Hormone therapy. What is it for men, women, types

Hormone therapy is a treatment for disorderscaused by insufficient production of its own hormones in the body. Both synthetic and natural types of hormones are used.

What are hormones and how do they affect the body

The endocrine system (endocrine glands) is responsible for the production of hormones. Their role in the body is high, since they are responsible for the normal development and functioning of various systems and internal organs.

Main functions:

• development and growth of bones and body;
• sexual activity, libido;
• regulation of biological rhythms;
• reproductive function;
• condition of the skin and hair;
• full development of the reproductive system and other internal organs.

A deficiency, like an excess of them, can cause many different diseases and health problems.

How hormone replacement therapy works

HRT is aimed at maintaining the required concentration of hormones in the human body. Upon receipt of the substance, the deficiency of the missing hormone is replenished and, thereby, the patient's condition is stabilized.

With a lack of sex hormones (testosterone, estrogen), there is a decrease in sexual and reproductive function. In the case of admission of the necessary amount of substances, an increase in sexual activity is noted, the ability to conceive increases and the general psychosexual well-being improves.

Sex hormones also stimulate the nervous system, so their use is justified in patients and patients with nervous disorders. Treatment helps eliminate signs of apathy, depression, mood swings.

Also, hormones help to normalize the condition in patients after menopause and reduce negative concomitant symptoms (vasomotor disorders).

Is hormone replacement therapy harmful?

Hormone therapy is a method that in some cases can lead to consequences and complications.

Adverse reactions:

• nausea;
• headaches;
• increased appetite;
• general malaise, rapid fatigue;
• muscle spasms;
• acne breakouts;
• blood clots;
• pain in the abdomen;
• violation of the menstrual cycle;
• nervous disorders;
• disturbances in the work of the cardiovascular system;
• heart attack and stroke;
• infertility.

In women, taking hormones is associated with the risk of developing neoplasms in the mammary glands. However, this phenomenon occurs extremely rarely and only when hormones are used for more than 10-15 years.

Also, the risks of complications after HRT increase in obese patients and those who abuse alcohol or smoke.

After completing the course of treatment, some patients experience changes in the body and psychoemotional disorders due to the refusal of hormones and the inability of the body to independently produce the necessary substances.

Indications for taking hormones

Treatment with hormones in men and women is carried out in different ways. Moreover, therapy may differ not only in indications, but also in the regimen and types of hormones used.

For women

In most cases, HRT in women is carried out in connection with age-related changes, as well as with the onset of menopause.

Indications:

• menopause (pre- and post-menopause);
• hormonal disorders caused by various factors;
• surgical interventions related to gender reassignment;
• amenorrhea;
• malignant neoplasms in the area of ​​the mammary glands (cancer);
• diseases of the cardiovascular system;
• the presence of cysts and fibroids in the uterus;
• osteoporosis.

Most often, treatment is prescribed for women after 50, since at this age the onset of menopause occurs, and corresponding manifestations occur.

For men

For men, GTZ is prescribed for sexual and hormonal disorders - a decrease in libido and sexual activity, depression, osteoporosis and pathologies of the cardiovascular system. In some cases, this treatment is used in athletes to develop muscle mass and prevent the accumulation of fat masses. In more rare cases, therapy can be carried out in patients after castration (chemical, drug).

Contraindications to hormone replacement therapy

Hormone therapy is a treatment that is prescribed only in the absence of any contraindications and in case of emergency. It has many different restrictions that you need to be aware of in advance.

Contraindications:

• thromboembolism and thrombosis;
• oncological diseases;
• disorders of fat metabolism;
• functional disorders of the liver, including organ failure;
• bleeding in the vagina or uterus, of an unknown origin;
• neoplasms in the genital area;
• diabetes;
• intolerance to the components of hormonal agents;
• endometriosis and breast tumors;
• epileptic seizures;
• mastopathy;
• bronchial asthma.

Treatment with hormones is carried out only with the permission of a specialist and after conducting the necessary research.

Examination before starting HRT

Several studies are required before hormone therapy is prescribed. First of all, a specialist collects data, conducts a survey, studies anamnesis. Then a gynecological examination is carried out, after which blood and urine tests are prescribed.

After that, the patient is sent for instrumental diagnostics:

• Ultrasound of the pelvic organs.
• Rectal or digital examination of the prostate.
• Mammography.
• Ultrasound of the prostate.
• Prostate biopsy.
• Cytological examination.

In some cases, it may be necessary to consult other related and narrow-profile specialists.

Types of HRT

There are 2 main types of treatment - monotherapy and combination therapy. In the first case, drugs containing one of the hormones are used, in the second, a mixture of several active substances.

Type of HRT	Description
Monotherapy	Estrogens (pre- and postmenopausal)
Combined treatment	Estrogens and progestogens (endometrial carcinoma, hyperplasia)
Combination of male and female sex hormones	Estrogens and androgens
Monotherapy	Progestogens or Androgens

In this case, HRT is also subdivided according to the form of administration:

• pills;
• injections;
• local remedies - creams, ointments, gels, patches.

A foreign manufacturer of hormonal drugs is producing one more dosage form - implants. The devices are installed inside the body and systematically inject the necessary amount of hormones into the blood.

What drugs are prescribed for hormone replacement therapy

Hormonal drugs are selected individually, based on the identified disease and the patient's gender. In this case, therapy should be strictly controlled by the attending specialist, since this method of treatment has high risks of developing adverse reactions and complications.

For endometrial or ovarian cancer in women

In case of malignant lesions of the endometrium, hormonal drugs are prescribed with the progression of the disease, which has a low degree of oncogenicity.

With the development of malignant tumors in the endometrial layer or in the area of ​​the ovaries, drugs containing progestogens, antiestrogens or aromatase inhibitors are used.

Preparations:

• Depo-Provera (USA). It is produced in the form of a suspension for intramuscular administration. The tool belongs to the group of progestogenic drugs. The active substance is medroxyprogesterone acetate. Dosage: 0.4-1 g per week. With a good therapeutic effect, maintenance therapy is prescribed at a dosage of 0.4 g once a month.
• Cyclotal (Mexico). The medicine is available in the form of tablets and belongs to the class of progestogenic drugs. It is prescribed in the treatment of endometriosis caused by the onset of menopause, as well as in endometrial cancer. Dosing regimen: 10 mg orally 3 times a day. The duration of the course is 3 months.
• Duphaston (Netherlands). The medication is made in the form of tablets for oral administration. It belongs to the group of gestagens and is produced on the basis of dydrogesterone. The remedy is effective for endometriosis and other disorders caused by hormonal changes in the body. Admission rules: use during the menstrual cycle for 28 days. Dosage: 1-3 tablets, depending on the severity of the violation.
• Megace (Australia). The drug is produced in the form of tablets based on megestrol acetate. It belongs to the group of gestagenic antineoplastic agents. Dosage: 80-320 mg per day for 2 months.

All funds are subject to prescription and must be applied strictly in accordance with the instructions of a specialist.

For diseases of the prostate gland in men

For diseases of the prostate gland, complex treatment is carried out. At the same time, they are recommended to be used in conjunction with antiandrogenic drugs, since in the first 3-5 days of admission, an exacerbation of symptoms is observed.

The most popular and effective remedy is Digarelix (Firmagon). The drug is produced in the form of injections for subcutaneous administration.

Dosing regimen: in the abdomen of various localization, 120 mg 2 times a day. Supportive therapy is prescribed after a month. The dosage should be 80 mg per day.

With ovarian cysts, fibroids

Fibroids and ovarian cysts are the most common benign pathological phenomena.

List of medicines:

• Buserelin (Russia). This drug is produced as a nasal spray and is used for uterine fibroids. Treatment regimen: nasally, 900 mcg per day. A single dose should not exceed 150 mcg. The duration of treatment is according to the recommendations of a specialist.
• Janine (Germany). The medication is made in the form of tablets for oral administration. Dosage: 1 tablet once a day. Duration of admission - according to the doctor's recommendations.
• Utrozhestan (Belgium). The drug is a synthetic analogue of gestagen and is widely used in gynecological and obstetric practice. Dosages are calculated individually, based on the dosage form used.

Also, in the complex therapy of cysts and fibroids, other oral contraceptives can be prescribed, since this group of drugs contains various synthetic hormones.

With menopause

Hormone therapy is a technique that is highly effective in treating various disorders associated with the production of sex hormones. Thus, treatment for menopause allows you to alleviate the condition and prevent the development of various complications.

Preparations:

• Evista (raloxifene). Made in Germany in the form of tablets. The drug is used during the postmenopausal period to relieve symptoms and prevent the development of osteoporosis. Scheme of use: 1 tablet 1 time per day. Duration of treatment - according to the doctor's recommendations.
• Femoston (Netherlands). The medicine is available in pill form. The active ingredients are estrogen and gestagen. The tool belongs to the group of anti-climacteric drugs. Doses: 1 white tablet per day for 2 weeks, then take 1 gray tablet for 14 days.
• Ovestin (Ireland). It is made in the form of tablets and cream based on estriol. The agent has estrogenic activity and is used during the postmenopausal period and in climacteric disorders. Dosage regimen: 4-8 mg for a month. In this case, it is necessary to gradually reduce the dosage. The maintenance dose is 1-2 mg per day.

As an auxiliary therapy, phytoestrogens are used - herbal preparations that are similar in action to synthetic or natural hormones.

For breast cancer

When malignant tumors occur in the breast, anti-estrogen drugs are prescribed, which reduce the level of estrogen and have a depressing effect on neoplasms.

List of the most effective remedies:

• Tamoxifen (Finland). It is produced in the form of tablets with a high antitumor effect. The drug belongs to the group of antiestrogens. Dosages: 20-40 mg per day. The duration of therapy is individual, according to the doctor's indications.
• Sinfen (Russia). The medicine is made in the form of tablets and belongs to the group of antineoplastic agents. It is used in the treatment of malignant tumors (breast or prostate cancer). Dosing features: 20 mg per day. The maximum daily allowance should not exceed 40 mg. The duration of treatment is according to the doctor's recommendations. On average, drug therapy lasts about 5 years.
• Fareston (toremifene). The medication is produced in Finland in pill form. Pharmacological group - antiestrogens with antitumor activity. Admission rules: 3 tablets (60 mg) per day. The course of treatment is long, according to the recommendations of a specialist.
• Abitaxel (Argentina). The tool belongs to the group of anticancer drugs (alkaloids) and is widely used for various malignant tumors. The medicine is produced in the form of a concentrate required for infusion. Dosages are set individually, based on the form and stage of the disease.

It should be borne in mind that such hormonal agents increase the risk of tumor formation in the endometrial layer.

How soon to expect the effect of hormone replacement therapy

Hormone therapy is a method of treatment that requires long-term use of drugs and strict adherence to the rules for taking medications established by the doctor.

The first results from hormone therapy appear in each patient individually. The therapeutic effect depends on the form, stage and severity of the pathological process. As a rule, in most cases, the first noticeable results from HRT can be achieved after 1 month of using hormonal drugs. With mild disorders, as well as during menopause, the effectiveness of medications can occur after a few days of taking the pills.

Cancer conditions may require a longer period. In some cases, the results of hormone treatment for malignant tumors may appear after several months of therapy.

Is there a plant-based alternative to synthetic hormones?

The pharmaceutical market offers a wide selection of various herbal preparations.

Thus, the following remedies can be used for prostate cancer:

• tincture of Manchurian aralia;
• tincture of codonopsis:
• eleutherococcus (tincture);
• Radiola rosea extract;
• extract of lavsei;
• tincture of zamanihi.

These drugs can be purchased at any pharmacy without a doctor's prescription.

In the postmenopausal period, the following dietary supplements can be used to eliminate concomitant symptoms and alleviate the condition:

• Mastofort;
• Climodinone;
• Clement;
• Indinol;
• Klimonorm;
• Tsi-Klim.

For malignant tumors of the mammary glands, agents such as Hexal, Echinacea liquidum, Immunal, Endotenol, Befungin can be used.

Herbal preparations should be used only with the permission of the attending physician.

Can I drink alcohol during hormone therapy?

For the entire period of therapy, one should stop drinking alcoholic beverages, since the combination of alcohol and hormonal drugs can lead to various complications and consequences.

Possible reactions:

• nervous disorders - insomnia;
• disturbances in the work of the kidneys and liver and, as a consequence, the lack of results from treatment (in some cases, a worsening of the condition was noted);
• the occurrence of side effects - convulsive state, thrombophlebitis, headaches, exacerbation of stomach and duodenal ulcers.

Hormone therapy requires strict adherence to all the rules prescribed by the doctor. It is required to comply with the daily dosage of drugs and undergo systematic studies. This is necessary to track the dynamics of treatment and the patient's condition. When all recommendations are followed, the chances of clinical recovery are significantly increased.

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