Hormone therapy
Use of hormones in medical treatment
Hormone therapy or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also be referred to as hormonal therapy or antihormone therapy . The most general classes of hormone therapy are oncologic hormone therapy , hormone replacement therapy (for menopause), androgen replacement therapy (ART), oral contraceptive pills , and Gender-affirming hormone therapy .
Types
Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT), is for women with menopausal symptoms. It is based on the idea that the treatment may prevent discomfort caused by diminished circulating estrogen and progesterone hormones, or in the case of the surgically or prematurely menopausal, that it may prolong life and may reduce incidence of dementia.[ 1] It involves the use of one or more of a group of medications designed to artificially boost hormone levels. The main types of hormones involved are estrogen , progesterone , or progestins , and sometimes, testosterone . It is often referred to as "treatment" rather than therapy.
Hormone replacement therapy for people with hypogonadism and intersex conditions (e.g., Klinefelter syndrome , Turner syndrome )
Androgen replacement therapy (ART) in males with low levels of testosterone due to disease or aging. It is a hormone treatment often prescribed to counter the effects of male hypogonadism[ 2] or for men who have lost their testicular function to disease, cancer, or other causes.[ 3] It is sometimes used for late-onset hypogonadism (so-called "andropause"), but the significance of a decrease in testosterone levels is debated and its treatment with replacement is controversial. The Food and Drug Administration (FDA) stated in 2015 that neither the benefits nor the safety of testosterone have been established in older men with low testosterone levels.[ 4]
Gender-affirming hormone therapy for transgender people introduces sex steroids associated with the gender that the patient identifies with (notably testosterone for transgender men and estrogen for transgender women ). Some intersex and non-binary people may also undergo hormone therapy. Cross-sex hormone treatment for transgender individuals is divided into two main types: feminizing and masculinizing.
Hormonal therapy for cancer
Chemical castration of men or sex offenders with paraphilias or hypersexuality
Growth hormone therapy for growth hormone deficiency
Thyroid hormone replacement in hypothyroidism
Antithyroid therapy in hyperthyroidism
Glucocorticoid and/or mineralocorticoid replacement in conditions such as Addison's disease
Antiglucocorticoid therapy in Cushing's syndrome
Insulin therapy in type 1 diabetes
Oral contraceptive pills for various purposes including birth control
Menstrual suppression
Bioidentical Hormone Replacement Therapy is a bioidentical hormone replacement therapy uses hormones that are chemically identical to those the human body produces. One effective form of BHRT is hormone pellet therapy, which involves implanting tiny pellets under the skin that release hormones over time to balance hormonal levels, potentially alleviating symptoms such as chronic fatigue, irritability, and sexual dysfunction.[ 5] [ 6]
See also
References
^ 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 .
^ Kang, DY; Li, HJ (January 2015). "The effect of testosterone replacement therapy on prostate-specific antigen (PSA) levels in men being treated for hypogonadism: a systematic review and meta-analysis" . Medicine . 94 (3): e410. doi :10.1097/MD.0000000000000410 . PMC 4602637 . PMID 25621688 .
^ Giwercman, A; Lundberg Giwercman, Y (2015). "Hypogonadism in young men treated for cancer" . Hormones . 14 (4): 590– 7. doi :10.14310/horm.2002.1650 . PMID 26859600 .
^ Staff (3 March 2015). "FDA Cautions About Using Testosterone Products for Low Testosterone Due to Aging; Requires Labeling Change to Inform of Possible Increased Risk of Heart Attack And Stroke" . FDA . Retrieved 5 March 2015 . . NEJM Perspective piece: Nguyen, CP; et al. (20 August 2015). "Testosterone and "Age-Related Hypogonadism"--FDA Concerns" . The New England Journal of Medicine . 373 (8): 689– 91. doi :10.1056/nejmp1506632 . PMC 8905399 . PMID 26287846 . . Popular summary: Tavernise, Sabrina (March 3, 2015). "Drugs Using Testosterone Will Label Heart Risks" . New York Times . Retrieved March 19, 2015 .
^ "What is Bioidentical Hormone Replacement Therapy?" . WebMD . Retrieved 2024-07-26 .
^ Oropeza, Yosbel (2023-10-19). "Hormone Pellet Therapy: What It Is, Why It Works, and How a Compounding Pharmacy Can Help" . Wells Pharmacy Network . Retrieved 2024-07-26 .
Androgens (incl. AAS Tooltip anabolic–androgenic steroid )
Antiandrogens
AR Tooltip Androgen receptor antagonists Steroidogenesis inhibitors
Antigonadotropins
D2 receptor antagonists (prolactin releasers ) (e.g., domperidone , metoclopramide , risperidone , haloperidol , chlorpromazine , sulpiride )
Estrogens (e.g., bifluranol , diethylstilbestrol , estradiol , estradiol esters , ethinylestradiol , ethinylestradiol sulfonate , paroxypropione )
GnRH agonists (e.g., leuprorelin )
GnRH antagonists (e.g., cetrorelix )
Progestogens (incl., chlormadinone acetate , cyproterone acetate , hydroxyprogesterone caproate , gestonorone caproate , medroxyprogesterone acetate , megestrol acetate )
Others
Estrogens
ER Tooltip Estrogen receptor agonists
Steroidal: Alfatradiol
Certain androgens /anabolic steroids (e.g., testosterone , testosterone esters , methyltestosterone , metandienone , nandrolone esters ) (via estrogenic metabolites)
Certain progestins (e.g., norethisterone , noretynodrel , etynodiol diacetate , tibolone )
Clomestrone
Cloxestradiol acetate
Conjugated estriol
Conjugated estrogens
Epiestriol
Epimestrol
Esterified estrogens
Estetrol †
Estradiol
Estradiol esters (e.g., estradiol acetate , estradiol benzoate , estradiol cypionate , estradiol enanthate , estradiol undecylate , estradiol valerate , polyestradiol phosphate , estradiol ester mixtures (Climacteron ))
Estramustine phosphate
Estriol
Estriol esters (e.g., estriol succinate , polyestriol phosphate )
Estrogenic substances
Estrone
Estrone esters
Ethinylestradiol #
Hydroxyestrone diacetate
Mestranol
Methylestradiol
Moxestrol
Nilestriol
Prasterone (dehydroepiandrosterone; DHEA)
Promestriene
Quinestradol
Quinestrol
Progonadotropins
Antiestrogens
ER Tooltip Estrogen receptor antagonists (incl. SERMs Tooltip selective estrogen receptor modulators /SERDs Tooltip selective estrogen receptor downregulators )Aromatase inhibitors Antigonadotropins
Androgens /anabolic steroids (e.g., testosterone , testosterone esters , nandrolone esters , oxandrolone , fluoxymesterone )
D2 receptor antagonists (prolactin releasers) (e.g., domperidone , metoclopramide , risperidone , haloperidol , chlorpromazine , sulpiride )
GnRH agonists (e.g., leuprorelin , goserelin )
GnRH antagonists (e.g., cetrorelix , elagolix )
Progestogens (e.g., chlormadinone acetate , cyproterone acetate , gestonorone caproate , hydroxyprogesterone caproate , medroxyprogesterone acetate , megestrol acetate )
Others