Adrenopause

Age-related decline in adrenal gland function

Adrenopause refers to the gradual and progressive decline in the production of adrenal androgens, particularly dehydroepiandrosterone (DHEA) and its sulfate ester DHEA-S, that occurs with aging. This phenomenon is part of the broader spectrum of endocrine system changes that occur as part of the aging process.

Physiology

The adrenal glands are responsible for the production of several hormones, including cortisol, aldosterone, and adrenal androgens such as DHEA and DHEA-S. These androgens serve as precursors to more potent androgens and estrogens and play a role in various physiological processes, including immune function, metabolism, and cardiovascular health.

DHEA and DHEA-S levels peak in early adulthood and decline progressively with age. By the age of 70 to 80, levels of these hormones may decrease to 10-20% of their peak values. This decline is more pronounced in men than in women.

Clinical Significance

The decline in adrenal androgens has been associated with several age-related conditions, although the exact clinical significance of adrenopause is still under investigation. Some studies suggest a link between low DHEA levels and conditions such as osteoporosis, cardiovascular disease, cognitive decline, and depression. However, the causal relationships remain unclear.

Diagnosis

Adrenopause is typically diagnosed based on clinical symptoms and the measurement of serum DHEA and DHEA-S levels. However, there is no standardized threshold for defining adrenopause, and the condition is often considered part of the normal aging process rather than a distinct pathological state.

Management

There is currently no consensus on the treatment of adrenopause. Some individuals may seek hormone replacement therapy with DHEA supplements, although the benefits and risks of such treatment are not well established. Lifestyle modifications, including regular exercise and a balanced diet, may help mitigate some of the effects associated with declining adrenal androgen levels.

Research Directions

Ongoing research aims to better understand the role of adrenal androgens in aging and the potential therapeutic benefits of DHEA supplementation. Studies are also exploring the molecular mechanisms underlying the decline in adrenal androgen production with age.

Related pages

• Endocrine system
• Dehydroepiandrosterone
• Aging
• Hormone replacement therapy

Gallery

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  Dehydroepiandrosterone sulfate levels throughout life in human males and females

Adrenopause

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  Dehydroepiandrosterone sulfate levels throughout life in human males and females