The clinical practice of re-establishing circulating levels of sex steroids, specifically testosterone and estradiol, to a range associated with optimal health and vigor for a given age and sex profile. This aims to reverse hypoestrogenic or hypogonadal states that negatively impact metabolic and structural integrity across the body. Accurate measurement and subsequent replacement are central to this restorative practice.
Origin
This concept is deeply embedded in the history of endocrinology, specifically related to understanding the effects of gonadal decline across the lifespan. The term emphasizes “restoration” to a prior, healthier physiological baseline rather than achieving supraphysiological hormone levels. It directly relates to clinical management strategies for symptomatic hypogonadism in aging populations.
Mechanism
Involves the careful administration of exogenous hormones, often bioidentical formulations, guided by serum assays of free and total fractions alongside symptom resolution. The mechanism requires balancing the production and clearance rates to maintain steady physiological concentrations at target receptor sites within tissues. This re-engagement of sex steroid signaling supports bone density, lean mass accretion, and critical aspects of neurological function.
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