Hormone Replacement Therapy

What is hormone replacement therapy?

Your body produces many hormones that allow for normal daily functioning. When these hormones are disrupted or out of balance, hormone replacement therapy focuses on bringing the body back to center.

In some cases, hormone replacement therapy is ongoing. In others, treatment is temporary. Which works best for you depends on the imbalance you are experiencing and the goals of treatment.

Focuses of hormone replacement therapy

Your body produces many hormones that allow for normal daily functioning. When these hormones are disrupted or out of balance, hormone replacement therapy focuses on bringing the body back to center.

In some cases, hormone replacement therapy is ongoing. In others, treatment is temporary. Which works best for you depends on the imbalance you are experiencing and the goals of treatment.

Focuses of hormone replacement therapy

There are four hormones that constitute what is often referred to when the term “hormone replacement therapy” is used. These include the following.

Estrogen

Estrogen is a hormone produced by the ovaries and adipose (fat) cells. It has a variety of functions, including:

• Causes an increase in blood flow and oxygen metabolism
• Increases neurotransmitters responsible for many of the emotions you experience
• Improves mood by increasing serotonin levels

Balanced neurotransmitter function is often the target of estrogen replacement therapy.

Norepinephrine, serotonin, and dopamine are the neurotransmitters that help regulate mood. Norepinephrine increases alertness and plays a part in the production of long-term memory. Ideal levels of norepinephrine can produce a calm state in stressful situations. However, too much norepinephrine can produce anxiety.

Similarly, low serotonin levels may cause depression. Although antidepressants increase serotonin, estrogen may help serve the same function without the side effects. Dopamine is also a “feel good” hormone, and low levels can affect mood.

It is important to have a balanced level of neurotransmitters to maintain normal body functioning and stable mood. Estrogen replacement therapy helps maintain proper levels of these neurotransmitters, especially during times when estrogen naturally drops (e.g., during menopause).

Progesterone

Progesterone acts as a relaxing hormone produced by the ovaries. It works with a different neurotransmitter in the brain but has a calming effect. Progesterone allows for feelings of wellbeing. Just like estrogen, when progesterone levels are out of balance depression and anxiety may ensue.

Cortisol

Cortisol is a hormone produced by your adrenal glands. This hormone is necessary for survival. It is responsible for energy metabolism and is critical in the management of stress. Consider when quick responses are important for saving your life (i.e., jumping out of the path of a car). Cortisol is produced in quick bursts and then naturally recedes.

Increased levels of cortisol during stress are normal, but when cortisol levels are too high the impacts can be dramatic. Chronically high levels of cortisol can cause:

• Weight gain
• Excessive sweating
• Hypertension
• Easy bruising
• Thinning of the skin
• Stretch marks
• Hump-back fat deposits
• Insomnia
• Mood disorders, including depression and anxiety

On the other hand, inadequate levels of cortisol levels are not healthy either. The most common symptoms experienced with low cortisol levels are:

• Fatigue
• Muscle pain
• Muscle weakness
• Joint pain
• Weight loss
• Hypotension
• Vomiting
• Diarrhea
• Mood changes

Cortisol levels can be affected by many conditions, such as physical or emotional stress, strenuous activity, trauma, and infection. Hormone replacement therapy that focuses on cortisol levels brings your stress response back into balance.

Testosterone

Testosterone naturally wanes in men (and women) as they age, but in some cases low testosterone levels can cause physical symptoms earlier. Symptoms of low testosterone include:

• Depression
• Sleep disorders
• Loss of muscle and bone
• Weight gain
• Low sex drive or difficulty getting or maintaining an erection
• Hot flashes

It’s important to note that just having one or two symptoms in passing is not necessarily a sign of low testosterone. Talk to your doctor to rule out other possible causes.

How can hormone replacement therapy help me?

Hormone replacement therapy has a variety of uses for many different conditions, including the following.

Mental health

Depression is a mental illness that can result from a chemical imbalance of serotonin within the brain. As noted above, serotonin is the chemical in the brain that controls a person’s mood and is usually decreased in patients suffering from depression.

Some clinical research has shown that estrogen, progesterone, and testosterone replacement may be helpful in people with deficiencies that contribute to mental illness. A thorough work-up must be done to determine what hormone replacement you may benefit from

Thyroid conditions

Hyperthyroidism (increased thyroid hormone) and hypothyroidism (decreased thyroid hormone) are very common conditions. Patients who suffer from hyperthyroidism are often extremely anxious, have an increased metabolism, feel hot, lose weight, have a rapid heart rate, and may have panic attacks caused by increased levels of thyroid hormone.

On the contrary, patients with hypothyroidism often suffer from weight gain, slow thinking, cold sensations, and depression. If you suffer from thyroid hormone deficiencies or excess, you may benefit from medical regulation of these hormones.

Menopause issues

During menopause, the levels of estrogen, progesterone, and testosterone all decrease in a woman’s body. The drop in these hormones can cause many symptoms for the years before menopause (perimenopause), all the way through the cessation of menstruation.

These symptoms include:

• Hot flashes
• Weight gain
• Vaginal dryness
• Mood fluctuations
• Sleep disturbance
• Difficulty concentrating
• Painful intercourse

Hormone replacement therapy, also known as HRT, reduces many of these symptoms in women. HRT typically consists of estrogen and progesterone. Estrogen replacement has been helpful in reducing hot flashes, night sweats, vaginal dryness, and urinary tract problems. Low-dose estrogen along with low-dose progesterone may especially benefit women who experience disturbed sleep.

Progesterone reduces the risk of uterine cancer (higher when taking estrogen only). Women can also add testosterone to their regimen, as this helps with vaginal dryness.

HRT is also recommended by many physicians to decrease the risk of post-menopausal women from developing osteoporosis and heart disease. But while clinical trials demonstrate HRT’s effectiveness in preventing osteoporosis, women must weigh the risk of the therapy with the benefits. HRT may actually increase, rather than decrease, the risk of heart disease and is not recommended for women at high risk of this condition.

Chronic pain

When it comes to chronic pain, research is promising. One study found that in 372 patients with knee pain caused by osteoarthritis, tissue was able to better repair itself when the “sex hormones” (estrogen, progesterone, and testosterone) were present and balanced. Another study found that HRT in post-menopausal women was protective against the pain of arthritis in both the hands and knees.