Traditional treatment of endocrine hormonal deficiency with replacement therapy does not lead to rejuvenation but to potential damage, and hormonal changes among elderly people should be interpreted not only as aging but as specific adaptation for 'successful ageing'.
Key Findings
Background
Aging is acknowledged as a multifactorial, genetically and epigenetically programmed biological process with significant interactions with endocrine disruptions.
The paper frames aging as both a scientific and a social and demographic problem of current relevance.
Interactions between aging and accumulation of endocrine disruptions are described as evidenced.
The review covers endocrine aging across multiple glandular systems including thyroid, adrenal, pituitary, and gonadal axes.
Background
Approximately 150 years of searching for a potential endocrine 'elixir of longevity' has produced contradictive, mutually exclusive, and discouraging results.
The authors describe the historical search as 'variegated' over the 'last 150 years'.
Results of these searches are characterized as 'contradictive, mutually exclusive and even discouraging'.
No single endocrine intervention has been validated as a longevity treatment.
Background
The discovery of reference laboratory intervals of hormonal blood levels specific to elderly people improved the overall understanding of endocrine aging.
The authors state that 'the discovery of referent laboratory intervals of hormonal blood levels among elderly people improved the overall situation'.
This implies that prior assessments of hormonal deficiency in the elderly may have been based on inappropriate reference ranges derived from younger populations.
Age-specific reference intervals are presented as a meaningful advance in the field.
Results
Hormone replacement therapy for endocrine deficiency in elderly individuals does not lead to rejuvenation but to potential damage.
The paper states that 'traditional treatment of endocrine hormonal deficiency with replacement therapy does not lead to rejuvenation but to potential damage'.
This applies to the range of hormonal deficiencies reviewed, including somatopause, andropause, menopause, adrenopause, and hypoprolactinemia.
The finding challenges the clinical reflex to treat all age-related hormonal decline with replacement therapy.
Results
Hormonal changes in elderly people are better interpreted not solely as pathological aging but as a specific adaptation for 'successful ageing'.
The authors state it is 'more accepted to interpret hormonal changes among elderly people not only as aging but specific adaptation for successful ageing'.
This reframing has direct implications for clinical decision-making regarding when and whether to treat age-related hormonal changes.
The concept of 'successful ageing' is used as a framework to reconceptualize endocrine changes in older adults.
Results
The review covers multiple distinct endocrine aging syndromes including thyroid aging, hypercorticism, adrenopause, somatopause, hypoprolactinemia, andropause, menopause, and female hyperandrogenism.
Adrenal aging is addressed through both hypercorticism and adrenopause.
Pituitary aging is addressed through somatopause (growth hormone decline) and hypoprolactinemia.
Male gonadal aging is covered as andropause, and female gonadal aging as both menopause and hyperandrogenism.
Modern data on each of these conditions is presented as part of the review's scope.
What This Means
This research suggests that the widespread age-related changes in hormone levels — such as declining testosterone in men (andropause), declining estrogen in women (menopause), declining growth hormone (somatopause), and changes in thyroid and adrenal function — should not automatically be treated as diseases requiring hormone replacement. After roughly 150 years of trying to use hormones as a fountain of youth, scientists have found that these efforts have not led to rejuvenation and may actually cause harm. A key advance has been the development of hormone reference ranges specifically calibrated for older adults, rather than using young-adult norms to judge whether an elderly person's hormone levels are 'too low.'
The paper proposes a conceptual shift: rather than viewing every age-related drop in hormone levels as a deficiency to be corrected, clinicians and researchers should consider that these changes may represent the body's adaptive response to aging — what the authors call 'successful ageing.' This means the body may be adjusting its hormonal environment in ways that are appropriate and even protective for older physiology, not simply 'breaking down.'
For the general public, this research suggests that older adults and their doctors should be cautious about assuming that normalizing hormone levels to those of younger people is safe or beneficial. The findings underscore the importance of age-specific medical standards and individualized evaluation, rather than a one-size-fits-all approach to hormonal changes that come with getting older.
Mikheev R, Grigoryan O, Volevodz N, Rozhivanov R, Sheremetyeva E, Andreeva E, et al.. (2026). [The unbearable versatility of endocrine aging].. Problemy endokrinologii. https://doi.org/10.14341/probl13774