Hormone Replacement Therapy

What is Hormone Replacement Therapy

With Age and Illness, comes a loss of the normal hormone levels that keep us feeling younger, healthier, with stronger recovery and immune systems.  HRT look to restore levels of hormone functioning to improve livelihood.

Hormone Replace Therapy For Men

Hormone replacement therapy is a bit of a misnomer. It’s natural for men’s testosterone levels to decrease as they get older. So, hormone therapy doesn’t replace anything that is naturally missing.

Testosterone is required for:

  • male sexual development
  • reproductive function
  • building muscle bulk
  • maintaining healthy levels of red blood cells
  • maintaining bone density

However, the natural decrease of this hormone in men typically doesn’t affect overall health any more than the aging process does. Medical experts disagree about the significance of a testosterone level decrease. They also disagree about the health benefits of hormone therapy use to combat the natural aging process in men, especially given the risks.

USES

For use in certain men

Some men with unnaturally low levels of testosterone can benefit from hormone therapy. For example, the condition hypogonadism can cause unnaturally low levels of testosterone. It’s a dysfunction of the testicles that prevents the body from producing the right amount of testosterone.

What's less certain is whether testosterone therapy can benefit healthy men whose testosterone decline is simply caused by aging. This has been a difficult question for researchers to answer. Not many studies have observed the effects of testosterone therapy in men with healthy levels of the hormone. The studies that have were smaller and had unclear results.

Types of hormone therapy for men:

Testosterone Pellets:  Implanted under the skin, they slowly release testosterone over the course of three to six months. A short, simple procedure is performed in your doctor’s office to implant the pellets under the skin, usually near your hip. These pellets are a long-acting form of testosterone therapy. They should deliver a stable, steady dose of testosterone, typically providing the needed level of hormone for four months.

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Hormone Replacement For Women

What is hormone replacement therapy? HRT is a treatment used to augment the body's natural hormone levels, either in the form of estrogen-alone therapy (ET), for women who have had a hysterectomy (or surgical menopause) or as estrogen with progesterone therapy (EPT), for women who experience menopause naturally at midlife.

Why replace hormones?

In addition to thickening the lining of the uterus to prepare it for egg implantation, estrogen — in tandem with progesterone — serves many functions.

It helps the body to process calcium (important for the strengthening of bone), aids in maintaining healthy cholesterol levels, and keeps the vagina healthy.

With the onset of menopause, however, the amount of natural estrogen and progesterone the ovaries produce drops sharply. That, in turn, can lead to such symptoms as hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes, and sleep problems.

It also can boost the risk of osteoporosis. By replenishing the body's estrogen supply, HRT can help relieve menopause symptoms and guard against osteoporosis.

When is estrogen therapy alone appropriate?

Estrogen alone is generally prescribed for women undergoing surgical menopause (the result of a hysterectomy).

When is estrogen/progesterone therapy appropriate?

The combination of estrogen and progesterone is for women who still have a uterus (that is, those who have not had a hysterectomy). For women undergoing menopause naturally, taking estrogen alone can increase the risk of developing cancer of the endometrium (the lining of the uterus).

That's because during the reproductive years, endometrial cells are discharged during menstruation, but when menstruation ceases and the endometrium is no longer shed, the addition of estrogen can cause an overgrowth of uterine cells, which, in turn, can lead to cancer.

Adding progesterone (in the form of progestin, a synthetic version of the hormone) lessens the risk of endometrial cancer by causing the endometrium to shed each month.

Who should consider HRT?

Women with moderate to severe menopausal symptoms, as well as those with a family history of osteoporosis, are candidates for hormone replacement therapy.

Who should not consider HRT?

Women with breast cancer, heart disease, liver disease, or a history of blood clots, as well as women without menopausal symptoms, are not candidates for hormone replacement therapy.

When should a woman begin HRT treatment, and how long will treatment last?

Although the average age of menopause onset is 51 and, in many women, the most severe symptoms often last for two to three years, there are no hard and fast rules about when a woman reaches menopause or about the duration of her symptoms.

Doctors say that taking a low-dose treatment — the most effective way to get HRT's benefits while limiting the possible increased risks of heart disease and breast cancer identified by the Women's Health Initiative (WHI) — for up to five years is reasonable.

How is HRT given?

Both ET and EPT are available as a pill, a gel, a patch, and as a vaginal cream or ring (the latter two are most often recommended only for isolated vaginal symptoms).

Some doctors say there is reason to believe that a low-dose transdermal patch is the best delivery method because it sends the hormones directly into the bloodstream, bypassing the liver and therefore reducing potential metabolic risk factors.

The bottom line on HRT

Hormone replacement therapy is not the cure-all it was once thought to be, but for more severe cases, it remains the best bet for treating menopause's unpleasant symptoms and improving quality of life.

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Hormone Replacement Therapy