Manipulation of the hormonal balance is a recognized approach of contraception and of treatment of benign gynecological disorders. Hormone replacement therapy (HRT) alleviates not only the menopausal syndrome but also any rarefaction of bone which is present, and reduces the cardiovascular risk. Hormone replacement therapy has aimed to improve the quality of life during this natural aging process to alleviate symptoms associated with this time of transition and to reduce the likelihood or slow the progression of disorders and diseases associated with reduced hormone activity. The deficiency of hormone, in particular estrogen for women, secretion leads in many women to development of vasomotor signs and symptoms (hot flushes, sweating) as well as sleep disturbances, anxiety states and atrophy of hormone-controlled organs, such as in the mammary glands and the vaginal epithelium. These symptoms and signs are called the menopausal syndrome. In addition to this, the low level of hormone secretion likewise leads to an increase in cardiovascular disorders and the development of osteoporosis. It has been found advantageous to administer also an amount of progestin as a part of such steroid replacement therapy. Hormone intake by humans can occur through, inter alia, consumption of pharmaceutical compositions, foodstuffs, nutritional supplements and nutraceuticals. Such hormones include phytoestrogens, or nonsteroidal estrogens, steroidal estrogens and progestins. Phytoestrogens comprise genistein, daidzein and glycitein, and their respective glucoside, malonylglucoside and acetylglucoside derivatives.
Hormone replacement therapy (HRT) has been widely used. One form of HRT is estrogen replacement therapy (ERT), which is the administration of estrogen alone. It is believed that HRT and ERT help in relieving symptoms of menopause and can be used to combat osteoporosis and to prevent the early onset of heart disease, two conditions often associated with postmenopause. Hormone replacement therapy is currently utilized as a treatment to increase the level of estrogen in women having reduced levels of endogenous estrogen resulting from natural or surgical menopause. Estrogens are formed in the ovary predominantly by vesicular ovarian follicles and corpora lutea. In addition, many organs and tissues are able to generate estrogens, for example from androstenedione and dehydroepiandrosterone, which are secreted in substantial amounts by the adrenal glands of the human. Estrogen plays an important role in protecting the health of women such as protecting and maintaining cardiovascular health, bone mass, and mental cognition. However, normal ageing process results in lower levels of estrogen in women and the estrogen level may be significantly reduced upon entering menopause or upon surgical removal of the uterus or ovaries, for which reason those women risk the development of cardiovasculary diseases, bone mineralisation and/or poor mental cognition. Reduced estrogen levels have also been implicated in the development of urinary incontinence as a result of the effect of the loss or estrogen on the smooth muscle cells of the urethra. Reduced estrogen levels may also be implicated in significant weight and fat mass gain in postmenopausal women. Supplemental estrogen is provided to the women in order to inhibit, ameliorate, or prevent diseases or conditions which result from the reduction of endogenous estrogen. HRT is the administration of the female hormones including estrogen, progesterone, and androgens.
Hormone replacement therapy also find significant therapeutic utility in artificial manipulation of growth hormone levels. Growth hormone is a hormone that stimulates growth of all tissues capable of growing. Growth hormone is released from the pituitary. Growth hormone is normally produced throughout life, although in highest amounts during the pre-adult period. The hormone is required for pre-adult growth. Human growth hormone is known to promote skeletal growth, nitrogen retention, protein synthesis and affects glucose and lipid metabolism. In other words, growth hormone is a general anabolic agent. Deficiency in growth hormone results in a variety of medical disorders. The production of recombinant proteins allows a useful tool for the treatment of these conditions. HGH replacement therapy is widely used in patients with growth deficiencies and provides satisfactory growth, and may have positive psychological effects on the children being treated. Growth hormone replacement therapy is used in children to promote growth and in adults to improve muscle strength, reduce fat mass and improve metabolic profiles, which could predispose to cardiovascular disease.
The long term benefits of HRT and ERT, however, remain questionable due to concerns regarding safety and efficacy. For example, HRT and/or ERT may increase an individual's risk of developing cancer. Treatment with HGH injections results in an unphysiological profile of circulating GH levels, i.e., continuously elevated levels as compared to the intermittent pulses that characterize normal GH secretion, and this may be responsible for the development of the undesirable side effects which have been observed in long term treatments, including joint problems (carpal tunnel syndrome), water retention and impaired glucose tolerance. Generally hormone replacement therapy is administered on a daily basis, every day to a patient. But there may be instances where hormone free days could be desirable. In such a case, dosages containing placebo or any other hormone-free agent may be included in the regimen. Examples of suitable alternative hormone-free agents include vitamins or mineral supplements. |
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