Treatments & Therapies

Hormone substitution – treatment, effects and risks

Hormone substitution

With hormone substitution , a hormone deficiency is compensated for by the administration of synthetic or natural hormones . It is irrelevant whether the deficiency is absolute or relative. Hormone replacement therapy is a synonym for hormone substitution .

What is hormone replacement?

Hormone substitution refers to the replacement of missing or insufficiently concentrated hormones through the administration of synthetic or natural hormonal active ingredients. Hormone replacement therapy is also often referred to as hormone replacement therapy. The term hormone replacement therapy in the narrower sense is often used in connection with the administration of medication during menopause or gender reassignment measures.

However, hormone replacement affects all hormones. Insulin is administered when blood sugar is too high. Thyroid hormones are given in the case of an underactive thyroid . The administration of the growth hormone somatotropin takes place in the case of short stature . Finally, postmenopausal conditions are often treated with estrogens . There are hormone replacements that are absolutely necessary for survival.

Other hormone therapies are used to relieve symptoms. However, sometimes serious side effects can occur. An example of this is hormone treatment during the menopause in women and the virile menopause in men.

Function, effect & goals

Hormone replacement therapy often has life-saving effects in humans. A hormone must always be replaced when it is missing or when its concentration in the body is far too low. Hormones are essential for the functioning of bodily processes because all bodily functions are controlled by hormones. For example, if the islet cells of Langerhans in the pancreas fail, the hormone insulin is no longer produced. Since insulin causes blood sugar to enter the cells , it is essential for the body. 

Therefore, if it fails, it must be injected daily to sustain life. In the case of an underactive thyroid gland, too few thyroid hormones are produced. Since the thyroid hormones stimulate the energy metabolism, all bodily processes come to a standstill if they are absent. Therefore, hormone substitution of the thyroid hormones is vital in this case. Other hormones control growth, sexual arousal, the course of pregnancy , the menstrual cycle , and more. There are also hormones that stimulate other endocrine glands to produce hormones.

These include some hormones from the pituitary gland , such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the gonads to produce hormones. It also includes adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce glucocorticoids, and thyroid-stimulating hormone (TSH), which stimulates the thyroid gland. In addition to these hormones, the pituitary produces a number of hormones that have a direct effect on the organs .

If the pituitary gland fails, the hormonal regulatory system collapses. Therefore, a substitution of the missing hormones is necessary. If there is a deficiency of the male sex hormone testosterone, this is often replaced as part of a substitution therapy. The testosterone deficiency can have primary or secondary causes. When it is substituted in old age, there is a general increase in performance. Testosterone substitution may be necessary before puberty so that the secondary male sexual characteristics can be developed at all. In connection with hormone substitution, the administration of estrogens during the menopause is most frequently discussed.

Hormone substitution is carried out here to alleviate severe menopausal symptoms. However, this hormone therapy also carries risks. Therefore, the benefit and risk should be weighed against each other. The climacteric is characterized by the phase from sexual maturity to the end of ovarian hormone production. This is a natural process, but it is associated with sometimes severe symptoms such as hot flashes , sleep disorders , joint pain , nervousness, muscle pain and much more.

If the symptoms become very severe, hormone substitution with estrogens and progestins can prolong the menstrual cycle a little. This leads to an alleviation of the symptoms. Actually, in this case it is not a question of hormone substitution, because estrogen production is naturally stopped by the body. In addition, hormones are administered to alleviate associated symptoms.

Risks, side effects & dangers

Hormone replacement is often vital, but it can also be associated with risks. When the body stops producing existential hormones, they need to be replaced from the outside. This applies, for example, to thyroid hormones or insulin. The thyroid hormones ensure that the energy metabolism is maintained and insulin ensures that blood sugar is available in the cells. The only health risk here is an overdose. 

Most of the side effects and risks are associated with hormone substitution in women during the menopause. Actually, this is hormone therapy instead of hormone substitution. Since estrogen production is stopped naturally during the menopause, no hormone needs to be substituted here. With this therapy, the additional estrogens are intended to keep the process of menstruation a little longer in order to alleviate the symptoms that occur during the menopause. However, in addition to estrogen application, progestins must also be administered as antagonists of estrogens.

Otherwise there is a risk of developing cervical cancer. If the uterus has already been removed, progestogens do not have to be administered in addition. Overall, however, there is a risk of health impairments with long-term hormone therapy. The risks include the occurrence of breast cancer , ovarian cancer , strokes , thrombosis or heart attacks . Hormone therapy for postmenopausal symptoms should only be carried out if the quality of life is severely impaired and if the benefit clearly outweighs the risk.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.