MA 278 Rasussen College Hormone Replacement Treatment Discussion
Directions:
Hormone Replacement Therapy (HRT) is most commonly known for treating the discomfort associated with menopause. However, more broadly, HRT is any form of hormone therapy that involves a patient receiving hormones to supplement or replace naturally occurring hormones in the body. For this discussion post, research different forms of HRT and choose one type to focus on.
In your original post, describe a patient who may benefit from HRT. Explain the risks and benefits to using HRT in the scenario you chose. Be sure to include information on safety.
For your reply post, find a classmate who discussed a different type of HRT than you. In your response, put yourself in the scenario discussed. If you were the patient in that scenario, would you choose to go through with HRT or would you look for alternative treatments? Do the benefits of HRT outweigh the risks, in your opinion?
Reply:
Hormone Replacement Therapy (HRT) is a type of medication that contains female hormones that are meant to replace estrogen and/or progesterone that ceases to be produced after menopause. This is usually done to treat common symptoms such as hot flashes, sleep disturbances, genito-urinary problems, and vaginal discomfort that are associated with menopause. This procedure has also achieved significant results in replacing prevent bone loss and fractures after menopause (Mayo Clinic Staff, 2020). Mayo Clinic Staff (2020) further states that there are two types of Hormone Replacement Therapy namely; Systemic hormone therapy of which high doses of estrogen are absorbed directly into the bloodstream and Low-dose vaginal products such as cream, tablet, or ring which allow minimal absorption of estrogen to the body.
For this discussion, I will discuss oral estrogen hormone therapy using pills. This process entails daily administration of tablets containing either Estrogens, estradiol, or Estratab which are forms of female hormones. A study by Todd (2019) stated that the advantage of this form of HRT is that they alleviate troublesome symptoms of menopause such as hot flushes, night sweats, sleep disturbances, psychological and genito-urinary problems. They also reduce the risk of osteoporosis.
Just like any other estrogen therapy, oral administration of estrogen has side effects. Some of them include swollen and painful breasts, vaginal discharge, headache, and nausea (National Health Service, 2019). Significant disadvantages associated with oral estrogen hormone therapy using pills is increased risk of stroke, blood clot, and liver damage. It has also been discovered it increases the risk of breast cancer and heart attack when it is combined with the hormone progestin (Todd, 2019). However, it is important to take under the doctor's instructions.
Reply 2:
Prostate cancers in male patients need androgens to grow. Hormone therapies, which decrease androgen levels or block androgen action, can inhibit the growth of such prostate cancers, which are therefore called castration sensitive, androgen-dependent, or androgen-sensitive(National Cancer Institute. (n.d.).
Androgen suppression therapy(ADT) is a form of hormone therapy that can reduce male hormones, called androgens in the body, to stop them from fueling prostate cancer cells (Nelson et al., 2008). Men with metastatic prostate cancer can not choose radiation or surgery; androgen-ablation therapy is the standard initial treatment (Nelson et al., 2008). According to Nelson et al. (2008), the most common way to achieve androgen ablation is through chemical castration using luteinizing hormone-releasing hormone (LHRH) agonist. In the US, the most commonly used drugs are Lupron and Zoladex; these LHRH agonists significantly decrease the prostate-specific antigen (PSA) levels in men with late-stage prostate cancer and help manage disease progression (Nelson et al., 2008). Typically, when androgen levels in the body are low, the hypothalamus releases LHRH (National Cancer Institute. (n.d.). LHRH stimulates the pituitary gland to produce the luteinizing hormone, which enables the testicles to produce androgens. Like the body’s own LHRH, LHRH agonists initially stimulate the production of luteinizing hormone (National Cancer Institute. (n.d.). However, the continued presence of high levels of LHRH agonists causes the pituitary gland to stop producing luteinizing hormone. As a result, the testicles cannot produce androgens (National Cancer Institute. (n.d.).
According to the National Cancer Institute. (n.d.). The duration and effectiveness of hormone therapy (ADT) in suppressing prostate cancer are not guaranteed. Therefore, regular Prostate-specific antigen (PSA) tests in the blood to rule out the regrowth of cancer are critical (National Cancer Institute. (n.d.).
Patients with prostate cancer using hormone therapy (ADT) are at risk of severe side effects like hot flashes, osteoporosis, anemia, fatigue, loss of libido, and erectile dysfunction (Nelson et al., 2008). In addition, they are at risk of diabetes, risk of cardiovascular disease, and fatal cardiac events, as well as possible emotional distress (Nelson et al., 2008).
However, some of the effects of hormone therapy for prostate cancer are manageable. For example, men who lose bone mass during long-term hormone therapy may be prescribed drugs to slow or reverse this loss. In addition, exercise may help reduce some of the side effects of hormone therapy, including bone loss, muscle loss, weight gain, fatigue, and insulin resistance (Smith et al., 2021).
References
Hormone Therapy for Prostate Cancer Fact Sheet. National Cancer Institute. (n.d.). https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet.
Nelson, C. J., Lee, J. S., Gamboa, M. C., & Roth, A. J. (2008). Cognitive effects of hormone therapy in men with prostate cancer: a review. Cancer, 113(5), 1097-1106.
Smith, M. R., Saad, F., Chowdhury, S., Oudard, S., Hadaschik, B. A., Graff, J. N., ... & Small, E. J. (2021). Apalutamide and overall survival in prostate cancer. European urology, 79(1), 150-158.