Adrenopause (synonyms: DHEA(S) insufficiency, partial; DHEA deficiency; ICD-10-GM E88.9: metabolic disorder, unspecified) primarily describes an exponentially increasing decline in adrenal (originating from the adrenal cortex) DHEA(S) production in adults, which is clinically expressed in the middle years of life in at least partial DHEA(S) insufficiency.
Endocrinologically, adrenopause is manifested by decreased serum levels of dehydroepiandrosterone (DHEA) and DHEA sulfate with unchanged serum levels of cortisol. The latter increases even with age.
In this context, adrenopause is also pathophysiologically associated with the so-called “senile adrenal insufficiency” or partial adrenal insufficiency. Although both andropause and adrenopause cannot be described as a classical “pause”, as in the case of menopause in women in the sense of a final cessation of ovarian function, it can, however, be assumed according to current knowledge that the male climacterium virile (male menopause) finds its beginning in adrenopause.
Adrenopause as such affects both middle-aged men and women.
Frequency peak: adrenopause finds its origin in the exponential decline of DHEA production by the adrenal cortex over the entire course of adulthood, with largely normal serum ACTH levels.The temporal starting point of this progressive decline is the middle of the 4th decade of life, from about the age of 35.
In women, the onset of adrenopause is observed with a distinct temporal caesura, at about 5 years after menopause. Since the observed health decline in men as an expression of the climacterium virile (stage of life in which men’s testosterone levels rapidly decline) begins in temporal agreement with the onset of adrenopause in women, i.e. in the second half of the sixth decade of life, it can be assumed that the onset of adrenopause in men in the sense of a clinical deficit of DHEA(S) also occurs around the age of 56.
Course and prognosis: The diagnosis of adrenopause in the context of the health decline of the aging male plays an increasingly important role in the diagnosis and therapy of male andropause, the climacterium virile. According to current knowledge, the same applies to women in the climacteric.DHEA hormone replacement therapy can be given in the case of confirmed DHEA-specific indications with simultaneously confirmed DHEA-S levels below the age-appropriate sex-specific DHEA-S serum levels for men and women, respectively.
