Hormone Replacement Therapy - Report Example

Human replacement Therapy Introduction: A hormone is described as a “chemical messenger that targets a designated organ and stimulates it to function according to its design.” (Hulem, 2006). Therefore, when hormones stop functioning at their optimum levels after a woman reaches a certain age, she begins to experience symptoms such as vaginal dryness, mood swings, hot flashes insomnia and decreased libido. As pointed out by Hulem (2006) the research has shown that taking hormones helps to reduce these symptoms and therefore it follows that the problem of a decreased libido is also solved when women take hormones and estrogen in particular has been shown to reduce bone loss, vaginal dryness, hot flushes and the other concomitant symptoms that occur with menopause. However, the research has also raised the prospect of other risks associated with HRT, particularly breast cancer, gall bladder disease and endometrial cancer. However, since HRT does successfully address many of the symptoms of menopause of which decreased libido is one, it could positively impact upon a woman’s libido and help restore its function. Human replacement Therapy has for example been used extensively for osteoporosis with women over the age of 50 years, since the mortality rates from fractures when they occur over 50 years is 30 percent at one year and this has remained unchanged in the U.K, for the past two decades (Roberts and Goldacre, 2003), while menopausal flushes are also the case of insomnia and irritability. However, a study in the UK has found that hormone replacement patches may successfully increase the libido of post menopausal women. While hormone replacement pills that combine oestrogen and synthetic progesterone are given to women who are suffering from menopausal symptoms, one of the side effects is that action of the male hormones such as testesterone present in the body may be suppressed. However administering the male hormone may cause undesirable side effects such as growth of excessive facial hair, therefore the HRT patches help by aiding the woman’s body to utilize the testesterone present in her body more effectively.(BBC report, June 11, 2002). Another stud which was conducted by the University of Amsterdam demonstrated that women who took the HRT drug tibolene which is marketed as Livial experienced an increase in libido and this was measured through the blood flow in the vagina when sexually stimulated.(BBC Report, July 9, 1999) In another study that was conducted by researchers at the Yerkes National Primate Research Center, a different kind of finding was obtained.(Pazol 2004). It was shown in this study that female macaques became less interested in sex after they were given medroxyprogesterone which is an active component of Prempo, the most widely used hormone replacement therapy in the United States. The monkeys were also found to be more anxious when MPA was administered rather than when estrogen or a combination of estrogen and natural progesterone was administered. Therefore this study demonstrated that estrogen had the effect of stimulating the libido, however adding progesterone or MPA had the reverse effect and libido was suppressed. A recent study by Magee and Taylor (2006) revealed the results of a long term hormone replacement therapy study, in view of the generally held view that hormone replacement therapy was beneficial in counteracting the effects of menopausal declines and symptoms. They point out that several short term studies that were taken up on hormone therapy have concluded that there are long benefits that could accrue to women from hormone replacement therapy. However the long term study indicated that there were some risks in taking such an approach. From a statistical analytical viewpoint they were able to corroborate the fact that the benefits of long term hormone therapy were in prevention of fractures and the prevention of colon cancer and these results were noted only after five years of continuous use. However, the study also showed that in the case of women who were on continuous long term hormone therapy, there was a higher risk of stroke after three years, thromboembolism, cognitive impairment or dementia, endometrial cancer and a reduced quality of life. Other research also appears to indicate that the conclusions that doctors has drawn about the benefits of Hormone replacement theory mat be premature. For example in a study that was conducted by Francis Grodstein and others from Harvard University, it was demonstrated that about 43 percent of those who were on long term estrogen use reported a higher incidence of breast cancer as compared to non users.(Nemeck 1997). Mishra et al (2006) have undertaken a study among British women in order to examine the cessation of hormone replacement therapy from among various levels in society along different lines, such as their educational levels, social class and cardiovascular risks just after adverse publicity had pointed out the results of two clinical long term trials that showed the negative impact of hormone replacement therapy over time. The study by Mishra et al (2006) examined a total of 1387 women who were 57 years old reported their hormonal use habits and the cessation of the hormones that they were taking. The trends in change in users of HRT was evaluated in this study through the sue of a time regression analysis, to detect changes in the proportion of users who had stopped using Hormone replacement therapy. Such changes in trend among users was first noted by the researchers among women with higher educational qualifications and later among other groups, while the greatest declines resulted in women who had no formal education and were either hypertense or obese. Therefore, this indicates that the negative findings about Hormone replacement therapy that were reported in recent studies may have had a differential influence in terms of the rate of decline among users. The negative effects of the randomized trials which indicated that hormone replacement therapy may not always be beneficial, was also examine din the context of whether age differences could account for the differences in observational studies and random clinical trials in the specific context of the myocardial infection that was caused.(Kim et al, 2006). The conclusion in this study was that the effect of Hormone replacement Therapy when used long term is more likely to cause myocardial infection among older age groups, therefore it does not bode well for the sue of these hormones with women who when menopausal, are generally in the older age groups. In the light of these developments, other hormones may be considered as replacements rather than using synthetic hormones which, as shown in the study by the Yerkes Primate Center, is proving to lead to higher levels of anxiety and stress and may be more detrimental rather than beneficial. Wisemen (1997) has discussed Phytoestrogens which are weak oestrogens and these compounds are present in plant foods and since these compounds are weak oestrogens they can initiate the same beneficial effects that accrue from natural oestrogen, i.e, protection to the bones and freedom from cardiovascular disease. In particular, Clarkson et al (1995) have suggested the use of these compounds as natural supplements to be provided in the diet of menopausal women, as an alternative that may be considered instead of hormone replacement theory. One of the major advantages associated with the use of such natural compounds as compared to the hormone replacement therapy that is already used is the fact phytoestrogens tend to block the action of oestrogens which causes cells to grow rapidly and leads to breast and prostrate cancer. They are similar to oestrogens in that they are also anti oxidants and as such, may protect the body form those diseases that are associated with the presence of free radicals in the body. However they are also associated with the risk of deep vein thrombosis or the formation of blood clots and also have been known to cause infertility in some animals, therefore as Wiseman (1997) points out, it is necessary to undertake a close examination of the product be undertaken before it is recommended as a substitute for hormone replacement therapy. Moreover such compounds are already present in soy products and inhabitants of areas on the globe where higher volumes of soya are ingested do not appear to demonstrate any significant adverse effects. Therefore, in conclusion it may be stated that there appears to be some support for the fact that hormone replacement therapy causes an increase in libido, however in the long term, the benefits of such increases may have to be counterbalanced between the evaluation of the risk factor that is likely to accrue through their use. Since studies have identified the risk of cardiovascular and other kinds of diseases, it is vital that hormone replacement therapy be undertaken only for a short time since most of the negative results are associated with long term use of the hormones. Observational use of hormone replacement therapy The beneficial effect of hormone replacement therapy in increasing the libido of women has been demonstrated in some actual cases. In fact, as doctors Marcy Holmes and Dixie Mills put it, “Hormonal imbalance is the simplest cause of low libido.” These doctors point out that low libido is an associative function of menopause which is also accompanied by other symptoms such as hot flushes etc and therefore once women are able to get their hormones back in balance, they are able to function normally and have a good libido. Hulem (2006) has examined when a woman should start taking hormones and why, and has examined all the various kinds of hormonal preparations that are available, both synthetic and those that are naturally compounded. However, her conclusion also appears to be that compounded compounds are best and that hormone replacement therapy is beneficial overall For example, Dr. Nosanchuck describes an 80 year old woman named June who was sexually active and had a good libido because of the HRT treatment that she was getting.(DrN4U.com). When a television journalist sought to interview a woman over the age of 50 who was still having sex, the Doctor recommended this woman who was able to go on television and report that she had sex twice a week and was orgasmic and if her relationship with her husband had been better she would have probably had sex more often. Therefore, this appears to be one successful case who benefited from HRT in that her libido functions were boosted and did not suffer the usual decreases that occur with menopause (Dr N4 U, 2002). Another one of Dr. Nosanchuck’s patients was a 60 year old widow who was initially sent to the doctor for the treatment of osteoporesis. She had experienced a natural pause in her late forties and therefore had a diminished sex drive but she was not very interested in restoring her sex drive before her treatment with Dr. Nosanchuck began. However, once her treatment had been commenced, her libido had apparently begun functioning at higher levels again because after six months she had a new boyfriend and planned to marry him, thereby once again proving the benefits of hormone replacement therapy for the problem of decreased libido that occurs after menopause.(DR n 4 U, 2000). The results that were obtained in the cases of the two women identified above whop approached Dr Nosanchuck and were able to benefit from hormone replacement therapy appears to offer a clear indication that hormones do indeed boost libido, and such a revival of the libido is the only explanation that can be offered for the active sexual life of the 80 year old woman. In the case of the 60 years old women, the fact that she was not interested in sex earlier and had made her lack of interest very clear to the doctor, the fact that she was able to enter into an active sexual life appears to suggest that hormone replacement therapy is beneficial for the libido. However the one significant factor that must be considered in this context is the results that were obtained from the Yerkes Primate center, wherein some negative effects and drop in sex drive were also reported among female mice especially when they were injected with a hormone that contains a compound present in the synthetic hormone replacement products that are commonly available in the market. Conclusions: On the basis of the findings that have been noted above from various studies, the following aspects become clear (a) hormone replacement therapy is intended to counter or prevent the effects of menopausal ageing which in its turn, brings on symptoms such as hot flushes, insomnia, weight gain, irritability and a decrease in libido (b) hormones can be supplemented by taking them orally or by applying them vaginally and this helps to restore the hormonal imbalances created by menopause or address those created by hysterectomy, and other surgical operations (c) such hormones, in particular estrogen demonstrate that there is a noticeable escalation in the libido or the reversal of the menopausal symptoms which results in a more normal pre-menopausal condition (d) There are various kinds of hormones available in the market, however the synthetic ones have shown more detrimental effect sin long term studies, such as for example, cancers and cardiovascular diseases. (e) Thus it appears that hormone replacement therapy is effective in small doses for a limited time and must be seed only for such times and then stopped, since long term use is associated with detrimental health effects. (f) Hormone replacement therapy cannot also be withdrawn suddenly but will gradually have to be phased out, even in those cases where women want to stop taking it after hearing of the negative results pointed out in some randomized clinical trials despite the fact that earlier observations had demonstrated the onset of cancers and cardiovascular diseases, including blood clots. Therefore, in view of all the above factors, when the question is asked as to whether or not hormone replacement therapy increases the libido of women then the answer would appear to be in the affirmative. It does indeed increase the libido of women, mostly by restoring the hormonal imbalances that result from menopausal changes. Since some of the changes caused by menopause also includes vaginal dryness and thin, dry skin which makes sexual intercourse painful for such women, hormone therapy can be beneficial, since it helps to restore the hormonal balance and thereby lubricates and oils the skin so that sexual intercourse becomes less painful. However, on an overall basis, it would appear that this treatment may be beneficial only for a short term because there are many detrimental effects that are associated with its long term use such as cancers and cardiovascular diseases. Moreover, of the different types of hormonal products that may be used, the synthetic preparations appear to have worse long term detrimental effects as compared to natural compounds and natural estrogen appears to work best although it is also associated with high health risks. Therefore the compounded products appear to be the best and using these products short term may be the most beneficial. References: * BBC Report, 2002. “HRT patches boost libido” BBC News (Health)June 11, 2002 [online] available: http://news.bbc.co.uk/1/hi/health/2038376.stm * BBC report, 1999. “HRT Treatment can increase libido.” BBC News (health) July 8, 1999 [online] available at: http://news.bbc.co.uk/1/hi/health/388675.stm * Boyles, Salynn, 2004. “Birth Control, HRT and Sex Drive” WebMD Medical News[online] available at: http://www.webmd.com/content/article/88/99946.htm * Clarkson, T.B., Anthony, M.S. and Hughes, 1995. “Estrogenic soybean isoflavones and chronic risks and benefits”, Trends in Endocrinology Metabolism, Vol. 6, 1995, pp. 11-16. * Dr N 4 U.com, 2002. “Libido & HRT.” [online] available at: http://menopausehysterectomy.com/libido.htm * Dr N 4 U, 2000. “Sex and menopause” [online] available at: http://menopausehysterectomy.com/SexMenopause1.htm * Hulem, Rebecca, 2006. “Is there a hormone heaven?” USA Today, 135(2378), pp 66-69 * Holmes, Marcie and Mills, Dixie, 1998. “Low sex drive in women – causes and solutions.” [online] available at: http://www.womentowomen.com/sexualityandfertility/sexaftermenopause.asp * Kim, Joseph, Evans, Stephan, Smeeth, Liam and Pocock, Stuart, 2006. International journal of Epidemiology, 35: 731-36 * Magee, Susanna R and Taylor, Julie Scott, 2006. “Hormone therapy in post menopausal and perimenopausal women.” American Family Physician , 74(9): 1501-4 * Mishra, Gita, Kok, Helen, Ecob, Russell and Cooper Rachel, et al, 2006. “Cessation of hormone replacement therapy after reports of adverse findings from randomized controlled trials: Evidence form a british birth cohort.” American journal of Public Health, 96970; 1219-1226. * Nemecek, Sasha, 1997. “The good and the bad about post menopausal estrogen therapy.” Scientific American, 277 (Sept 1997): pp 38 * Pazol, K, 2004. “Birth Control, HRT and sex drive.” The Journal of clinical endocrinology and Metabolism, June 2004, vol 89. * Roberts, S and Goldacre, M, 2003. British medical Journal, 327:771 * Wiseman, Helen, 1997. “Dietary phytoestrogens: disease prevention versus potential hazards.” Nutrition and Food Science, Jan/Feb 1997:32-38 Read More