ABSTRACT
Normal somatic ageing progresses gradually and it causes a reduced function in most of
the major systems of the body (neural, respiratory, cardiovascular, endocrinological, uri-
nary, skeletal, muscle and motor). Why does this ageing take place? Two ageing pro-
cesses have been identified. While cells are continuously being replaced, the terminally
differentiated ones, like those in the brain, undergo “chronological ageing” and are rarely
replaced but others, like skin and the gastrointestinal tract, undergo “replicative ageing”
and are continually renewed (by the time you have read this sentence, 50 million of your
cells have died and been replaced!). Each cell, however, can only multiply a certain num-
ber of times before it dies. Every time a cell divides to make two cells, special zones at
the end of each chromosome (telomeres) shorten. When they reach a critical length, the
cell stops dividing and dies. Pines (2013) in reviewing the literature could not find, how-
ever, any relationship between telomere length and the menopause or the use of hormone
therapy (HT). As more cells are lost, the signs of the damage from ageing (from glucose
cross-linking, free radicals, ultraviolet radiation, activation of oncogenes and agents that
modify DNA or chromatin) become obvious.
