Pros and Cons of Adult Hormone Replacement Therapy (HRT)

adult hormone replacement therapy

Adult hormone replacement therapy is a controversial and hot bed topic for a variety of reasons, and it’s not possible to address all of them here in detail. However, one issue with adult hormone replacement therapy is a lack of understanding of what each type of therapy can and cannot offer men and women, including the pros and cons of each type of therapy. In fact, in some cases the term “therapy” may be misleading, as use of HRT in certain situations is not medically advisable and so is not therapeutic at all.

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Perhaps the most important thing to remember before you start any type of hormone replacement therapy is to have a medical professional check your hormone levels to determine whether a deficiency exists and if so, how severe it is. Only then will you be able to determine the best course of treatment, if any. No one should initiate hormone replacement therapy without medical supervision.

What is Adult Hormone Replacement Therapy?
According to the National Cancer Institute, the definition of hormone replacement therapy is “treatment with hormones to replace natural hormones when the body does not make enough.” Using this definition, HRT can include hormones to treat a malfunctioning thyroid, for example. In fact, insulin is a hormone, so people who are diabetic and using insulin might be said to be taking HRT.

However, the HRT for adults we focus on here involves forms commonly associated with the term and include
• Estrogen
• Progesterone
• Testosterone
• Human growth hormone (HGH) (Note that HGH is typically prescribed for children and adolescents who are experiencing growth-related issues. That use is not discussed here.)

These types of HRT are typically sought after by men and women for the following reasons:
• For women, to relieve symptoms of menopause or postmenopause and/or to combat aging
• For men, to relieve symptoms of andropause (male menopause), to achieve better athletic performance, and/or to combat aging

Estrogen Replacement
Estrogen replacement is typically reserved for women, for whom it has the potential to provide a wide range of benefits. When prescribed for men, it usually is to address the risk of osteoporosis.

Women often turn to estrogen replacement therapy to address symptoms that are significantly affecting their quality of life. That said, the pros of estrogen replacement therapy can include:
• Stronger bones
• Improved vaginal lubrication and better sexual function
• Relief from muscle pain and aches
• Enhanced mood
• Relief from hot flashes and night sweats
• Better sleep
• Improved symptoms of urinary frequency
• Possible improvement in memory and cognitive functioning

A higher risk of the following conditions is associated with estrogen replacement therapy:
• Blood clots
• Stroke
• Heart attack
• Breast and endometrial cancers
• Gallbladder disease

Estrogen replacement is available as a pill, patch, injection, cream, vaginal tablet and cream, and spray.

Progesterone Replacement
Progesterone replacement therapy is usually targeted at women who are seeking help from menopausal symptoms, such as hot flashes, mood swings, weight gain, fatigue, bone loss, night sweats, and mental fogginess. Use of progesterone replacement also may help protect women against ovarian, breast, and endometrial cancers, reduce or prevent uterine fibroids, reduce the risk of heart disease, assist thyroid hormone function, and regulate blood clotting.

In most cases, progesterone replacement is delivered as a bioidentical cream, although oral forms are prescribed occasionally. It’s important to note that progesterone replacement is not the same as progestin, which is a synthetic formula used in birth control pills.

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Progesterone replacement for men can provide a variety of benefits as well, especially for those older than 50 who may be exhibiting changes associated with a rise in estrogen levels, such as fat accumulation and an increase in breast tissue. Use of progesterone replacement may result in
• Better urinary flow (important for men with prostate issues such as enlarged prostate and prostatitis)
• Increased muscle mass and tone
• More energy
• Reduced risk of heart disease
• Weight loss
• Enhanced mood
• Better libido

Side effects associated with the use of progesterone replacement can include changes in appetite, stomach upset, fluid retention, drowsiness, allergic rashes, fever, headache, depression, breast enlargement or discomfort, altered menstrual cycles, weight gain, and fatigue, among others.

Testosterone Replacement
Testosterone replacement is typically prescribed for men, especially those who are experiencing symptoms of andropause, such as depression, fatigue, loss of muscle tone and mass, reduced sex drive, accumulation of body fat (belly fat in particular), erectile dysfunction, mood swings, and hot flashes. Among women who are going through menopause, symptoms can be worse if their testosterone levels are low.

Some of the benefits associated with testosterone replacement include:
• Increase in energy levels, stamina, and endurance
• Weight loss
• Faster metabolism
• Less hot flashes
• Stronger bone mineral density and less risk of osteoporosis
• Decline in low-density lipoprotein (LDL) cholesterol
• Stronger immune function
• More lean muscle mass
• Improved sleep
• Better ability to concentrate, focus, and remember
• Healthier skin, hair, and nails

Testosterone replacement is best delivered via injection, a topical cream/gel, or a transdermal patch. Possible side effects include irritation at the injection site, enlarged breasts (men), mood changes, nausea, vomiting, fast or slow heartbeat, mouth or gum irritation, appetite changes, weakness or fatigue, and pounding in the ears.

Human Growth Hormone
HGH is produced by the pituitary gland and, as its name implies, it promotes growth and is primarily intended for use in children and adolescents who have growth issues. Its other attributes include regulation of body fluids, muscle and bone growth, body composition, fat and sugar metabolism, and heart function.
Levels of HGH begin to decline between the ages of 20 and 30 and drop about 14 to 15 percent every 10 years. Therefore, adults who want to help restore their HGH levels as they get older sometimes seek HGH injections.

However, the only Food and Drug Administration (FDA) approved uses for HGH in adults include HGH deficiency, chronic renal insufficiency, intrauterine growth retardation, Prader-Willi syndrome, Turner’s syndrome, and muscle-wasting disease associated with HIV/AIDS. Use of HGH for anti-aging is not FDA approved.

Adults can receive HGH safely and legally if they seek the assistance of a physician who can test for a deficiency of HGH (using dynamic endocrine testing and confirmed with a stimulation test), write a prescription, and supervise treatment. At National HRT, for example, it is emphasized how important it is for adults to be assessed individually and that treatment be customized for each person’s unique needs.

Adults who take HGH injections may experience one or more of the following benefits:
• Better mental cognition
• Younger appearance due to improvements in skin health
• Weight loss
• Muscle gain
• High energy level
• Increased libido
• Stronger bone mineral density
• More stable emotional state
• Help with erectile dysfunction
• Lower bad (LDL) cholesterol

HGH replacement therapy is associated with possible side effects, including the following:
• Development of impaired glucose tolerance and diabetes
• Recurrence or progression of tumors in individuals with preexisting tumors
• Intracranial hypertension
• Bone defects
• Kidney problems
• Worsening of hypothyroidism
• Pancreatitis

References
National HRT
WebMD. Human growth hormone
World Health.net. Age-related HGH decline

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