Hormone Therapy

Aging is a phenomenon that will become a part of your lifecycle eventually. With aging comes along different factors that can bring big differences in the quality of your life. Can they be good? Not necessarily. Aging will not only bring fine lines and wrinkles, but it will also bring hormone imbalance. Will it be uncomfortable? Definitely.

Now, the whole point of biohacking is to change your biology or psychology by your own self for better body performance and also to increase your energy. In short, it improves the quality of life with a longer life expectancy. As we already established the fact of aging, we also know we have to deal with fluctuations of hormones that will cause your energy levels to drop and your mood to get worse. Aging, we can’t touch, but these factors, these factors can be dealt with by the biohacking method called Hormone Replacement Therapy (HRT).

Men and women both come across the phase of aging and imbalanced hormones. With your hormones, that is known to be bioidentical hormones (BHRT), that act as the same hormones that your body needs and pass through the body as identical to your original hormones. Let’s suppose your hormones level are going down as you age, then you can produce your own bioidentical hormones. Unlike synthetic hormones, which are substitutes of the hormones but not identical, bioidentical hormones do not involve those side effects.

With this advancement, biohacking your hormones will give you a balanced life, allowing you to live independently, beautifully for many years to come.

A study concluded that millions of women around the world are forgoing the opportunity to live longer than their life expectancy by not taking hormone replacement therapy. Thorough research made on 3000 women aged from 30 to 75 who underwent HRT after menopause resulted in women living longer than those who did not opt for HRT.

Imbalance hormones can be dangerous for your health as balance hormones are essential for the body to function properly (6). To know more about how Hormone Replacement Therapy can help us achieve longevity, we must dig deeper into this phenomenon.

What is Hormone Therapy?

Hormone Therapy is related to females. Women, after decades of painful mensuration, must go through menopause as well. All through their lifetime, the women have to deal with their hormones fluctuating now and then. The human body once goes through different phases such as stress, diseases, aging, and lifestyle habits, which can decrease the body’s ability to create or utilize hormones. With the introduction of hormone replacement therapy, women are allowed to treat their menopause and low testosterone symptoms.

So the question is, what exactly does Hormone Replacement therapy do? It is a medication made specifically for women to replace their estrogen levels. Why estrogen? Well, when a female goes into the menopause phase, the body stops making estrogen, hence the need for hormone replacement therapy. Due to low estrogen levels, the body may not be able to function properly and can experience hot flashes, vaginal discomfort/dryness, and insomnia. Many females opt for HRT to put ease to their symptoms.

Hormone therapy is one of the government-approved medications for menopausal symptoms. But this is not the end of its usage. Hormone therapy has been proven to be beneficial in preventing bone loss and reducing fracture rates in postmenopausal females. It is very important to know the options for hormone replacement therapy such as estrogen, progesterone, and testosterone. The appropriate option can be selected by knowing your full medical history and recent symptoms and what kind of therapy you seek.

It seems that hormone therapy is too good to be true. So, yes, it has some risks associated with it. Most of these risks are correlated with what kind of therapy you underwent, how long was the therapy going on, what was your main medication, and if it had any impact on the overall health? All of these factors contribute to the effectiveness and downfall of hormone therapy. Therefore, it is important to note that every hormone therapy should be customized and tailored individually for each person. This way, we can get the optimal benefits from this treatment.

Hormones and Menopause

In females, the levels of estrogen and progesterone hormones vary throughout their course of life. This fluctuation in hormones contributes to the menstrual cycle in females every month.

Perimenopause

When females reach around the age of 40, the estrogen and progesterone hormones begin to drop down, but the menstrual cycle does not end just yet. This period in women’s lives might lead to irregular menses, hot flashes, and other symptoms of menopause.

While in perimenopause, women can still conceive, although the probability of becoming pregnant declines with time.

According to the National Institute of Aging, perimenopause usually happened for about 7 years, but in some cases, it can also continue for up to 14 years.

Menopause

Usually, menopause begins after a year from the last period, and this usually occurs at the age of 52. However, when a woman reaches menopause, she no longer can conceive. But if she still wishes to get pregnant, medical support will be required. The symptoms of menopause might be different for every woman, but common symptoms that women usually experience are hot flashes and changes in mood.

According to research carried out in 2015, for more than 50 percent of the female population, vasomotor symptoms continued for about 4 and half years, on average, after the menses ends (11). In some cases, symptoms like hot flashes can remain for more than 7 years, and some instances suggest that symptoms may begin even before the last monthly period of a woman’s life. In these instances, Hormone Replacement Therapy (HRT) can help manage the symptoms during this period.

But for some women, menopause can start earlier, and if this happens HRT can help. Sometimes the early transition may begin without any definite reason, but some reasons for this early transition include the following. The women:

  • may smoke
  • may have had surgery for the removal of ovaries, uterus (or both)
  • may have some type of cancer
  • May have some definite chromosomal or genetic factors, or certain autoimmune diseases.

Anyone who is planning to undertake any kind of treatment or surgery, that might influence their reproductive system, should ask their doctor if there is any chance of early menopause. A health care practitioner can recommend appropriate treatment if a person needs any.

It is well established at this point that experiencing menopause comes with many related symptoms that can disrupt the quality of your life. So let us recap a little on what we have learned so far;

Perimenopause – It is also known as the menopause transition, and perimenopause is the timeline in which the menopause is about to start and a year after the last menstrual cycle. This is when the ovaries stop producing estrogen.

Menopause – After the last menstrual period and a year has passed, menopause is confirmed.

Post menopause – This timeline starts with the induction of menopause and the time that precedes it.

The common symptoms of menopause and perimenopause are:

  • Bloating
  • Redness
  • Irritability
  • Mood swings
  • Fatigue
  • Disturbed sleep
  • Depression
  • Weight gain or loss
  • Wrinkles
  • Weak Hair
  • Breast Tenderness
  • Sexual dysfunction
  • Low sex drive
  • Weak bones
  • Sensitivity to heat or cold
  • Hot flashes
  • Night sweats
  • Painful intercourse

These painful symptoms are avoidable with hormone therapy. Hormone therapy is usually introduced to the body in the form of oral pills, topical creams/gels, skin patches, and vaginal rings.

Types of hormone therapy

Hormone Replacement Therapy comes in two types: Estrogen-only Therapy and Estrogen combined with Progestogen Therapy.

Estrogen Therapy (ET): This therapy is given to women going through their menopause and had a hysterectomy, removal of their uterus. This treatment acts as a relief from menopausal symptoms.

Estrogen + Progestogen Therapy (EPT): Women with their uterus not removed are given estrogen plus progesterone to avoid stimulating the growth of the uterus’s lining. This therapy adds progestogen along with estrogen to prevent endometrial cancer from developing, which is possible with a high level of estrogen levels.

There are two ways in which we can take estrogen treatment, through systemic products and non systemic products.

Systemic products help the blood flow to circulate throughout the body. These products can be taken orally through a pill, through the spray, injection, a patch, and even gel. These products can help relieve menopausal symptoms such as hot flashes and vaginal dryness. They also help in preventing your bones from breaking when you get older. And that is something we must not go through as menopause is painful enough to make us realize we are getting older.

As for non systemic products, they have targeting a specific area of the body. These come in form of creams, rings, tablets which can be applied for vaginal symptoms. These are also known as the low dose vaginal products that make sure that the estrogen is being absorbed by the body at a minimum scale and must only be used as a treatment for vaginal treatments.

The dosages will be prescribed by a healthcare provider, who will address the symptoms with the minimum possible dosage. It may need some adjustment to come to an accurate dosage. Once the treatment is no longer needed, these medications can be stopped over time by the physician’s guideline.

Why Hormone Therapy?

Yes, we know it’s great for women on menopause, but is it really necessary? Yes, again. It should be necessary because it can relieve Perimenopause and menopause symptoms which are usually uncomfortable. These symptoms occur due to low levels of estrogen and progesterone. In case you need to know what symptoms it helps relieve from then let us refresh your memory. Perimenopause and menopause symptoms include hot flashes, night sweats, trouble sleeping, mood swings, irregular periods, difficulty in focusing and poor memory, weight gain, and lower sex drive, among others.

Then another benefit that we can drive from this therapy is that it can reduce women’s risk for osteoporosis to a considerable level. Osteoporosis is a health condition in which bones become thinner and porous, which is a leading cause of bone fractures. Women are at a greater risk of osteoporosis after menopause, but hormone replacement therapy has the potential to offset this risk.

Studies have also suggested that Hormone therapy protects against heart disease. Some of the research has proven that women who get hormone replacement therapy after menopause have a decreased risk for heart disease.

A more surprising outcome is that it can help hold off the signs of skin aging. Well, isn’t that a treat to your ears? Hormone therapy can have Anti-aging properties and let you appear youthful for a little longer. Skin elasticity decreases with age due to hormonal changes. Hormone replacement therapy re-tracks those changes and maintain skin elasticity.

A major discovery on hormone therapy is related to breast cancer. If you have a medical or family history of breast cancer, options and limitations of HRT can be discussed. Women need Testosterone too and hormone pellets are the choice for replacement.  Even younger women can have low testosterone and experience fatigue, inability to build muscle or lose weight and have a decreased libido even though they still have adequate levels of Estrogen and Progesterone.

Risks of Hormone Therapy

Coming to the scary parts of this chapter, we shall discuss how risky can hormone therapy be.

To date, hormone replacement therapy in a major clinical trial involved estrogen combined with progestin tablets, popularly known as Prempro in the market, and it increased the risk of certain severe health conditions, including cardiovascular diseases, Stroke, Blood clotting, and Breast cancer.

Subsequent studies have suggested that these risks vary depending on certain demographic and other factors for example:

  • Age: Those women are at greater risk of the above condition who entered hormone therapy after the age of 60 or above or if they have passed 10 years after their menopause. But if they start getting hormone therapy before they reach 60, or if they were still within the 10 years of their menopause phase, the pros will be greater than the cons.
  • Type of hormone therapy: The risks of hormone therapy depend on whether the estrogen-only therapy was prescribed or estrogen-progestin therapy was given. The type of estrogen and its dosages also play a part in the risk factors of Hormone therapy.
  • Health history: certain health conditions determine the risk attached to hormone replacement therapy. These include but are not limited to you and your family’s medical history, and chances of the tumor, heart diseases, stroke, liver disease, and weak bones. These factors play important role in figuring out whether hormone therapy is beneficial for you.

All of these cons should be assessed by you and the healthcare provider, which will help you decide which appropriate hormone therapy will be effective.

Who can benefit from hormone therapy?

It will be a plus point for you if you are a healthy individual because then the benefits of hormone therapy will outshine the risks.

If you are experiencing some normal to severe hot flashes, then systemic estrogen therapy will be able to help you release yourself from these pains. It is also effective against night sweats. If you have any vaginal symptoms such as redness, dryness, itchiness, and painful intercourse then estrogen can be the solution to all these.

If you are looking to keep bones stronger and you are afraid to break bones in old age, then systemic estrogen is the best option for it. It protects your bones from bone thinning diseases and can also help you tolerate osteoporosis symptoms.

People with estrogen deficiency can also benefit from this treatment. Women who had their ovaries removed surgically will be exposed to low levels of estrogen. Estrogen Hormone Therapy can help cater to the risks of low estrogen levels such as weak bones, heart diseases, stroke, memory loss, and mood swings.

We know, you are planning to reduce the risks as much as you can, and there is always a way to do so. Talking thoroughly to your doctor to help you understand what are your options and what strategies you must adopt to find the best method of hormone therapy for yourself.

It is always recommended to lower your medication dose and use it for a small period. Once you have treated your symptoms. You must stop taking these medications. Always get a regular check-up on your condition and always try to tackle the risks that are associated with Hormone therapy.

Moreover, the best possible way to get positive results is by living a healthier life. Lifestyle habits matter more than you think about your age, health, and longevity. Avoid smoking, taking drugs, keep a check on your health, especially if you have serious health issues such as high blood pressure.

The next question that comes to your mind is if  Hormone Therapy is right for you?

Different HRTs have different merits and demerits. Expert advice is needed to carefully weigh the best options. Some factors such as the acuteness of symptoms and medication record of the patient may be decisive factors in the choice of therapy.

Here are some questions to ask:

  1. Is there any harm in using the HRT, suggested by medical records?
  2. Can the therapy successfully alleviate the symptoms including vaginal dryness and sleep disorders?
  3. What are the alternative solutions? (Therapy for sleep disorders and discomfort)
  4. Are the possible side-effects worth the cost? (Detailed medical history may help in the choice)
  5. Are there any congenital issues that need to be dealt with? (Genetics plays a vital role in HRT and family history along with different conditions that may be inherited will require discussion with specialists and physicians)
  6. What is the kind of HRT that best complements my requirements?

Once you are sure about what kind of treatment you want, you will be directed to it.

Conclusion

Aging brings about changes in your life that can make you helpless t times. When you believe the end is near, biohacking gives you a shortcut to a better and longer life. Just like Menopause is difficult to navigate around with no single solution safeguarding the life around menopause and the time after, Hormone therapy can help but there are risks associated. However, the risks or side effects are a mere possibility and not a certainty of an adverse outcome. The risks are directly related to the age groups and younger women menopausal women are at a lower risk of any adverse outcome. This is also true for women who have had a hysterectomy and have had their uterus removed surgically. Hormone therapy risks are also found to be lower in the age group of 50-70. These were initially reported to be higher. It is to be noted that every woman differs in profile and may need to overcome the psychological and physical barrier of treatment differently.

Further research in hormonal studies has changed many views held by professionals but it is a fact that the extent of study is not exhaustive and there is more to be learned. Published studies like the WHI have provided insight for a large number of people, however, they still do not envelope all the issues a woman might face.

Different characteristics like age, risk, and available options for treatments and their costs, all contribute to the decision-making process of a woman while choosing the use of a hormone product. This requires an in-depth cost-benefit analysis to identify the most suitable solution. Careful understanding of each woman’s situation and expert advice from certified consultants also play a vital role in this choice. The choices may need to evolve and be reconsidered as the body undergoes more changes and new studies or better solutions come to light.

References

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  7. Hill M. Perimenopause Power: Navigating Your Hormones on the Journey to Menopause. Bloomsbury Publishing; 2021. 336 p.
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  14. HRT taken for 10 years significantly reduces risk of heart failure and heart attack [Internet]. [cited 2021 Nov 19]. Available from: https://www.bmj.com/press-releases/2012/10/10/hrt-taken-10-years-significantly-reduces-risk-heart-failure-and-heart-atta
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