The endocrinology of gonadal involution: menopause and andropause

Most aging individuals die from atherosclerosis, cancer or dementia. In the oldest old also loss of muscle strength resulting in frailty becomes the limiting factor for an individual's chances of living an independent life until death. Two hormonal changes mark the aging process in man. In women an acute drop in estrogen production by the ovaries around the age of 50 initiates a symptom complex called menopause. In men a more subtle drop of testosterone bioactivity from 40 yrs onwards might be accompanied by more difficulty to recognize symptomatology (andropause). Hormone replacement strategies in elderly women and males with estrogens or androgens, respectively, has some clear advantages, but is currently controversial, because of the occurrence of adverse effects.