Hormone Replacement Therapy
After aging, the body starts to lose normal function part by part. Most commonly, it is the endocrine system, which starts deteriorating. This loss in function of the endocrine system can manifest itself in the form of various disorders. Disorders such as osteoporosis, which is generally caused due to an imbalance in the hormone levels in the body, even though not lethal, can be quite dangerous. Replacing the lost hormones to ameliorate these conditions is called as Hormone Replacement Therapy (HRT).
Role of Estrogen and Progesterone in the Body
Estrogen and progesterone hormones in the body play a wide variety of roles. Traditionally, it has been taught that one of the most important roles that estrogen plays is that it helps to mineralize the bone by increasing the uptake of calcium in the bone. Now, because of the research conducted by Dr. John Lee, MD, author of several best selling books, including "What Your Doctor May Not Tell You About Menopause", and promoted in books by actress Suzanne Somers, it is become evident that progesterone and testosterone make bones stronger. Thus, when levels of these hormones fall in the body, bone demineralization begins to occur causing increased risk of osteoporosis and increased fragility of the bone.
Aim of Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT), aims to reduce the incidences of cases of osteoporosis and other hormone related disorders, by restoring normal balance of the hormones within the body. With the availability of estrogen substitutes such as estradiol and equine estrogens, researchers are trying to determine the combination that would be ideal for treating the reduced levels in the body. Drug companies are injecting a lot of funds in finding the ideal composition of hormones, which a person would need in case of an imbalance. However, such research has failed time and again; and that replacing the hormones artificially can cause severe side effects, and even lead to cancer.
Risks associated with Hormone Replacement Therapy
Hormone replacement therapy generally given to women post menopause includes estrogen and progesterone substitutes. Replacing estrogen levels does bring about significant improvement in conditions such as osteoporosis, however with a price. It is known that 80% of breast cancers rely on estrogen to grow, and in fact, suppression of normal levels of estrogen within the body is supposed to be a modality of treatment for breast cancer. Increasing body estrogen levels in women has been shown to increase the risk of breast and endometrial cancer.
It is also observed that HRT increased the risk of endometrial cancer. In fact, in the 1970s, many women discontinued the use of estrogen due to this increased risk of cancer; and this led to addition of progestin in the regime, to counter balance the effects of estrogen. The addition of progestin seemed to help, but it did not eliminate the increased risk, hence it is still essential that women receiving HRT should be monitored for cancers.
Hormone replacement therapy has also shown to increase the risk of uterine fibroids, which are benign overgrowths of the smooth muscles of the walls of the uterus. In women who have fibroids pre-menopause, it is generally observed that there is a reduction in the benign neoplasm after menopause due to reduced estrogen levels. However, in women taking HRT, the possibility of more uterine fibroids to occur is also present.
Apart from the risk of cancer involved, hormone replacement therapy also has possible cardiac complications. In a study conducted by the NIH in Women’s Health Initiative it was seen that estrogen supplements had shown to increase the risk of deep vein thrombosis and strokes, while estrogen-plus-progestin sub study was shown to increase the risk of pulmonary emboli, along with myocardial infarction, stroke and even invasive breast cancer.
After weighing the risks against the benefits, the NIH was prompt to discontinue with the trials conducted by the Women’s Health Initiative. The U.S. Food and Drug Administration (FDA) also concluded that even though hormone replacement therapy did improve menopausal symptoms, it carried with it severe risks and complications. It is thus recommended by the U.S. FDA that hormone replacement therapy, if at all has to be administered; should be done at the lowest possible dose.
Other Side Effects of HRT
Apart from the above severe complications, other side effects of hormone replacement therapy also occur. These side effects include withdrawal bleeding, premenstrual syndrome (PMS) like symptoms, skin irritation and migraine.
