Hormone Replacement: Treatment, Effects & Risks

Hormone replacement involves compensating for a hormone deficiency by administering synthetic or natural hormones. It is irrelevant whether the deficiency is absolute or relative. A synonym for hormone replacement is hormone replacement therapy.

What is hormone replacement?

Hormone replacement is the process of compensating for a hormone deficiency by administering synthetic or natural hormones. Hormone replacement refers to the replacement of hormones that are missing or too low in concentration by the administration of synthetic or natural hormonal agents. Hormone replacement is often referred to as hormone replacement therapy. In the narrower sense, the term hormone replacement therapy is often used in connection with the administration of medications during menopause or in gender reassignment procedures. However, hormone replacement applies to any hormones. For example, insulin is administered for high blood sugar. Thyroid hormones are administered for hypothyroidism. The growth hormone somatotropin is administered for short stature. Finally, postmenopausal symptoms are often treated with estrogens. There are hormone substitutions that are absolutely necessary for survival. Other hormone therapies are used to relieve symptoms. However, this can sometimes result in serious side effects. An example is hormone therapy during climacteric in women and climacteric virile in men.

Function, effect, and goals

Hormone substitutions often produce life-saving effects in humans. A hormone must always be replaced when it is missing or when its concentration in the body is much too low. Hormones are essential for the functioning of bodily processes because all bodily functions are controlled by hormones. For example, if the pancreatic islet cells of Langerhans fail, the hormone insulin is no longer produced. Since insulin causes blood sugar to enter the cells, it is essential for the body. Therefore, when it fails, it must be injected daily for life support. In the case of hypothyroidism, in turn, too little thyroid hormone is produced. Since thyroid hormones boost energy metabolism, all bodily processes come to a halt in their absence. Therefore, thyroid hormone replacement is vital in this case. Other hormones control growth, sexual excitability, the course of pregnancy, the menstrual cycle and much more. Furthermore, there are hormones that stimulate other endocrine glands to produce hormones. These include some hormones of the pituitary gland such as follicle stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the gonads to produce hormones. Furthermore, it also includes adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce glucocorticoids, and thyroid-stimulating hormone (TSH), which stimulates the thyroid gland. In addition to these hormones, the pituitary gland also produces a number of hormones that act directly on the organs. Therefore, when the pituitary gland fails, the hormonal regulatory system collapses. Therefore, a substitution of the corresponding missing hormones becomes necessary. In the case of a deficiency of the male sex hormone testosterone, this is often replaced as part of a substitution therapy. The testosterone deficiency may have primary or secondary causes. Its substitution in old age results in a general increase in performance. Before puberty, testosterone substitution may be necessary so that the secondary male sexual characteristics are formed at all. In connection with hormone substitution, the administration of estrogens during the menopause is most frequently discussed. Here, hormone replacement is performed to alleviate severe menopausal symptoms. However, this hormone therapy also carries risks. Therefore, the benefits and risks should be weighed against each other here. The climacteric is characterized by the phase from sexual maturity to the cessation of ovarian hormone production. This is a natural process, but it is associated with sometimes severe symptoms such as hot flashes, sleep disturbances, joint pain, nervousness, muscle aches and much more. If the symptoms become very severe, hormone substitution with estrogens and progestins can prolong the menstrual process a little more. This leads to a weakening of the symptoms.Actually, this case is not a hormone replacement, because estrogen production is naturally stopped by the body. In this case, additional hormones are administered to relieve associated symptoms.

Risks, side effects and dangers

Hormone replacement is often vital, but it can also come with risks. When the body stops producing existential hormones, they must be replaced externally. This applies, for example, to thyroid hormones or insulin. For example, thyroid hormones ensure the maintenance of energy metabolism, and insulin ensures the supply of blood sugar in the cells. Here, there is only a health risk in case of overdose. Hormone replacement in women during the menopause is associated with the most side effects and risks. Actually, instead of hormone substitution, this is hormone therapy. Since estrogen production ceases naturally during the menopause, there is no need for hormone substitution here. In this therapy, the additional estrogens are intended to maintain the menstrual process a little longer in order to alleviate the symptoms that occur during the menopause. However, in addition to the estrogen application, progestins must be administered as antagonists of the estrogens. Otherwise, there is a risk of developing uterine cavity cancer. If the uterus has already been removed, progestins do not need to be applied additionally. Overall, however, there is a risk of adverse health effects with permanent hormone therapy. The risks include the occurrence of breast cancer, ovarian cancer, strokes, thromboses or heart attacks. Thus, hormone therapy for postmenopausal symptoms should be undertaken only if the quality of life is severely compromised and if the benefits clearly outweigh the risks.