Adrenal Androgens and Aging

Dehydroepiandrosterone (DHEA) and its active metabolite DHEA sulfate (DHEAS), are steroid hormones synthesized and excreted primarily by the zona reticularis of the adrenal cortex in response to adrenocorticotropic hormone (ACTH). They exert weak androgenic effects and are therefore considered precursor hormones that need to be transformed to potent androgens or estrogens to exert their effects. The potential clinical roles of DHEA/DHEAS have been studied extensively, as previous epidemiologic and prospective studies associated the age-related decrease of DHEA/DHEAS levels with higher prevalence of degenerative disorders and increased frailty and mortality from all causes in the elderly, attributing to adrenal androgens anti-ageing properties. But do they really suggest that they are hormones related to longevity or just another pointless alchemy against ageing? This chapter summarizes the physiology and pathophysiology of adrenal androgen synthesis, secretion and action and provides current evidence regarding their efficacy in the management of aging-related disorders.