Ever since its inception in the 1960s, hormone replacement therapy or HRT for short has been a topic of interest in the field of medicine. It’s taken great strides in recent years, and although we understand it better than ever before, some dilemmas remain in the general public.
For example, one of the main questions regarding HRT is whether the gains outweigh the risks. The short answer is, yes — if the therapy is administered properly. When HRT is mentioned, usually it’s assumed that it refers to female hormone replacement, with TRT or testosterone replacement therapy being its opposite. Even though female and male hormones aren’t the only type of HRT, they are the ones administered most often. Here’s everything you need to know about hormone replacement therapy:
The Basics of Hormones
Hormones serve the function of being our body’s chemical messengers. Endocrine glands are the organs that produce them, and there’s plenty of different types of hormones. They control various processes in our bodies, such as growth, development, sexual functions and reproduction, metabolism and even mood. The gender-specific hormones which are often used in HRT and TRT have huge effects on our behavior by inciting significant changes within cells, tissues, and organs.
However, different hormones are produced in varying amounts. Furthermore, deficiencies need to be carefully measured in each case, so the right amount of hormones can be administered. It’s effortless to go overboard with it, and that can cause all sorts of medical issues and put you at risk.
Estrogen and Progesterone — the Female Hormones
With estrogen and progesterone, it’s important to remember that a female’s ovaries produce them and regulate the development of secondary sex characteristics as well as control the menstrual cycle. Three basic types of estrogen are estrone, estradiol, and estriol, with the addition of progesterone. They impact various areas of female life: mood, sleep quality, water retention, body fat levels, and intercourse functions.
While both men and women produce estrogen, women produce more than men. However, sometimes female levels of estrogen and progesterone could be out of balance, caused by illness, specific cancer treatments, and aging. It can have different symptoms as a result, which is why HRT can be necessary.
Testosterone — the Male Hormone
Testosterone is produced by the Hypothalamic-Pituitary-Testicular axis (HPTA) and serves as the male’s primary natural hormone. Similarly to estrogen, testosterone also affects sexual characteristics, but that’s not its only area of impact. It plays a significant role in almost every aspect of male development, from birth to pubertal changes, affecting libido, sexual functioning, but also fat distribution and partitioning of human muscle.
Both women and men produce testosterone, but men produce ten times more than females as it is so vital for their proper functioning. Anything from male mental acuity to stress coping capacity and sperm production is affected by testosterone. Its deficiency can cause a multitude of problems, same as with estrogen and progesterone in women. So how have HRT and TRT developed to answer the issues of hormone imbalance in men and women?
History of Hormone Research and Therapy
During the 1930s, a Canadian researcher and co-discoverer of insulin, James Bertram Collip, was the man who studied ovarian and gonadotrophic hormones, eventually managing to extract estrogen. At first, this hormone was used to treat common menopause symptoms such as hot flashes, but in the 1960s it became more widespread.
In 1962, the first estrogen pill called Premarin entered the market. It was marketed as the youth pill for women, boasting amazing effects that echoed especially with the older population. Doctor Robert Wilson, who popularized it, went so far as to call menopausal women “castrates” if they weren’t taking hormones. The consensus created by biased sources created an image of hormone therapy that didn’t quite fit reality, especially in the way it was being administered.
It was only during the 1990s that hormone therapy started to be questioned. Eventually, the study by the Women’s Health initiative in 2002 revealed that Premarin and Prempro did not decrease women’s chances of getting heart disease if they took it. However, the study did show an increased risk of blood clotting, breast cancer, and stroke.
HRT had a long way to go since then to reduce the risks and increase the benefits. Let’s have a look at what modern HRT does.
Hormone Replacement Therapy — How It Works
Hormone replacement can affect different endocrine glands. All of them receive feedback from the hypothalamus, which is located just above the brain stem. The neurohormones produced by the hypothalamus are the primary tool in regulating specific processes of the autonomic nervous system and metabolism. It is how the endocrine glands are controlled. Hypothalamus has the final say in the workings of the pituitary, pineal, thymus, thyroid, adrenals, pancreas, testes and ovaries.
HRT is not only used to treat symptoms of menopause. It can successfully address other hormone-caused issues such as diabetes (by regulating the production of insulin,) premenstrual syndrome, thyroid problems, endometriosis, post-partum depression, infertility, weight gain, etc.
When it comes to HRT, it’s most important to get the dosage right and make sure that the artificial hormones have the same chemical structure as the naturally occurring human hormones. It is why tests are mandatory, so healthcare professionals could adequately customize the hormone therapy to fit each patient’s needs. Mass-produced HRT formulations can be suitable, but everyone’s hormonal makeup is fundamentally different. What works for you may not work for someone else, even if they exhibit similar symptoms.
Hormone replacement therapy has the goal of optimizing the functioning of endocrine glands, helping with the process of aging and enhancing the quality of life. It has come a long way since the first mass-produced pills that were expected to help everybody. Today, with custom-developed HRT, the treatment is getting more efficient while minimizing the risks that can come with hormone replacement. But as with any medication, caution and careful testing are advised.
Author: Kirill Vesselov
Kirill Vesslov is our resident writer about health and wellness as well as our pharmacy services.