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Hormone replacement therapy

From Wikipedia
hormone replacement therapy
medical procedure type
Subclass ofhormone therapy, replacement therapy Edit
Discoverer or inventorMoritz Schiff Edit
Useshormone Edit
Opposite ofantihormone therapy Edit

Hormone replacement therapy (HRT), dem sanso know as menopausal hormone therapy anaa postmenopausal hormone therapy, be a form of hormone therapy dem use to treat symptoms associated plus female menopause.[1][2] Effects of menopause fi include symptoms such as hot flashes, accelerated skin aging, vaginal dryness, decreased muscle mass, den complications such as osteoporosis (bone loss), sexual dysfunction, den vaginal atrophy. Dem mostly be caused by low levels of female sex hormones (e.g. estrogens) wey dey occur during menopause.[1][2]

Estrogens den progestogens be de main hormone drugs dem use insyd HRT. Progesterone be de main female sex hormone wey dey occur naturally wey e sanso be manufactured into a drug wey be used insyd menopausal hormone therapy.[1] Although both classes of hormones fi get symptomatic benefit, progestogen specifically be added to estrogen regimens, unless dem remove de uterus, to avoid de increased risk of endometrial cancer. Unopposed estrogen therapy dey promote endometrial hyperplasia den dey increase de risk of cancer, while progestogen dey reduce dis risk.[3][4] Androgens like testosterone sam times be used as well.[5] HRT be available thru a variety of different routes.[1][2]

De long-term effects of HRT on most organ systems dey vary by age den time since de last physiological exposure to hormones, wey der fi be large differences insyd individual regimens, factors wich make analyzing effects difficult.[6] De Women's Health Initiative (WHI) be an ongoing study of over 27,000 women wey begin insyd 1991, plus de most recent analyses wey dey suggest say, wen dem initiate within 10 years of menopause, HRT dey reduce all-cause mortality den risks of coronary disease, osteoporosis, den dementia; after 10 years de beneficial effects on mortality den coronary heart disease no longer be apparent, though der be decreased risks of hip den vertebral fractures den an increased risk of venous thromboembolism wen dem take am orally.[7][8]

"Bioidentical" hormone replacement be a development insyd de 21st century wey e dey use manufactured compounds plus "exactly de same chemical den molecular structure as hormones wey be produced insyd de human body."[9] Dese mainly be manufactured from plant steroids[10] wey fi be a component of either registered pharmaceutical anaa custom-made compounded preparations, plus de latter generally no be recommended by regulatory bodies secof dema lack of standardization den formal oversight.[11] Bioidentical hormone replacement get inadequate clinical research to determine ein safety den efficacy as of 2017.[12]

De current indications for use from de United States Food and Drug Administration (FDA) dey include short-term treatment of menopausal symptoms, such as vasomotor hot flashes anaa vaginal atrophy, den prevention of osteoporosis.[13]

Side effects

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Side effects insyd HRT dey occur plus varying frequency den dey include:[14]

Common

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  • Headache
  • Upset stomach, stomach cramps anaa bloating
  • Diarrhea
  • Appetite den weight changes
  • Changes in sex drive anaa performance
  • Nervousness
  • Brown anaa black patches on de skin
  • Acne
  • Swelling of hands, feet, anaa lower legs secof fluid retention
  • Changes in menstrual flow
  • Breast tenderness, enlargement, anaa discharge
  • Sudden difficulty wearing contact lenses

Uncommon

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  • Double vision
  • Severe abdominal pain
  • Yellowing of skin anaa eyes
  • Severe depression
  • Unusual bleeding
  • Loss of appetite
  • Skin rash
  • Lassitude
  • Fever
  • Dark-colored urine
  • Light colored stool
  • Chorea[15]

References

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  1. 1 2 3 4 Stuenkel CA, Davis SR, Gompel A, Lumsden MA, Murad MH, Pinkerton JV, Santen RJ (November 2015). "Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline" (PDF). J. Clin. Endocrinol. Metab. 100 (11): 3975–4011. doi:10.1210/jc.2015-2236. PMID 26444994.
  2. 1 2 3 Santen RJ, Allred DC, Ardoin SP, Archer DF, Boyd N, Braunstein GD, Burger HG, Colditz GA, Davis SR, Gambacciani M, Gower BA, Henderson VW, Jarjour WN, Karas RH, Kleerekoper M, Lobo RA, Manson JE, Marsden J, Martin KA, Martin L, Pinkerton JV, Rubinow DR, Teede H, Thiboutot DM, Utian WH (July 2010). "Postmenopausal hormone therapy: an Endocrine Society scientific statement". J. Clin. Endocrinol. Metab. 95 (7 Suppl 1): s1 – s66. doi:10.1210/jc.2009-2509. PMC 6287288. PMID 20566620.
  3. ↑ Shuster, Lynne T.; Rhodes, Deborah J.; Gostout, Bobbie S.; Grossardt, Brandon R.; Rocca, Walter A. (2010). "Premature menopause or early menopause: Long-term health consequences". Maturitas. 65 (2): 161–166. doi:10.1016/j.maturitas.2009.08.003. ISSN 0378-5122. PMC 2815011. PMID 19733988.
  4. ↑ Eden KJ, Wylie KR (1 July 2009). "Quality of sexual life and menopause". Women's Health. 6 (4): 385–396. doi:10.2217/WHE.09.24. PMID 19586430.
  5. ↑ Ziaei S, Moghasemi M, Faghihzadeh S (2010). "Comparative effects of conventional hormone replacement therapy and tibolone on climacteric symptoms and sexual dysfunction in postmenopausal women". Climacteric. 13 (3): 147–156. doi:10.1016/j.maturitas.2006.04.014. PMID 16730929.
  6. ↑ Manson, JE; Aragaki, AK; Rossouw, JE; Anderson, GL; Prentice, RL; LaCroix, AZ; Chlebowski, RT; Howard, BV; Thomson, CA; Margolis, KL; Lewis, CE; Stefanick, ML; Jackson, RD; Johnson, KC; Martin, LW; Shumaker, SA; Espeland, MA; Wactawski-Wende, J; WHI, Investigators. (12 September 2017). "Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials". JAMA. 318 (10): 927–938. doi:10.1001/jama.2017.11217. PMC 5728370. PMID 28898378.
  7. ↑ Langer, RD; Hodis, HN; Lobo, RA; Allison, MA (February 2021). "Hormone replacement therapy – where are we now?". Climacteric. 24 (1): 3–10. doi:10.1080/13697137.2020.1851183. PMID 33403881. S2CID 230783545.
  8. ↑ Løkkegaard, E; Nielsen, LH; Keiding, N (August 2017). "Risk of Stroke With Various Types of Menopausal Hormone Therapies: A National Cohort Study". Stroke. 48 (8): 2266–2269. doi:10.1161/STROKEAHA.117.017132. PMID 28626058. S2CID 207579406.
  9. ↑ Files, JA; Ko, MG; Pruthi, S (July 2011). "Bioidentical hormone therapy". Mayo Clinic Proceedings. 86 (7): 673–80, quiz 680. doi:10.4065/mcp.2010.0714. PMC 3127562. PMID 21531972.
  10. ↑ "Bioidentical hormones". Cleveland Clinic. 12 December 2012.
  11. ↑ Conaway E (March 2011). "Bioidentical hormones: an evidence-based review for primary care providers". J Am Osteopath Assoc. 111 (3): 153–64. PMID 21464264.
  12. ↑ Cobin, RH; Goodman, NF; AACE Reproductive Endocrinology Scientific, Committee. (1 July 2017). "Position Statement on Menopause – 2017 Update" (PDF). Endocrine Practice. 23 (7): 869–880. doi:10.4158/EP171828.PS. PMID 28703650. Archived from the original (PDF) on 1 March 2019. Retrieved 1 March 2019.
  13. ↑ "USPTF Consensus Statement". 2012. Archived from the original on 2013-05-30. Retrieved 14 May 2013.
  14. ↑ Deleruyelle, LJ (2017). "Menopausal Symptom Relief and Side Effects Experienced by Women Using Compounded Bioidentical Hormone Replacement Therapy and Synthetic Conjugated Equine Estrogen and/or Progestin Hormone Replacement Therapy, Part 3". International Journal of Pharmaceutical Compounding. 21 (1): 6–16. PMID 28346192.
  15. ↑ Suchowersky O, Muthipeedika J (December 2005). "A case of late-onset chorea". Nat Clin Pract Neurol. 1 (2): 113–6. doi:10.1038/ncpneuro0052. PMID 16932507. S2CID 11410333.
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