What is hormone replacement therapy?
The human body produces a multitude of different messenger substances. Some of these hormones are only produced at certain times or in certain phases of life. The sex hormones in women, for example, decrease rapidly during the menopause and this sudden loss of hormones leads to some symptoms which are so pronounced in some women that the menopause becomes a disease. However, the hormones can be replaced artificially so that the hormone loss is less sudden and the woman can adjust to it. This is called hormone replacement therapy.
When is hormone replacement therapy useful?
The most common reason for hormone replacement therapy is the onset of menopause. Many women suffer from hot flashes, sleep disorders, mood swings and other symptoms during this phase. These symptoms are due to the sudden drop in hormone production and can therefore be treated with artificially supplied hormones.
These artificially supplied hormones are mostly estrogen preparations. However, this therapy is only recommended in the case of very pronounced symptoms. Hormone replacement therapy is not recommended as a protection against diseases such as osteoporosis, as the side effects are too strong if taken over a long period of time.
Other reasons for hormone replacement therapy are various diseases which lead to a limited hormone production already at a younger age. Early removal of the ovaries also leads to a kind of menopause, which can be prevented by hormone replacement therapy. Hormone replacement therapy is also available for men. In this case testosterone can be replaced, as men can also have a similar change in hormone production in old age. In sex-modifying interventions in transgender patients, hormones of the desired sex are also administered artificially.
Preparations for hormone replacement therapy
The hormones used during menopause are mostly estrogens and progestins. Estrogens can be given in various forms: Each of these is sold by different distributors under different names. The most commonly prescribed drug is Presomen Compositum (with conjugated estrogen, among others).
Kliogest and Activelle (containing estradiol) and Climopax (with conjugated estrogen) are also frequently used. The patch that is most frequently written down is Estragest. In addition to the estrogens, women are given the antagonist progestin.
This is not necessary after removal of the uterus.
- Micronized estradiol is a natural estrogen and can be given through the digestive system and skin.
- Oestradiol valerate is a precursor of estradiol and is given orally (as an oral tablet).
- Conjugated estrogens are obtained from mare’s urine and are also to be taken in tablet form.
- Estriol is a weak but natural estrogen. The standard dosage is not effective against osteoporosis. Oestriol can be used as an ointment form directly in the genital area where it counteracts the breakdown of the mucous membrane.
- Ethinyl estradiol is a very strong, artificial estrogen, but it is only used for contraception and therefore not during menopause.
