Chapter 11 - Hormones in aging

Abstract

Aging is a natural phenomenon, affecting human behavior and functions alike. While there is no way to “turn back time,” it is generally acknowledged that there are several factors which can ease the transition through a “healthy” aging. The endocrine milieu is perhaps one of the clearest representations of how much organic factors are involved in the development of comorbidities of aging, especially in women. Menopause, and to a lesser extent its male counterpart, late-onset hypogonadism (LOH), are universally recognized to have detrimental effects on sexual, as well as general health. Hormone replacement therapy is often suggested in order to reduce the often-debilitating symptoms of aging; however, such treatments are not to be suggested indiscriminately, and adequate evaluation and follow-up are mandatory. LOH and menopause are however just the tip of the iceberg, as most of the endocrine axes are somehow affected by age: the inevitable effects of age reach most organs, including the thyroid, adrenal, and pituitary glands. Even when the endocrine production does not decline, receptor sensitivity could be decreased, therefore resulting in impaired endocrine function despite normal serum hormone levels. Aging and hormones are therefore closely intertwined: endocrine factors affect aging, and aging alters the hormonal status. Whether treatment of aging-related endocrine alterations would result in improved health is a matter largely open to debate, as current literature does not allow to provide clear, undeniable evidence of such benefits.