The Need for Hormone Replacement - Essay Example

?Running head: HORMONE REPLACEMENT THERAPY Hormone Replacement Therapy Insert Here Insert Affiliation Here Hormone Replacement Therapy Introduction: With advancements in medical science, it has now become possible to overcome any shortcomings, limitations or inconveniences concerning human health. Thanks to unconventional medical procedures, altering one’s innate characteristics, viz., gender, genetic makeup, physical appearances, etc., is not impossible anymore. One of the most significant advances of medical sciences is in the field of Hormonal Replacement Therapy (HRT). HRT is used to replace or replenish any hormone that the body is deficient in, or is not able to synthesize anymore. While the most common use of HRT is the replacement of the estrogen hormone in postmenopausal women, it has found use in many other clinical applications. Some of these include thyroid hormone replacement therapy in patients suffering from hypothyroidism and androgen replacement therapies in treating male hypogonadal disorders. HRT is a very vast and expansive subject. Through this paper, an attempt is made to discuss some hormonal replacement therapies, their uses and side effects. I. The need for hormone replacement and their various applications The basic question in dealing with HRT is to first ascertain why it is actually needed. Hormonal replacement is required for the treatment of many disorders where the normal synthesis of a vital hormone is either malfunctioning or is not functioning at all. For instance, Levothyroxine (L-thyroxine) is used for thyroid hormone replacement in those suffering from hypothyroidism (Cygan and Rucker, 1983, p. 232). In case of menopausal women suffering from symptoms like hot flushes and night sweats, estrogen replacement therapy has largely helped in relieving the unpleasant symptoms of menopause (Barrett-Connor, 1998, p. 457). In other cases, testosterone replacement therapies are being explored for use in counteracting male “andropause”, a term used to refer symptoms like hot flushes, decreased libido and mood swings observed in ageing men (Biundu and Shippen, 2000, p. 429). As is evident, hormonal replacement therapies are vital in most cases, and more and more individuals are considering HRT for getting rid of inconveniences in health. A. Use of HRT in menopausal women 1. Symptoms When the menstrual cycle in women ceases, they are said to have attained menopause. A majority of the menopausal women does not experience any troublesome symptoms and the type and severity of symptoms vary across different races and ethnicities (Barrett-Connor, 1998, p. 457). After the attainment of menopause, the vaginal wall gets thinner and becomes less vascular, leading to symptoms like dyspareunia, i.e. painful intercourse, and vaginal dryness. Hot flushes, mood swings, insomnia and night sweats are other common symptoms (Barrett-Connor, 1998, p. 457). Menopause occurs any time between the ages of 45 to 56 years (Abernethy and Tiran, 2002, p. 2). The level of estrogen hormone dips, thereby aggravating the symptoms. Decreased levels of estrogen lead to increase in vaginal pH, which reduces immunity to infections, decreased blood flow and elasticity, and dryness (Abernethy and Tiran, 2002, p. 16). In view of all these unpleasant symptoms, physicians often recommend HRT. 2. Treatment Estrogen replacement therapies are used to treat these symptoms. “Hot flushes and night sweats are the only symptoms universally reported to respond (usually almost immediately) to oestrogen” (Barrett-Connor, 1998, p. 457). If left untreated, hot flushes disappear in a year or two in some women, and stay for more than 20 years in some others. Intravaginal estrogen helps in treating these symptoms and prevents the risk of urinary tract infection by modifying vaginal microbial populations (Barrett-Connor, 1998, p. 457). Furthermore, the dosage of estrogen hormone in replacement therapies is designed to prevent bone loss and endometrial cancer (p. 460). B. Use of HRT in andropausal men 1. Symptoms Symptoms of andropause in men are treated with hormonal supplements and replacement therapies. Middle-aged men are said to experience “andropause”, when they have testosterone deficiency, which is the major cause of all the symptoms characterizing andropause. Once a man reaches a certain age, “an undetected decline in testosterone will continue, and an increased risk of early death from stroke, heart attack, diabetes, or hypertension could result” (Biundu and Shippen, 2000, p. 429). Common symptoms include impotence, depression, mood swings, lethargy and weakness. 2. Treatments Several methods for the treatment of these symptoms include boosting the production of the hormone by stimulating the pituitary gland or testicles, or by replacement of the hormone itself (Biundu and Shippen, 2000, p. 430). The testosterone hormonal replacements are administered intramuscularly or with the help of topical creams, lozenges, gels or lotions and even implantable hormone pellets that are implanted subcutaneously (Biundu and Shippen, 2000, p. 430). The use of hormone replacement therapies is increasing in popularity and these are considered as alternatives to anti-ageing treatments. C. HRT for other disorders Hormonal replacement therapies are of high utility in the management of any disorder or health concern that manifests due to abnormality in the production and synthesis of a hormone. Therefore, many disorders resulting from such malfunctions are being treated with HRT. Some of them are discussed as follows: 1. Hypothyroidism Primary hypothyroidism that results from the failure of the thyroid gland to produce the hormone thyroxine, and secondary hypothyroidism, that results from inadequate synthesis of thyrotropin hormone by the pituitary gland and thyrotropin releasing hormone by the hypothalamus, both can be treated using appropriate HRTs (Cooper, p. 107). Levothyroxine sodium, i.e. L-thyroxine, is commonly used for thyroid hormone replacements and “Periodic thyroid-stimulating hormone determinations can be used to confirm the adequacy of replacement” (Cygan and Rucker, 1983, p. 232). 2. Diabetes insipidus Diabetes insipidus may result from malfunctions in the secretion of the vasopressin hormone. Through HRTs using vasopressin hormones or desmopressin, which is a synthetic form of vasopressin, this condition can be treated effectively (Zimmerman and Uramoto, p. 18) C. HRT for transgenders Apart from being used for the treatment of symptoms relating to medical disorders and health concerns, HRT is also used for medical treatment of transsexuals. Transgender people often opt for cross-sex hormonal treatments to convert from their natural sex to the opposite sex. “Cross-sex hormonal treatment is desired by such patients to successfully live as a member of their identified gender” (Moore et al, 2003). Based on the requirements of the conversion, i.e. male to female, or female to male, appropriate hormonal replacements using testosterone or estrogen are done. II. Side-effects and implications of HRT While the use of HRT is now commonplace, a number of side-effects are being reported through clinical trials and studies. Side effects to hormone replacement therapies in menopausal women include an increased risk of blood clots, ovarian cancer and blood clots, and an increased risk of breast cancer and heart disease is also being reported “Hormonal replacement therapy side effects’, 2011). Moreover, in sight of the use of hormonal therapies to alter the body’s physiology, “Many health professionals have concluded that altering a woman's physiology will always increase risks over time” (Watkins, 2003). Furthermore, hormonal replacement therapies for other purposes have also been reported to have considerable side effects. HRTs used for transgenders have been confirmed to cause depression, elevated liver enzymes, breast cancer, decreased IGF, decreased insulin sensitivity and several other serious side effects (Moore et al, 2003). It was considered that natural hormone therapy has lesser side effects when compared to synthetic hormonal drugs. However, this notion is false. A number of cases have been reported where companies have misused this notion to increase of their products. For instance, case of such a misuse is reported by the TheAge, which reports Gary Aaron, a medical entrepreneur who was prosecuted in the Federal court for “misleading and deceptive conduct” and spreading the false notion that natural HRT was “safe alternative to synthetic HRT (Brown, 2011). HRT, synthetic or natural, will always have incumbent side effects and the choice of going for these treatments is at the behest of the users. Conclusion: As discussed, HRT has proven to be beneficial in the treatment and relief of a number of symptoms and disorders. It is thus evident that HRTs will continue to be popular among people as long they meet their expectations. However, the side effects of these cannot be undermined and “playing” with human physiology and nature will always have unfathomed implications. Wisdom lies in a balanced use of these treatment modalities and in practicing moderation in the use of hormonal replacements. References Abernethy, K., Tiran, D. (2002). The menopause and HRT. China: Hardcourt Publishers Ltd. Barrett-Connor, E. (1998). Hormone replacement therapy. British Medical Journal, 317, 457-461. Biundo, B., Shippen, E. (2000). Testosterone De?ciency in Men: New Treatments for Andropause, International Journal of Pharmaceutical Compounding, 4(6), 429-431. Browne, R. (2011, August 14). Menopause experts warn against doctor pushing 'untested' HRT. Scientific American. Retrieved from http://www.theage.com.au/national/menopause-experts-warn-against-doctor-pushing-untested-hrt-20110813-1is6g.html. Cooper, D.S. (n.d.). Thyroid hormone replacement therapy for primary and secondary hypothyroidism. In A. W. Meikle (Ed.), Hormone replacement therapy (pp. 107-118). New Jersey: Humana Press Inc. Cygan, R., & Rucker, L. (1983). Thyroid hormone replacement. Western Journal of Medicine, 1(2), 550-554. “Hormone Replacement Therapy Side Effects”. (n.d.). hormonereplacementtherapysideeffects.org. Retrieved from http://hormonereplacementtherapysideeffects.org/. Moore, E., Wisniewski, A., & Dobs, A. (2003). Endocrine treatment of transsexual people: a review of treatment regimens, outcomes, and adverse effects. The Journal of Clinical Endocrinology & Metabolism, 88(8), 3467-3473.  Watson, D. (2003, September 15). Hormone Hysteria? Hormone replacement therapy may not be so bad. theage.com.au. Retrieved from https://www.scientificamerican.com/article.cfm?id=hormone-hysteria. Zimmerma, D., Uramoto, G. (n.d.). Diabetes insipidus in pediatrics. In A. W. Meikle (Ed.), Hormone replacement therapy (pp. 3-18). New Jersey: Humana Press Inc. Read More