Steroid secretion and psychological well-being in men 40+

Current demographic statistics show that modern societies are rapidly aging. Aging in general is accompanied by an increased susceptibility to physical and mental disease as well as an increased risk of mortality. Health care costs are expected to rise enormously. Therefore, successful aging with less disease burden and dependency is emerging as one of the most crucial health care goals of the upcoming decades. Over the last 20 years, research on successful aging in men has increasingly focused on age-related hormonal changes. A gradual reduction in testosterone and dehydroepiandrosterone beginning around die age of 40 has been well documented. At the same age, other steroid hormones including estradiol and Cortisol also show an age-dependent progressive change. These changing patterns of steroid hormone secretion play an essential role for general health and psychological well-being in males over 40. In the following chapter, we will discuss the underlying biological mechanisms of age-related hormonal alterations and elucidate their influence in the context of psychological, sexual, cognitive and physical areas of life in aging men. Considering these widespread consequences due to age-related hormonal changes, we will also discuss the clinical implications for men facing these conditions. Apparent good health or specific lifestyle factors were shown to slow down age-related hormonal changes. Since clinical conditions cannot be prevented for every male by maintaining good health or establishing a healthier lifestyle, hormone replacement represents a reasonable opportunity to overcome certain psychological, sexual, cognitive and physical impairments caused by age-related steroid alterations. Besides individual psychological support for the successful management of severe symptoms of age-related hormonal changes, targeted psychoeducation at a population-based level would, in the long term, be one possibility to inform men about their options and to support them in countering these largely neglected disorders