Medical history (history of illness) represents an important component in the diagnosis of adrenopause. Family history Are there any diseases in your family that are common? What is the general health of your family members? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). Do you feel weak, low in drive? Tired? Do … Adrenopause: Medical History
The following differential diagnoses are equally possible causes of adrenopause: Endocrine, nutritional, and metabolic diseases (E00-E90). Obesity Gonadopause (drop in testosterone) Insulin resistance – decreased effectiveness of the body’s own insulin at the target organs skeletal muscle, adipose tissue and liver. Somatopause (decrease in growth hormone and IGF-1). Addison’s disease (Primary adrenocortical insufficiency) due to … Adrenopause: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by adrenopause:Psyche – Nervous System (F00-F99; G00-G99). Chronic fatigue syndrome Insomnia (sleep disorders) Cognitive deficits – memory impairment, concentration and attention deficits. Reduced performance, fatigue, lack of drive. Erectile dysfunction (ED). Libido disorders Further Immune senescence Sweating, heat exhaustion Altered body … Adrenopause: Complications
Laboratory parameters of the 1st order – obligatory laboratory tests. DHEA-S Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Hormone analyses: total testosterone, SHBG (sex hormone-binding globulin), FSH, prolactin, TSH, possibly IGF-1 (insulin-like growth factor), IGFBP-3 (insulin-like-growth-factor-binding-protein-3), estradiol. Small blood count Inflammatory parameters … Adrenopause: Lab Test
Therapeutic target Improvement of symptoms and complaints indicative of adrenopause. Therapy recommendations DHEA hormone replacement therapy Indications (areas of application) for DHEA hormone replacement therapy The indications for DHEA hormone replacement therapy are: Primary and secondary adrenal insufficiency. Androgen deficiency in postmenopausal women, e.g., after removal of the ovaries or under glucocorticoid therapy (cortisol) DHEA … Adrenopause: Drug Therapy
Obligatory medical device diagnostics. Transrectal prostate sonography (ultrasound examination of the prostate). Electrical impedance analysis (measurement of body compartments/body composition) – for determination of body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass) and total body water incl. body mass index (BMI, body mass index) and waist-to-hip ratio … Adrenopause: Diagnostic Tests
Micronutrient therapy (vital substances) is a useful complementary measure in the treatment of adrenopause Compensation of vital substance deficits (micronutrients) – determination of the individual vital substance additional requirement (vital substance supplementation). Improvement of antioxidant capacity – determination of oxidative stress (vital substance supplementation).
To prevent adrenopause, that is, to delay its onset, attention must be paid to reducing individual risk factors. Behavioral risk factors Stimulants Alcohol Tobacco Physical activity Lack of physical fitness Overweight (BMI ≥ 25; obesity).
The following symptoms and complaints may indicate adrenopause:Mental disorders. Adynamia (decreased performance, fatigue, lack of drive). Chronic fatigue Cognitive deficits – memory impairment, concentration and attention deficits. Insomnia (sleep disorders) Vasomotor vegetative disorders Sweating, heat exhaustion Organic disorders Drop in vitality Immune senescence – slow deterioration of the immune system in the elderly. Libido disorders … Adrenopause: Symptoms, Complaints, Signs
Pathogenesis (development of disease) 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. Beyond … Adrenopause: Causes
General measures Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight. BMI ≥ 25 → participation in a medically supervised weight loss program. Falling below the BMI … Adrenopause: Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection Skin, mucous membranes, and sclerae [sweating, heat episodes; visceral adiposity (abdominal fat ↑), decreased muscle mass (muscle strength ↓)] Auscultation (listening) of the heart. Auscultation of the lungs Palpation (palpation) … Adrenopause: Examination
