Hormone Replacement Therapy
As we age, our bodies go through many internal and external fluctuations. Reduced hormonal activity is among these changes that can lead to profound adverse effects on your physical and mental well-being. For this reason, many people turn to hormone replacement therapy to restore their hormonal balance and reduce the side effects associated with lower levels of certain hormones in the body. If you're considering giving hormone replacement therapy a shot but are unfamiliar with the treatment, fret not. In this article, we'll break down the nitty-gritty details of hormone replacement therapy to help you make a better choice. So, let's get to the chase without further delay!
What is Hormone Replacement Therapy and Why It’s Needed?
We know that hormones control and regulate most of our body's basic functions. They function as the internal communication system of the body that links cells throughout the body. They coordinate every bodily function, such as growth, digestion, libido, and the immune system. Hence, when your hormones spiral out of control, even a touch, they can cause serious implications for your health and well-being. Hormone replacement therapy can help reinstate your body to its best shape.
Hormone replacement therapy is simply a medical treatment aimed at replacing the dropping levels of hormones the body is no longer capable of producing and protecting health in the long run. In addition, it relieves various symptoms related to menopause in women, such as feminine area discomfort, hot flashes, bone loss, etc. In men, it can help restore various bodily functions, such as sexual drive and reproductive function, maintaining healthy bones and muscles, etc.
Hormone Imbalance in Women
As we know, as women approach their late 40s or early 50s, their ovaries stop releasing an egg every four weeks, and they no longer get their monthly periods. It indicates that they will not be able to have children naturally. HRT is a commonly used treatment that replaces lower levels of female hormones to relieve menopausal symptoms in women. Estrogen and progesterone are the most crucial hormones in women's reproductive systems and during menopause. Estrogen is responsible for stimulating the release of an egg, while progesterone helps to prepare the uterus for egg implantation. During the natural process of aging or as a result of a hysterectomy, the amount of eggs decreases, and so does the estrogen level. Some of the other downsides of a fall in the production of estrogen include hot flashes, sweating, mood swings, osteoporosis, loss of libido, urinary problems, thinning of hair, sleep disorders, lower fertility, difficulty with memory and concentration, accumulation of fat in the abdomen, hair loss, feminine area discomfort or dryness, and smaller breasts. The symptoms are usually more severe during the perimenopausal and menopausal phases and decline within 2 to 5 years after the postmenopausal phase.
Types of Female Hormone Replacement Therapy
There are various forms of Female Hormone Replacement Therapy. You can consult your doctor about the pros and cons of each before making a final decision. Here are the most commonly used methods of administering hormonal replacement therapy in women to replace the levels of estrogen and progesterone:
- Hormone Replacement Tablets: Tablets are one of the most common and simplest ways to give women hormone replacement therapy. You can find estrogen-only tablets or estrogen combined with progesterone. Normally, the suggested dose is one tablet a day.
- Hormone Replacement Patches: These skin patches are another convenient and common method of receiving hormone replacement therapy. You must stick a patch to your skin and replace it every day.
- Estrogen Gel: The topical application of estrogen gel is also a popular and easy way to apply HRT-like skin patches. You'll need to rub the gel onto your skin once every day.
- Estrogen Implants: During the procedure, a small pellet-like implant is placed under the skin, usually on the stomach. The process involves numbing the skin with a local anesthetic. The implant keeps releasing estrogen and works for several months.
Hormone Replacement Therapy Routines
The hormone replacement therapy routine is set according to the stage of menopause. Your doctor will assess whether you're at the early stage of menopause or have been facing the symptoms for some time before deciding your treatment routine.
The two treatment routines are:
- Cyclic HRT: Also known as sequential Hormone Replacement Therapy, this is recommended for women experiencing menopausal symptoms but still getting their periods. In Monthly Cyclic HRT, estrogen is taken daily, and progesterone is taken for the last 14 days of the menstrual cycle. 3-Monthly Cyclic HRT involves taking estrogen daily and progesterone for 14 days every three months. The first is used if you have regular periods, while the second is for women with irregular periods, so you have periods every three months.
- Continuous Combined HRT: A woman in her postmenopausal stage (if she has not had her period for one year) is usually given this treatment routine. It includes taking estrogen-only or combined estrogen and progesterone continuously every day.
Hormone Imbalance in Men
It's common for male hormonal levels to decline with age. Therefore, Hormone Replacement Therapy is used in men as well. Men are given testosterone during the treatment. This hormone is required for the development of male sex organs and the manifestation of male characteristics, such as facial hair. Male Hormone Replacement Therapy is often used to treat hypogonadism, which causes the male body to produce a very low amount of testosterone. Some men are born with this condition, while some may develop it later in life. Without the optimal testosterone level, men can have issues like lower sex drive, impotence, infertility, osteoporosis, weaker muscles, and loss of facial or body hair. Male Hormone Replacement Therapy includes providing the missing testosterone to restore its optimal level for sexual function, preventing osteoporosis, boosting energy, and strengthening the muscles. Additionally, Male Hormone Replacement Therapy is used for men undergoing a sex change.
Types of Male Hormone Replacement Therapy
If you're considering hormone replacement therapy to compensate for the lower testosterone level in your body, your doctor might suggest the following options.
- Intramuscular Testosterone Injections: Testosterone is injected into the muscles of the buttocks during this procedure. The treatment is repeated every two or three weeks.
- Testosterone Patches: You'll be asked to apply a testosterone patch to your arm, buttocks, back, or abdomen daily. It's crucial to rotate the application sites of these patches.
- Topical Testosterone Gel: The gel is applied daily to the arms, shoulders, or abdomen.
Bioidentical Hormone Replacement Therapy
Bioidentical refers to a drug with the same molecular and chemical structure as the hormones occurring naturally in the body. Some people might confuse them with natural hormones, but, in reality, these are prepared in a lab. Bioidentical Hormone Replacement Therapy is a type of Hormone Replacement Therapy that has become the talk of the town in recent years. The therapy claims to be a natural solution to hormonal issues among men and women. It helps to improve and restore the dropping or out-of-balance hormonal levels and eliminate the pesky symptoms that come with menopause in women and hypogonadism in men. Besides, it can ease symptoms of cancer treatments or certain conditions, like adrenal and thyroid disorders, osteoporosis, insulin resistance, and fibromyalgia.
Bioidentical Hormone Therapy includes giving hormones procured from plant-based estrogen, progesterone, and testosterone. These hormones are identical in their chemical composition to the ones produced in the human body. These plant hormones come in tablets, skin patches, creams, gels, implants, and injections. Some drug companies make bioidentical hormones, while others are custom-made by pharmacies according to a doctor's instructions. The process of customizing bioidentical hormones is known as compounding and involves combining or altering the ingredients to fulfill a person's specific needs. The FDA approves some forms of manufactured bioidentical hormones, while none of the custom-made bioidentical hormones are FDA-approved.
Side Effect of Male Hormone Replacement Therapy
The Risks of using testosterone are a primary drawback of male hormone therapy. Some side effects are more serious, while others are relatively minor. Some minor risks of taking testosterone include fluid retention, frequent urination, and acne breakouts. The serious side effects may include:
High doses of testosterone can lead to various serious issues in men, including infertility, sleeping problems, prostate disorders, breast enlargement, reduced testicle size, elevated cholesterol level, increased risk of stroke, decreased sperm count, and increased amount of red blood cells in the body. Increased red blood cells can lead to high blood pressure, muscle pain, chest pain, blood clots, and blurry vision. Some studies show that higher testosterone levels given to treat hypogonadism may cause the prostate to enlarge. It's mandatory to get regular checkups and tests while taking male hormone replacement therapy to detect and treat any of these side effects.
Risks of Female Hormone Replacement Therapy
After widespread speculation about the potential risks of using Hormone Replacement Therapy, women became more mindful and cautious about whether they should go for the therapy. However, according to several healthcare professionals, the Endocrine Society, the American College of Obstetricians and Gynecologists, and the North American Menopause Society, the list of benefits outweighed the potential risks for many women. The risks associated with using Hormone Replacement Therapy mainly depend on the type of hormone therapy used, the dose, and the duration of taking the medication. Here are a few of the risks associated with Hormone Replacement Therapy:
- Breast Cancer: Taking breast cancer screening tests regularly is important due to the potentially increased risk of breast cancer during hormone replacement therapy.
- Weight Gain: Many women using hormone replacement therapy believe their medication will make them gain weight. However, there is no scientific evidence that supports this assertion.
- Blood Clots or Thrombosis: Studies suggest that hormone replacement therapy can lead to a greater risk of blood clots. However, some analyses show no increase in the risk of blood clots when you use hormone replacement therapy gel, cream, or skin patches. Since the chances of menopausal women having blood clots are usually quite low, the overall risk due to hormone replacement therapy tablets is still considered small. Indicators be aware of redness, pain, leg swelling, sudden breathlessness, coughing up blood, and chest pain. Let your doctor know about any sudden changes in your body.
- Muscle and Bone Problems: Changes to the structure or function of muscles and bones are often observed in women using hormone replacement therapy. Mild painkillers can be used to manage and control these aches and pains. Some women may develop joint pains, which often settle down after a few weeks of the therapy. Weight-bearing exercises like cycling, running, walking, or gym exercises can aid in building up and protecting the bones. In severe cases of bone thinning, women can develop osteoporosis and bone fractures if osteoporosis lasts for a few years.
Who Should Use Hormone Replacement Therapy?
Despite all the potential health risks and side effects, hormone replacement therapy is still considered the most effective way of treating various problems caused by dropping levels of hormones. The benefits offered by hormone replacement therapy outperform its associated risks in healthy people. People suffering from menopausal symptoms, hypogonadism, or loss of bone mass, stopped having periods before age 40, had their ovaries removed, or lost the function of ovaries before their 40s can benefit from hormone replacement therapy.
Who Should Avoid Hormone Replacement Therapy?
Hormone replacement therapy is not deemed suitable for anyone who has or previously had breast, womb, or ovarian cancer, has a history of thrombosis, has a liver disorder, has uncontrolled or untreated hypertension, or is pregnant. Alternative treatments to hormone replacement therapy are recommended under these circumstances. Your doctor might suggest other strategies to reduce the symptoms associated with decreased hormonal activity to reduce the risk of certain health issues, including heart disease and osteoporosis. A healthy diet, lifestyle changes, and medications are some commonly used alternatives to hormone replacement therapy.
Hormone replacement therapy is one of the best options for treating symptoms caused by lower levels of hormones in the body. Though hormone replacement therapies come with many potential risks, you can minimize these risks with the help of your doctor. If you're not fit for hormone replacement therapy, there are many alternative ways of relieving the symptoms and protecting your health in the long run. Discuss your symptoms and health risks with your doctor to decide whether hormone replacement therapy is appropriate.