Man has always been looking for the elixir of life and especially the secret of eternal youth. In the last 10 years, huge strides have been made in research to find out why we age and how to slow down the ageing process while maintaining a good quality of life.
So important were these studies that five of them were awarded Nobel Prize.
Most theories that try to explain why we age focus on the fact that over the years damage accumulates in our cells that our body cannot repair (oxidised proteins, inflammation). All researchers also agree that at least two biological clocks are involved in the ageing process: telomere length and hormones.
«Every time our cells divide, the telomeres at the ends of the DNA get smaller. Our somatic cells divide 40-50 times, then they stop and we enter the aging phase. Also, our hormones, especially those associated with sex, reach peak levels during puberty and then decline and stop being produced during menopause and andropause», explains the κ. Michael Papacharalambous, Specialist Pathologist, Director of Metropolitan Hospital, Vice President of the European Scientific Society for Prevention and Anti-Aging.
During the transition to this stage of life, most women go through a phase in which the levels of their two main hormones, oestrogen and progesterone, are imbalanced, with progesterone mainly decreasing and oestrogen predominating (oestrogenic predominance). In this phase called premenopause, most women experience severe discomfort such as hot flashes, night sweats, migraines, weight gain, decreased libido, depression, which significantly affect their quality of life. At this stage they must follow the rules of healthy living. This is followed by the menopause phase, during which menstruation does not occur for a year. To counter the severe symptoms of menopause and future risks such as osteoporosis, since the 1950s the two main hormones, estradiol and progesterone, have been substituted. This method was called hormone replacement. As a substitute for 17b estradiol, which is the form of oestrogen present in humans, Premarin, which is a mixture of oestrogens taken from the urine of pregnant forebears, was administered. To substitute progesterone, which is the form that exists in humans, progestogen, which is a chemical variant of progesterone, was used. The mixture (premarin and progestogen) was called Prempro.
In 1993 a large study was launched in the USA to test the benefits and risks of using hormone replacement therapy. In 2002 the use of synthetic (chemical) progestogen given in place of natural progesterone was stopped because an increase in the incidence of breast cancer and thrombosis was found in women taking oral oestrogen. So the use of hormone replacement has been significantly reduced, worldwide. A heated public debate then began as to why more natural solutions were not being used, solutions that the big pharmaceutical companies were not promoting. The pioneers in this effort were the famous television personality Oprah Winfrey and the actress and writer Suzanna Somers who they pushed for the use of so-called bio-identical hormones taken from plants such as soy or Mexican yam and prepared to be exact copies of human hormones.
Eventually the FDA, the US Food and Drug Administration, recognised the biosimilar hormones and so women who suffer from severe symptoms during premenopause and menopause can take 17b estradiol in the form of a cream or gel to prevent thrombosis and progesterone (micronized) at night before bedtime. It is important to start as early as possible and the duration of treatment should not exceed ten years.
But menopause is not just about women. Men have the same condition. It is called andropause and is due to the progressive reduction in testosterone levels, resulting in the appearance of symptoms, the intensity of which varies from person to person. Men complain of unexplained fatigue, difficulty in concentrating, irritability, depression, while suffering from osteopenia and loss of muscle mass.
In recent years, research has been revolutionised by studies that found that testosterone does not cause prostate cancer when administered during andropause. However, rules have been laid down for its administration. The testosterone level must be below a certain threshold and the symptoms that accompany andropause must be present.
Testosterone is mainly given in the form of a cream or gel every morning and certain indicators are monitored every 6 months. For those who do not wish to use a daily cream, an injection is also prescribed which is given intramuscularly every 3 months. It has also been found that in obese men and men with metabolic syndrome, testosterone should be measured, as its restoration can reduce the risks of heart disease.
