The progressive, age-related reduction in the production and circulating levels of sex steroid hormones, primarily testosterone, estrogen, and progesterone, secreted by the testes in men and the ovaries in women. This physiological phenomenon, encompassing andropause and menopause, leads to profound systemic changes affecting musculoskeletal, cardiovascular, and cognitive health. It is a hallmark of reproductive senescence and a key focus in hormonal longevity medicine.
Origin
The term is fundamental to reproductive endocrinology and gerontology, describing the involution of gonadal function that occurs as a natural part of the aging process. The clinical understanding of its symptoms and sequelae led to the development of modern hormone replacement therapies.
Mechanism
In women, the mechanism involves ovarian follicular depletion, leading to reduced estrogen and progesterone synthesis and a subsequent rise in pituitary gonadotropins (FSH and LH) due to loss of negative feedback. In men, it is characterized by Leydig cell dysfunction and a decrease in the pulsatile release of GnRH, resulting in lower testosterone production, often compounded by increased Sex Hormone-Binding Globulin (SHBG). These hormonal shifts directly impair cellular repair, protein synthesis, and mood regulation via widespread receptor systems.
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