Hrt Therapy For Men: Is It Right For You
Hormone replacement therapy is an effective treatment for healthy men with low testosterone levels or men who have hypogonadisma testicle disorder that prevents the body from producing adequate amounts of testosterone. HRT can also help men over 40 boost testosterone levels that have declined due to aging.
What Is Hormone Replacement Therapy
Hormone replacement therapy also referred to as menopausal hormone treatment or postmenopausal hormone therapy, is a type of hormone therapy used to ease the symptoms related to female menopause. Hot flashes, vaginal shrinkage, rapid skin ageing, vaginal dryness, reduced muscle mass, sexual dysfunction, and bone loss are some of the symptoms. They are mainly driven by decreased sex hormone levels that develop with menopause.
Estrogens and progestogens are the most common hormonal drugs used in Hormone replacement therapy for menopausal symptoms, with progesterone being the most common naturally occurring female sex hormone as well as a synthetic medication used in menopausal hormone treatment. Though both types of hormones can help with symptoms, when the uterus is present, a progestogen is added to oestrogen regimens to reduce the risk of endometrial cancer. This is because uncontrolled oestrogen treatment increases endometrial thickness, which raises the risk of cancer, whereas progestogen lowers the risk. Testosterone and other androgens are sometimes employed. HRT is available in several various forms.
How To Use Estrace
Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor. You may take it with food or right after a meal to prevent stomach upset.
If you are taking the extended-release tablets, do not crush, chew, or dissolve them. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
The dosage is based on your medical condition and response to treatment.
Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day as directed. Follow your dosing schedule carefully. Do not increase your dose or take this medication more often or for a longer time than directed.
Tell your doctor if your condition does not improve or if it worsens.
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Hormone Replacement Therapy May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- dark-colored urine
- light-colored stool
Hormone replacement therapy may increase the risk of developing endometrial cancer and gallbladder disease. Talk to your doctor about the risks of taking this medication.
Hormone replacement therapy may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administrationâs MedWatch Adverse Event Reporting program online or by phone .
Stroke And Heart Attacks
The latest analysis from Womenâs Health Concern regarding the risk of heart disease and stroke for women taking HRT states that:
- the risk of stroke is increased in women who smoke and are overweight
- women starting HRT and aged below 60 are not at an increased risk of stroke
- HRT is not recommended for women with a history of stroke or deep vein thrombosis
Speak to your GP if you are taking HRT and are worried about the risk of stroke or heart disease.
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What Is The Best Hormone Replacement Therapy
- What is the Best Hormone Replacement Therapy?
When it comes to hormone replacement therapy, you have options. If youre an older adult female going through menopause, youre bound to experience some unpleasant changes in your body that a male could never understand. At this time, your hormone levels are all over the place. Theyre consistently inconsistent, and theyre dropping at an increasingly alarming rate. Some of these treatments are known to raise the level of a particular hormone that has seen a substantial decline. Unfortunately, this hormone may not be the only one that needs prompt attention. This is why its vital to take a closer look at the various types of HRT that are being offered today. What is best hormone replacement therapy, and what makes this one better than the other?
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Estrogen Therapy And Cancer Risk
In women who still have a uterus, using systemic ET has been shown to increase the risk of endometrial cancer . The risk remains higher than average even after ET is no longer used. Although most studies that showed an increased risk were of women taking estrogen as a pill, women using a patch or high-dose vaginal ring can also expect to have an increased risk of endometrial cancer.
Because of this increased cancer risk, women who have gone through menopause and who still have a uterus are given a progestin along with estrogen. Studies have shown that EPT does not increase the risk for endometrial cancer.
Long-term use of vaginal creams, rings, or tablets containing topical estrogen doses may also increase the levels of estrogen in the body. Its not clear if this leads to health risks, but the amounts of hormone are much smaller than systemic therapies.
ET is not linked to a higher risk of breast cancer. In fact, certain groups of women taking ET, such as women who had no family history of breast cancer and those who had no history of benign breast disease, had a slightly lower risk of breast cancer.
The WHI study of ET did not report any results about ovarian cancer.
To put the risk into numbers, if 1,000 women who were 50 years old took estrogen for menopause for 5 years, one extra ovarian cancer would be expected to develop.
ET does not seem to have any effect on the risk of lung cancer.
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How Do The Hormones Used In Mht Differ From The Hormones Produced By A Womans Body
The hormones used in MHT come from a variety of plants and animals, or they can be made in a laboratory. The chemical structure of these hormones is similar, although usually not identical, to those of hormones produced by womens bodies.
Non-FDA-approved hormone products, sometimes referred to as bio-identical hormones, are widely promoted and sold without a prescription on the Internet. Claims that these products are safer or more natural than FDA-approved hormonal products are not supported by credible scientific evidence. The FDA provides more information about these products on its Menopause page.
Womens Health Initiative Studies Of Hormone Therapy And Cancer Risk
Several large studies have looked at possible links between systemic hormone therapy in menopausal women and different types of cancer.
The main randomized studies of MHT were part of the Womens Health Initiative . The WHI included 2 randomized placebo-controlled clinical trials of MHT in healthy women:
- One study looked at estrogen therapy in post-menopausal women who didnt have a uterus. Over 5,000 women in the ET group took a daily dose of estrogen in the form of conjugated equine estrogen for an average of about 6 years. The researchers then continued to follow them for several years to look for any further effects of the hormone. The women were compared to more than 5,000 in the placebo group.
- The other study looked at estrogen-progestin therapy in post-menopausal women who still had their uterus. Over 8,500 women in the EPT group took a daily dose of CEE plus a progestin called medroxyprogesterone acetate for an average of about 5 years. This group was compared to a group of more than 8,000 women in the placebo group.
The WHI also conducted some observational studies. However, when we mention a WHI study below, were referring to one of the randomized studies.
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Is It Safe For Women Who Have Had A Cancer Diagnosis To Take Mht
One of the roles of naturally occurring estrogen is to promote the normal growth of cells in the breast and uterus. Some cancers also use estrogen to promote their growth. Thus, it is generally believed that MHT may promote further tumor growth in women who have already been diagnosed with breast cancer. However, studies of MHT use in breast cancer survivors have produced conflicting results, with some studies showing an increased risk of breast cancer recurrence and others showing no increased risk of recurrence .
Does Having Or Not Having A Uterus Make A Difference In Deciding What Type Of Hormone Therapy I Should Take
Yes, it does.
If you still have your uterus:
Progesterone is used along with estrogen. Taking estrogen without progesterone increases your risk for cancer of the endometrium . During your reproductive years, cells from your endometrium are shed during menstruation. When the endometrium is no longer shed, estrogen can cause an overgrowth of cells in your uterus, a condition that can lead to cancer.
Progesterone reduces the risk of endometrial cancer by making the endometrium thin. If you take progesterone, you may have monthly bleeding, or no bleeding at all, depending on how the hormone therapy is taken. Monthly bleeding can be lessened and, in some cases, eliminated by taking progesterone and estrogen together continuously.
If you no longer have your uterus :
You typically won’t need to take progesterone. This is an important point because estrogen taken alone has fewer long-term risks than HT that uses a combination of estrogen and progesterone.
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What Is Known About Hormone Therapy And The Risk Of Heart Disease
Scientists continue to learn about the effects of HT on the heart and blood vessels. Many large clinical trials have attempted to answer questions about HT and heart disease. Some have shown positive effects in women who started HT within 10 years of menopause some have shown negative effects when started greater than 10 years of menopause. Some studies have raised more questions about the potential benefits of HT.
Based on the data, the American Heart Association issued a statement for use of HT. They say:
- Hormone therapy for the sole purpose of preventing heart disease is not recommended.
Choosing The Right Hrt For You
It is important to find the correct HRT to help your symptoms.
A low dose of HRT hormones is usually prescribed to begin with. If you need to, you can increase your dose at a later stage.
Once you’ve started HRT, it’s best to take it for a few months to see if it works well for you. If not, you can try a different type or increase the dose. It’s really important that you talk to your GP if you have any problems with HRT.
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How Soon Will I See Results From Hrt
Just like any other new medical regimen, it will take your body some time to get used to HRT. Once treatment begins, it may take six to eight weeks before your body is fully adjusted to the hormone replacement therapy medications. However, after four to six months, you should be able to completely experience the benefits of male hormone replacement therapy.
How To Get Started On Hrt
Speak to your local GP practice if you’re interested in starting HRT.
You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you’re aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if youre under 40 and have menopausal symptoms.
Your GP can explain the different types of HRT available and help you choose one that’s suitable for you.
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Is This The Same Thing As Hormone Replacement Therapy
Many experts now use the term hormone therapy instead of hormone replacement therapy. The word replacement suggests that something is gone thats supposed to be there, said Dr. Mattatall.
But perimenopause and menopause are natural parts of aging, even if they come with difficult symptoms, she pointed out. There was a historical misogynist view that older women are supposed to be hormonally like they were in your 20s, she said. Thats unfair, she added. Theres nothing wrong with you in menopause. If you have these symptoms, we have therapies that can help.
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Reducing The Cancer Risks Of Hormone Therapy
If you and your doctor decide that MHT is the best way to treat symptoms or problems caused by menopause, keep in mind that it is medicine and like any other medicine its best to use it at the lowest dose needed for as short a time as possible. And just as you would if you were taking another type of medicine, you need to see your doctor regularly. Your doctor can see how well the treatment is working, monitor you for side effects, and let you know what other treatments are available for your symptoms.
All women should report any vaginal bleeding that happens after menopause to their doctors right away it may be a symptom of endometrial cancer. A woman who takes EPT does not have a higher risk of endometrial cancer, but she can still get it.
Women using vaginal cream, rings, or tablets containing only estrogen should talk to their doctors about follow-up and the possible need for progestin treatment.
For women who have had a hysterectomy , a progestin does not need to be a part of hormone therapy because theres no risk of endometrial cancer. Adding a progestin does raise the risk of breast cancer, so ET is a better option for women without a uterus.
Women should follow the American Cancer Society guidelines for cancer early detection, especially those for breast cancer. These guidelines can be found in Breast Cancer Early Detection.
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How To Tell If Hormone Therapy Is Working
If you are taking hormone therapy for prostate cancer, you will have regular PSA tests. If hormone therapy is working, your PSA levels will stay the same or may even go down. But, if your PSA levels go up, this may be a sign that the treatment is no longer working. If this happens, your doctor will discuss treatment options with you.
If you are taking hormone therapy for breast cancer, you will have regular check-ups. Checkups usually include an exam of the neck, underarm, chest, and breast areas. You will have regular mammograms, though you probably wont need a mammogram of a reconstructed breast. Your doctor may also order other imaging procedures or lab tests.
Estrogen Replacement Therapy: Are There Any Risks
Almost every form of medication comes with potential risks and estrogen replacement therapy is no different. There have been many research studies into menopause and HRT and its often shown that the benefits of taking HRT can be greater than the risks for lots of women, Welsh says. However, there are risks of HRT and depending on your medical and family history, you may be at a higher risk than others.
Some of the risks include endometrial cancer , breast cancer, blood clots, and strokes, according to Welsh. Its important to talk with your doctor about your individual risk, the benefits versus the risks, and which form of HRT would be best suited to you, she says.
Research from 2019 by the Womens Health Initiative actually found that estrogen-only replacement therapy can lower the risk of breast cancer, while combination hormone therapy increases the risk.
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How To Start Hrt What Do I Need
To start the HRT process, you will need to schedule an appointment with your licensed mental health provider so they can provide you with a referral letter and a Release of Information Form. The release form will allow male hormone replacement therapy doctors to review your referral letter and records so they can accurately determine your needs for HRT and create a plan to help you get started.
Do Local Formulations Of Menopausal Hormone Therapy Have Different Risks
Both systemic and local treatment options for MHT are available in the United States. Which option a woman receives depends on the menopausal symptoms the treatment is meant to address. Systemic MHT is usually prescribed to treat hot flashes and to prevent osteoporosis. Systemic MHT with combined estrogen plus progestin or with estrogen alone can be given as oral medications as transdermal patches, gels, or sprays and as implants.
Local MHT is prescribed to treat genitourinary symptoms such as vaginal dryness. Local MHT contains low-dose estrogen only and is prescribed to women regardless of their hysterectomy status. Local MHT with low-dose estrogen alone includes creams, tablets , and rings.
Findings from the Womens Health Initiative Observational Study showed that, among women with an intact uterus, those who used vaginal estrogen and those who didnt had similar risks of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonaryembolism/deep vein thrombosis .
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Menopause Symptoms And Hrt
Menopause symptoms that may be relieved by HRT include:
- hot flushes and night sweats
- vaginal dryness
- hair loss or abnormal hair growth
- dry and itchy eyes.
Other therapies, including vaginal oestrogen products, antidepressants or other medications, may be used depending on the symptoms and risk factors. Seek advice from your doctor.
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