Age associated decreases in hormonal function have collectively come to be called “pauses,” deriving the term from the mother of all pauses, Menopause.


Menopause is that significant transition in a woman’s life marked by the inability of her ovaries to continue to produce the important sex steroids Estradiol, Progesterone and, to a lesser extent, Testosterone. Her fertility, along with her menstrual cycles, has ended. Her ovaries are at the end of their functional life.
Getting through menopause without treatment is not easy. Life after menopause is just not the same. The early years of menopause are typically difficult as waves of hot flashes and sweats invade a women’s life day and night. Her joints ache, her memory weakens, her skin thins. Typically, she has labile moods. Not uncommonly, she experiences depression. Her libido declines and her ability to perform sexually diminishes. Vaginal dryness and thinning develop. She feels past her prime. She feels herself getting old.
Underlying these symptoms are complex physiological changes that are accelerating the stigmata of aging. Bone loss is extremely rapid in the first 5 years after menopause. The same damaging changes are occurring in the arteries as well. The risk of breast cancer also rises postmenopausally.
It is imperative that a woman begins natural hormone treatment as soon as possible after the onset of menopausal symptoms to prevent not only the clinical symptoms of menopause but the accelerating degenerative changes in the body that are associated with the loss of these beneficial sex steroids. 


Andropause refers to the decrease in testosterone in men that occurs as a man ages. A parallel decrease in testosterone occurs in women, so we also apply the term andropause to a women’s loss of testosterone.

Symptoms of testosterone deficiency also mirror those associated with aging. These signs and symptoms include loss of energy, depressed mood, decreased libido, erectile dysfunction, decreased muscle mass and strength, increased fat mass, frailty, osteopenia and osteoporosis. The image of the grumpy old man comes to mind!

One can see an overlap in symptoms engendered by the age-associated loss of both testosterone and growth hormone. Both of these hormones are anabolic, or bodybuilding, and therefore are crucial to muscle, skin, brain and bone tissue maintaining their resiliency and vigor.

Numerous studies over the years have demonstrated that replacing bio-identical testosterone, either by injection or topically, can improve energy, improve sexual interest and performance, increase lean body mass, increase muscle strength, decrease body fat, strengthen bones and improve cognitive function.


Thyroid function also declines with age, especially in women. Fully 25% of postmenopausal women have either clinical or subclinical hypothyroidism. Furthermore, as thyroid affects the metabolism of every cell in the body the impact can be rather important. The symptoms of thyroid disease can be similar to postmenopausal complaints and are clinically difficult to differentiate. There can also be an absence of clinical symptoms. It is important that even mild thyroid failure can have a number of clinical effects such as depression, memory loss, cognitive impairment and a variety of neuromuscular complaints. Heart muscle function has been found to be subtly impaired. There is also an increased cardiovascular risk, caused by increased serum total cholesterol and low-density lipoprotein cholesterol as well as reduced levels of high-density lipoprotein. These adverse effects can be improved or corrected by bio-identical thyroid therapy.


The somatopause is the term used to describe the loss of growth hormone (GH) activity that occurs as we age.

Aging is associated with loss of muscle mass, called sarcopenia, thinning and sagging skin, decreased vital capacity, decreased endurance, decreased reaction time, decreased concentration, decreased bone density, decreased visual accommodation, decreased organ size and other physical losses.

It is precisely the loss of GH, which occurs as we age, that contributes to so much of these stigmata of aging. Replacement with Recombinant Human Growth Hormone (rhGH or hGH), either alone or in combination with testosterone, has been shown to slow, halt or reverse these changes. This is why GH is such an essential hormone for aging management in those individuals who are deficient, and has emerged as the most important of the restorative hormones.

Growth Hormone has this dramatic impact because it is an anabolic hormone, which stimulates protein synthesis and thus is involved with the building up of tissue. As indicated, sarcopenia refers to age associated loss of muscle mass. More specifically, it involves the loss of muscle fiber itself. Whereas muscle mass can increase through exercise and testosterone replacement by increasing the size of the remaining muscle fibers, it is only with the addition of Growth Hormone that one can also preserve the number of fibers themselves.


Adrenopause refers to the marked decline in adrenal androgens that comes about as a result of aging. Though the adrenal glands, located on top of the kidneys, produce other hormones such as cortisol and aldosterone, it is only the adrenal androgens, DHEA and DHEA-Sulfate, which undergo a marked decrease in secretion as a person ages. Cortisol, in fact, tends to rise as we age.

Among the most significant consequences of this age-associated loss of adrenal androgens is the impact on an older individual’s immune system, specifically a decrease in cellular immunity. This Immunodysregulation, i.e. “cockeyed” immune system, may explain the propensity to disease observed in the aged. The decline in adrenal androgens correlates as well with age-associated increases in diabetes, atherosclerosis, dementia, obesity and osteoporosis.