Who Needs Hormone Replacement Therapy

There are many reasons that an individual may need hormone replacement therapy. A woman may request hormone replacement therapy (HRT) as she transitions into menopause as early as in her mid-40s, where symptoms such as flushes, night sweats, sleep disturbance, along with mood changes, loss of sexual interest, cognitive changes and decreased strength start to impact her quality of life. Men go through comparable changes as well, such as increased weight, sexual dysfunction, depression, loss of strength, and endurance and cognitive changes that may lead them to request hormone replacement therapy.

If you are considering hormone replacement therapy, it is important to consult with a doctor to determine the best course of action for your body and your particular situation. A knowledgeable doctor will be able to effectively guide you through this process.

Age for Replacement

There is no typical age in either sex for starting HRT. For instance, if a woman undergoes removal of her ovaries in her 20s or 30s, she is an excellent candidate for estrogen replacement. Men may demonstrate very low testosterone levels as early as their 40s. Aside from the symptomatic improvement of all aspects of aging, HRT most importantly provides protection against cardiovascular disease, diabetes, dementia, cancer, and degenerative diseases such as osteoporosis. In many instances, these disease processes can be reversed, as proven in well controlled medical studies.

Just as there is no minimum age for initiation of treatment, there is no age ceiling as well. Many women starting HRT in their late seventies for osteoporosis have seen dramatic reversals and strengthening of their bones.

HRT vs. Other Forms of Therapy

The alternatives to hormone replacement therapy are limited in scope and effectiveness. Essentially, over the counter products alleviate mild symptoms such as flushes and night sweats or can exert a testosterone-like effect. However, measurement of blood or urine levels of these substitutes rarely shows any significant levels which can back off diseases of the aging process. They offer no preventative attributes, their effects tend to be short-lived, and many of the benefits are anecdotal.

Points to Consider

The first consideration many individuals face is what they are committing to. Regarding only estrogen replacement therapy (ERT), there is the alternative of a simple approach. That is only the use of a topical estrogen along with oral progesterone to prevent breast and uterine cancer. Commercially made hormones, in limited doses that are usually covered by insurance, can be used for symptom relief and for limited cardiovascular protection, however, therapeutic levels oftentimes are not reached. They are excellent for symptom relief and require little monitoring.

Vitamin D and other supplements compounded by the pharmacist to one’s individual needs for optimization of blood or urine levels requires a greater commitment to comply with daily usage, willingness to be monitored on a periodic basis, and understanding that compounded medications are more costly than commercially made products and may not be covered by insurance. The benefits, however, are far greater than the simple approach outlined above.

Men and HRT

Men are not immune from loss of hormone support as they age. Starting in their mid-twenties testosterone levels decrease, thyroid hormone activation and effectiveness slows down, and adrenal function becomes more stressed. As men age they become susceptible to hardening of the arteries, heart disease and stroke, diabetes, erectile and libido problems, prostate cancer, excess weight gain, concentration and focusing difficulties, and depression.

By replacing the age-related diminished hormones, all the previous maladies can be arrested and even reversed. In addition, there is an uplift in mood and sexual function. An increase in muscle mass produces more strength and endurance along with reduced fatigue.

Genetically Prone Individuals

The need for hormone replacement therapy is a combination of both genetic and environmental factors. For instance, an inherently impaired immune system will be poorly impacted by environmental toxins such as cigarette smoke or pesticides. Osteoporosis has a strong genetic determinant that can be worsened by risk factors such as deficiencies in dietary calcium and Vitamin D, smoking, and excessive caffeine intake.