What Is Hormone Therapy?

Hormones are chemicals produced by glands (small organs) that make up the endocrine system. Hormones travel through the bloodstream sending messages to tissues or organs.

Some people require medications that increase or decrease hormone levels to treat certain diseases and medical conditions. This type of treatment is called hormone therapy (HT).

This article discusses hormone therapy's uses, benefits, and risks.

What Is Hormone Therapy?

Hormones are essential to metabolism, growth and development, sexual function, reproduction, and mood. Unfortunately, certain hormone fluctuations can cause unpleasant side effects and even deadly illnesses like cancer.

By preventing or inducing hormone production, people may feel better and have an improved quality of life. Hormone therapy refers to medications that either increase or decrease specific hormones in the bloodstream.

Uses

Hormone therapy is used for several medical conditions and disorders. Once a diagnosis has been made, your healthcare provider will discuss treatment options with you.

Cancer

Hormone therapy is used to prevent cancer from growing or to ease cancer symptoms. It is often used with chemotherapy or other cancer treatments, depending on the type and stage of cancer. The types of cancer include:

• Breast cancer: Hormone-positive breast cancer is caused by estrogen and progesterone. Stopping the production of both hormones can help prevent cancer from recurring or spreading. Some people need to be on hormone suppression for five to 10 years after a cancer diagnosis.
• Prostate cancer: This type of cancer is driven by male hormones such as testosterone. Eliminating androgen (male hormones) can reduce unpleasant symptoms in people with prostate cancer who can't have surgery or radiation.
• Adrenal cancer is treated with adrenolytics, medications that block the hormones responsible for cancer's growth.
  

Gynecologic Conditions

Certain conditions, such as menopause, endometriosis, and polycystic ovary syndrome (PCOS), require hormone therapy.

• Menopause commonly requires hormone replacement therapy. As the ovaries produce less estrogen, people can experience hot flashes, irregular menstruation, poor bone health, and vaginal dryness. Adding small amounts of estrogen into the body can alleviate unwanted symptoms and improve overall health.
• Endometriosis is a painful condition that usually affects premenopausal people. Normal to high levels of estrogen can worsen the symptoms. The surgical removal of the ovaries and taking of medications that prevent estrogen production can improve endometriosis.
• PCOS is an endocrine disorder that results from an overproduction of androgen hormones, which can lead to hyperandrogenism. The ovaries also form cysts, which can prevent pregnancy. Oral antiandrogens can improve the symptoms of PCOS.
  

Endocrine Disorders

The endocrine system is made of glands that produce hormones and regulate multiple body systems. Dysregulation can occur throughout the body when endocrine glands secrete too much or too little of certain hormones. Examples of endocrine disorders that may require hormone therapy include:

• Hypoparathyroidism (absence of the parathyroid hormone)
• Hypothyroidism (underactive thyroid)
• Hypogonadism (insufficient sex hormones)
• Growth hormone deficiency (when the pituitary gland doesn't make enough growth hormone)
• Diabetes
  

Gender Confirmation Therapy

Transgender people seeking to transition may choose to undergo hormone therapy as part of their gender-affirming care. Hormone blockers and enhancers are used in addition to surgical procedures for gender affirmation.

Types

Two types of hormone therapy include hormone replacement therapy (HRT) and hormone deprivation therapy. Both types of hormone therapy come in the form of oral pills, skin gels or creams, patches, vaginal applications, or injections.

Hormone Replacement Therapy

Hormone replacement therapy occurs when medications are taken to increase a hormone level. Your healthcare provider may replace or increase certain hormones in your body, such as:

• Bioidentical hormones: Identical to the hormones produced by the ovaries, these are also known as "natural" hormones because they are made from plants and are structurally similar to those in the body. Estradiol is an example of a bioidentical hormone.
• Synthetic hormones: Although synthetic hormones are "manmade" and are not structurally similar to the hormones in your body, they are converted to a usable form by the body. An example of a synthetic hormone is Provera.
• Other hormones: Some hormones come from plants and are synthesized in a laboratory to imitate other compounded hormones. Hormones can also come from animals. Premarin, for example, is derived from pregnant mares' urine.

Hormone Deprivation Therapy

Hormone deprivation therapy occurs when a specific hormone is being reduced or prevented. Common drugs that prevent or mitigate specific hormone production in the body include:

• Aromatase inhibitors (AIs): These medications block aromatase, an enzyme that converts androgens into estrogen. Femara (letrozole) is an example of an AI.
• Selective estrogen receptor modulators (SERMs) block estrogen in some areas of the body but not others. Tamoxifen is a SERM.
• Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists: This class of medication reduces estrogen levels in the bloodstream. Zoladex (goserelin) is an example of a GnRHa.
• Luteinizing hormone-releasing hormone (LHRH) analogue: LHRHa controls testosterone production by the testicles. Leuprolide acetate is an LHRHa.
• Antiandrogens block the production of androgens (male hormones). Abiraterone acetate is an example of an antiandrogen.
  

Benefits

In many instances, the benefits of hormone therapy outweigh the risks. Depending on the type of hormone therapy, here are some benefits:

• Decreased hot flashes
• Less vaginal dryness
• Improved pelvic pain
• Improved bone health
• Decreased depression and anxiety
• Improved cancer symptoms
• Reduced risk of cancer recurrence
  

Risks

Anytime hormones are added or removed from the body, risks are involved. Risks of hormone therapy include:

• Blood clots
• Increased risk of cancer
• Stroke
• Heart disease
• Gallstones

Keep regular follow-up visits with your healthcare provider while on hormone therapy.

Legality

Not all hormone therapy is FDA-approved. A study found that from 1 million to 2.5 million women in the United States may take hormone therapy. Still, many lack awareness that their medication has inadequate evidence to support its use. Poor regulation of product advertising also leads to inaccurate or untruthful claims about product safety and efficacy. It's essential to talk to your healthcare provider or local pharmacist about the safety of your hormone therapy.

Summary

Hormone therapy is used to increase or decrease certain hormones in the body. Several medical conditions require hormone therapy to improve symptoms or prevent disease recurrence. Although there are risks, hormone therapy's benefits often outweigh the side effects. Speak with your healthcare provider or pharmacist about the safety of hormone therapy before starting treatment.

A Word From Verywell

Deciding to be on hormone therapy is a big decision, and feeling overwhelmed is normal. Bringing a support person with you to discuss HT with your healthcare provider can lend an additional set of ears. Taking notes during your visit can also help you recall the information later. If you don't understand something your healthcare provider is saying, ask them to explain it differently.