Hormone Therapy for Women
Some older men and women suffer from serious symptoms caused by the natural aging process. Fortunately, bio-identical hormone replacement therapy can help them cope with the changes caused by sudden drop of hormones, a condition which can predispose them to osteoporosis, heart disease, and other age-related diseases.
Due to aging, it is normal for women to experience significant drop in their hormonal levels, however, some suffer from hot flashes and other discomfort associated with menopause such as vaginal itching, burning, and pain especially during a sexual intercourse. To address such symptoms, some patients are advised to undergo hormone therapy in which they take estrogen and progestin, which is a man-made version of progesterone.
The Benefits of Hormone Replacement
Nowadays, hormone replacement therapy is no longer routinely recommended for long-term use as it may increase certain risks. For this reason, many doctors only use this treatment as a short-term relief for menopausal symptoms and protection against certain conditions such as:
Colorectal cancer: Research studies have shown that hormone replacement therapy can reduce the risk of colon cancer that primarily affects the large intestine.
Osteoporosis: As women age, they become vulnerable to hip fractures and other related injuries due to osteoporosis in which their bones become brittle. Fortunately, several studies have suggested that hormone therapy can prevent bones from becoming fragile.
Heart disease: If taken during early post-menopausal stage, estrogen can decrease the risk of heart disease among female patients. It is important to note that this hormone is often prescribed along with progestin because the former alone has been found to increase the risk of uterine cancer. However, women who became menopause due to hysterectomy or surgical removal of the uterus can take estrogen alone.
Ideal Candidates for Hormone Therapy
If used as a short-term relief for menopausal symptoms, hormone replacement therapy often outweighs the risks especially if a woman experiences decrease in bone mass, moderate to severe hot flashes, premature menopause (her period stopped before the age of 40), and premature ovarian failure.
In general, patients suffering from premature ovarian failure and premature menopause are ideal candidates for hormone therapy because it has been found to reduce the risk of osteoporosis, breast cancer, and heart problems. According to studies, these individuals face more health risks compared with women who have experienced menopause around the age of 50. Research studies have also suggested that younger women who undergo early menopause can benefit from hormone therapy which can reduce the risk of coronary heart disease and osteoporosis.
Not Ideal Candidates
Not all women who are exhibiting menopausal symptoms are considered a good candidate for hormone replacement therapy due to risks. For instance, patients with history of blood clots, heart disease, and breast cancer are often discouraged to take the treatment because it further increases their risks.
Aside from increasing the risk of breast cancer especially for women with a family history of the disease, hormone replacement therapy also results to more abnormalities during mammogram which is an important test for patients who are at higher risk of developing breast cancer. Also, women who can tolerate the post-menopausal symptoms and individuals who are only concerned with memory loss should not take hormonal replacement therapy because they can use other treatments which can even provide better reliefs.
Making Hormone Therapy Safer
There are many ways to minimize the potential risks associated with hormone replacement therapy and one of these is by using the lowest effective dose in the shortest time possible. But in case that a patient needs longer-term treatment to address her severe menopausal symptoms, it is a requirement to conduct regular follow-up to determine if the benefits continue to outweigh the risks.
Another way to minimize the risks is to use the best delivery method. For instance, women who are only experiencing vaginal dryness, itching, and discomfort are often advised to use vaginal tablet, ring, or cream instead of skin patch or oral medication. In this way, they will experience relief using the lowest effective dose of estrogen.
Lastly, giving hormone therapy during the early menopausal years is the best way to minimize the risk of heart disease. For this reason, women who are under the age of 60 may consider having this treatment as long as they are suffering from intolerable menopausal symptoms and have no history of breast cancer, heart disease, and blood clots.
Hormone Replacement Therapy for Men
Men also experience a significant decline in hormone levels caused by aging; for this reason, they may seek testosterone replacement therapy which can reduce the risk of diabetes, osteoporosis, heart disease, and other age-related medical conditions. According to research studies, low levels of testosterone can result to metabolic syndrome in which a man experiences high blood pressure and abnormal cholesterol, increasing the risk of stroke, heart attack, and death.
Common Physical Symptoms Associated with Low Levels of Testosterone
- decrease in body hair
- decrease in muscle mass
- increase in body fat
- lower levels of hemoglobin which may lead to anemia
- osteoporosis in which the bones become fragile and prone to injuries
- erectile dysfunction
Aside from these physical symptoms, some older men suffer from reduced sex drive, depression, and difficulty concentrating; consequently, they may also experience decreased sense of well-being and mood swings. The best way to detect abnormal levels of testosterone is through a blood test that is usually performed early in the morning because this is when the hormone levels are at their highest. In many cases, several examinations are conducted because the concentration of this male hormone fluctuates throughout the day.
The Benefits of the Treatment for Male Patients
Men with alarmingly low levels of testosterone often suffer from high blood pressure, low numbers of “good cholesterol” or HDL, elevated blood sugar, and high levels of triglycerides, which is a type of fat found in the blood. These common signs of metabolic syndrome may be treated by hormone replacement therapy. According to a recent study, male patients with low levels of testosterone who received hormone therapy have increased levels of “good cholesterol” just after one year of treatment. It has also reduced their levels of “bad cholesterol” by one-fourth to one-third, resulting to smaller potbellies and lower risk of heart attack, strokes, and other age-related problems.
Compared with hormone therapy for women, testosterone replacement has not been associated with increased risk of heart disease and other problems for some patients with certain diseases or medical conditions. However, some experts have suggested that further studies must be conducted in order to strengthen this claim. Meanwhile, some doctors also believe that hormone replacement for women are fundamentally different from testosterone therapy because the benefits of the latter are the same with older and younger patients. (As mentioned before, younger women enjoy more benefits and less risk from the treatment compared with patients aged 60 years and older.)
Delivering Testosterone Hormone
There are many ways to deliver this male hormone in order to treat the symptoms and risks associated with testosterone deficiency. These include the following examples:
- skin patch worn either on the body or scrotum, which is the sac containing the testicles
- testosterone gel
- mucoadhesive material that is applied above the teeth twice a day
- oral medications
- intramuscular injections which are often administered every two to three weeks
It is important to note that each of these delivery methods has advantages and disadvantages which must be taken into consideration. To be on the safe side, a doctor has to guide his patients in choosing the best approach for the hormone replacement therapy.
Things to Keep in Mind When Considering Therapy
Because prostate cancer is a slow-growing tumor that “feeds” on testosterone, a patient must be first ruled out from the disease before starting the treatment. And to be on the safe side, most doctors recommend routine checkups while on treatment.
Aside from a regular prostate examination, hematocrit, which is a test for monitoring red blood formation, is also important since testosterone can increase red blood cells. In theory, too much of these cells can predispose a person from heart attack and stroke. In general, men with prostate cancer and breast cancer should not take hormone replacement therapy because it may aggravate their condition.
Possible Side Effects
Most doctors believe that with the right dosage and use of testosterone, hormone replacement therapy is generally safe. However, some patients may experience side effects such as oily or acne skin, changes in urination (more frequency or decreased stream), mild fluid retention, decreased in testicular size, aggravated sleep apnea in which a person experiences frequent night time awakenings, and breast enlargement. In very rare cases, oral testosterone replacement can cause liver problems, although administering this male hormone via skin patches and other transdermal techniques has not yet lead to this problem up to this day.
Another important consideration is the risk of temporary or permanent infertility; for this reason, doctors do not recommend hormone replacement for younger men and patients who are planning to have children of their own. The problem happens when the testes stop producing their own testosterone because it is given from outside, resulting to the complete shut down of sperm production. But if a younger patient really needs to undergo testosterone replacement therapy, his doctor will most likely recommend “banking” his sperm beforehand; so in case the treatment results to permanent fertility, he can still have his own children.