romance/vampire/erotica genre. I still think it might be. The British are so good at that sort of thing, aren’t they? But sendup or not, I found the first two books to be genuine page turners. Why are they so appealing? It’s certainly not the writing. I’ll leave the psychological theories to the experts in those areas and give you my Fifty Shades of Low Testosterone theory.

Men are less manly than they used to be. Their testosterone levels are lower, their sperm counts are lower, and they’re fatter. Now this has its positive aspects, such as greater sensitivity to the feelings of others, improved communication skills, willingness to do the dishes and change a diaper now and then, and less inclination to start a barroom brawl or a war. But oh my, sometimes a woman just wants to be swept off her feet by a fully testosteronized male. (Yes, I made up the word testosteronized.)

The trend of less manly men has more to do with higher estrogen levels than lower testosterone levels. Estrogen is the female hormone, testosterone is the male hormone, but the male body produces a little bit of estrogen and the female body produces a little bit of testosterone. It’s a matter of degree.

We’re all exposed to estrogen-mimicking chemicals, known as xenoestrogens, from conception on, in the form of plastics, pesticides, industrial pollution, smog, fake fragrances (so-called air fresheners, scented laundry products, perfumes), body care products (lotions, shampoos, cologne, hair gel), carpeting, fiberboard cabinets and furniture and on and on. This is more exposure to estrogen than a man should ever have and it gives his cells, including brain cells, mixed messages about hormone balance.

Estrogen tells the body to hold water, gain fat in the hips and butt, soften the skin, make the voice higher, grow breasts, and lose chest hair. It makes women chatty multi-taskers and it opposes or counteracts the effects of testosterone. Estrogens also send cells a “grow and multiply” message, which is why it is associated with so many cancers. There is a growing body of evidence that excess estrogen in men contributes to prostate enlargement and cancers. Testosterone tells the body to build muscle and lose fat, roughen the skin, lower the voice, reduce the size of the breasts and grow facial and chest hair. It makes men less verbal and more able focus intently on one task, and it increases sex drive in both men and women.

Overweight men have higher estrogen levels because fat cells are little estrogen-making machines in both women and men. In fact, fat cells particularly like to take male hormones and convert them to estrogen. That beer gut is the engine behind man boobs, soft skin, a higher-pitched voice, increased sensitivity and moodiness, and low sex drive. Excess weight and chronically high insulin levels caused by eating too much sugar and white bread also weakens blood vessels, which causes softer erections.

The stress hormone cortisol also blocks testosterone production and increases the appetite.

There are hundreds of prescription drugs that block testosterone production and/or increase estrogen. Some of the most common offenders are heartburn drugs (Tagamet, Zantac, Prilosec), benzodiazepines (Valium, Xanax), some heart medications (Lanoxin, Norvasc), and some antibiotics (Ketoconazole, Metronidazole). One way to tell if a medication increases estrogen or decreases testosterone is to look for the side effect of gynecomastia or enlarged breasts in men.

Excess alcohol and marijuana also raise estrogen levels.

It’s no wonder that body building is a multi-billion dollar industry, as men sweat out the estrogen in the weight room, and testosterone replacement is one of the fastest-growing segments of the pharmaceutical industry.

While men are getting less manly, women are getting more manly. The ideal woman’s body in our culture is lean and muscular; more tomboyish than womanly. Young women today are playing sports, going to the gym, and are in the workplace, exercising their bodies and their authority, being active, assertive and decisive. Building muscle increases testosterone levels and increased testosterone increases assertiveness and sex drive. Or to put it another way, men and women are starting to look more and more alike. For better or worse, while the male libido is decreasing, the female libido is increasing. Enter Christian Grey.

(A woman isn’t as affected by xenoestrogens as a man because as long her ovaries are making the hormone progesterone (or she is taking it), and she has a low estrogen to progesterone ratio, her body has the ability to keep the effects of excess estrogen in check. Women with low progesterone levels often become estrogen dominant, and suffer from PMS, weight gain, water retention, headaches, and sore breasts, and are at a higher risk for breast cancer.)

Does a less manly man need an überfeminine woman and does a more manly woman need an übermasculine man to ignite the sexual fires? This can be problematic. Women are shaving their pubes, making themselves look like prepubescent little girls down there. How young in appearance do they need to be in order to be sexually desirable? While Shades of Grey heroine Anastasia Steele has been accused of being naïve, I would suggest that instead she’s inexperienced, because otherwise she is quite competent and capable of taking care of herself. While she can be überfeminine and submissive, she can also turn the tables and be assertive and dominating. While Christian is the übermale, he can also be receptive and submissive.

Shades of Grey may be an instruction manual for sex in the new millennium. Not the S&M, which is window dressing, but the enthusiasm for experimentation and creativity.

Virginia Hopkins, MD

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