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Hormone Therapy – Effects, Uses and Risks

Hormone therapy is a medical treatment in which hormones are used to regulate or balance hormone levels in the body, addressing deficiencies or hormone-dependent conditions.

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Things worth knowing about "Hormone Therapy"

Hormone therapy is a medical treatment in which hormones are used to regulate or balance hormone levels in the body, addressing deficiencies or hormone-dependent conditions.

What is Hormone Therapy?

Hormone therapy (also referred to as hormonal therapy or hormone treatment) is a medical approach in which natural or synthetic hormones are administered to compensate for a hormone deficiency, suppress excess hormone activity, or treat conditions that are driven by hormonal imbalances. Hormones are chemical messengers produced by glands throughout the body that regulate essential functions such as metabolism, growth, reproduction, and mood.

Indications and Areas of Use

Hormone therapy is used across many medical specialties. The most common indications include:

Menopause symptoms: Relief of hot flashes, sleep disturbances, and mood changes through estrogen and progestogen preparations.
Thyroid disorders: Replacement of thyroid hormones in patients with hypothyroidism (underactive thyroid).
Type 1 diabetes mellitus: Insulin therapy as a life-sustaining form of hormone replacement.
Male hypogonadism: Testosterone therapy for men with confirmed testosterone deficiency.
Growth hormone deficiency: Somatropin supplementation in children and adults.
Hormone-sensitive cancers: Anti-hormonal therapy in breast or prostate cancer to inhibit tumor growth.
Gender-affirming hormone therapy: Hormonal treatment to align physical characteristics with gender identity in transgender individuals.

Mechanism of Action

Depending on the therapeutic goal, hormone therapy works in different ways:

Substitution Therapy

When a hormone deficiency is present, missing hormones are supplied externally to restore physiological levels. Classic examples include levothyroxine for hypothyroidism and insulin for type 1 diabetes.

Suppression Therapy

Hormones or hormone analogues are used to inhibit the body´s own hormone production. This approach is used, for example, in the treatment of hormone receptor-positive breast cancer, where estrogen stimulates tumor growth.

Hormonal Stimulation

In reproductive medicine, hormones are used to stimulate ovulation or support embryo implantation during fertility treatments.

Forms of Administration

Hormones can be delivered through various routes:

Oral: Tablets or capsules (e.g., thyroid hormones, estrogen preparations)
Transdermal: Patches, gels, or creams (e.g., estrogen gel for menopause)
Injections: Subcutaneous or intramuscular (e.g., insulin, testosterone)
Vaginal rings or suppositories: For local hormonal effects in the genital area
Nasal spray: Used in certain reproductive medicine protocols

Risks and Side Effects

Like any medical treatment, hormone therapy can have side effects that vary depending on the hormone used, the dosage, and individual patient factors:

Increased risk of thrombosis and pulmonary embolism (especially with oral estrogen therapy)
Potential increase in breast cancer risk with long-term combined estrogen-progestogen therapy
Weight gain, fluid retention, or mood changes
Skin reactions at the application site (with patches or injections)
Changes in blood pressure or blood lipid levels

Regular medical monitoring is essential during hormone therapy to carefully weigh the individual benefits against potential risks.

When to See a Doctor

Anyone experiencing persistent hot flashes, unexplained fatigue, unintentional weight changes, menstrual irregularities, or other signs of a hormonal imbalance should consult a healthcare professional. Before starting hormone therapy, a thorough medical history, physical examination, and laboratory tests are necessary to determine the most appropriate treatment.

References

The NAMS 2022 Hormone Therapy Position Statement Advisory Panel – The 2022 hormone therapy position statement of The Menopause Society. Menopause, 2022.
World Health Organization (WHO) – Endocrine System and Hormonal Therapies. WHO Press, Geneva.
Bhasin S. et al. – Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 2018.

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