Growth hormone, menopause and ageing: no definite evidence for 'rejuvenation' with growth hormone.

BACKGROUND Estrogens regulate growth hormone (GH) secretion and modulate the tissue responsiveness to GH. After the menopause, and during ageing, a decline in GH secretion (somatopause) is physiologically observed. This article (i) provides a brief overview of the different regulators of GH secretion, (ii) reviews the mechanisms involved in age-related changes in GH concentrations, with particular emphasis on the interrelationships between menopause and GH, and (iii) discusses the interventions aimed at the restoration of GH and insulin-like growth factor (IGF-1) circulating levels. METHODS A systematic literature search was conducted in the PubMed database using the search terms 'Growth Hormone', 'Somatopause' and 'Menopause'. The search included full English articles covering the period 1972-2008. We selected 234 relevant citations. We also included three chapters from books. RESULTS Estrogen deficiency may contribute, through its action on GH, to the complex physical and metabolic alterations of menopause. Several attempts have been made to restore the GH and IGF-1 levels within the young adult range. CONCLUSIONS There is no definite evidence that elderly subjects really benefit from treatment with GH or GH secretagogues. Strategies aimed at enhancing spontaneous GH secretion such as sleep and exercise are safer and certainly less expensive than GH supplementation regimen.