Hormone Replacement Therapy

Hormone Replacement Therapy

A Product
Hormone Replacement Therapy
By: Alex Scott



Reasons For Use of Product
Hormone Replacement Therapy (HRT) is used mainly to lower menopausal symptoms like hot and cold flashes (periods of excessively high body temperature and shortly there after, normal or low temperatures) and vaginal dryness. It has also been proven that HRTs may prevent osteoporosis. The U.S. Health Institute has banned the use of HRTs for their negative effects, while Health Canada has adopted its use for the positive effects.
HRTs are also used alone or in conjunction with gender reassignment surgery and differentiation of gender in hermaphrodites.
The focus of this editorial will be based on these two factors.

Biological Reactions/Effects Involved in Use
Treatment of Menopausal Symptoms
HRTs are taken in pill form and can be found in two different types:
1. Combined: Estrogen and Progestin
2. Estrogen without Progestin
Progestin is added to prevent the development of uterine cancer in women who have not received a hysterectomy.
In 1991 the U.S. National Health Institute (NHI) began a study called the Women’s Health Initiative (WHI). The study was divided into two sections- one comprised of 16, 000 post-menopausal women 50-79 who had not had a hysterectomy. The experiment involved a daily dose of either a combined estrogen and progestin pill or a placebo. The other section focused on 10 000 women who had received a hysterectomy and took either estrogen alone or a placebo. (For further information on the dynamics of this study, visit http://www.hc-sc.gc.ca/iyh-vsv/med/estrogen_e.html.)



The results of the study were as follows (Minister of Health, 2006):




Increased risk of Coronary Heart disease (7 more cases were present when given HRT as opposed to placebo)

Increased risk of stroke (8 more cases, compared to placebo)

Doubled risk of blood clots in lungs and legs (18 more than those who took the placebo)

Essentially, HRTs in the treatment of menopausal symptoms provide relief of night sweats, hot flashes, and vaginal dryness while increasing risks of heart problems, blood clots and strokes. The U.S. Institute deemed these negative effects greater than the positive ones which is why HRTs use has been banned in the states. Canada however, has accepted the risks and feels HRTs are still necessary.


Gender Differentiation/Reassignment
Hermaphrodite- a person or animal having both male and female sex organs or other sexual characteristics.
HRTs are used with hermaphrodites in order to reinforce their dominant, psychological gender.
female to male
When a hermaphroditic woman is born and is psychologically a man, they are given androgens (an example would be testosterone) after extensive counsilling in order to develop male characteristics (both reversible and irreversible)
The irreversible changes consist of: deeper voice, excessive body hair (as well as on the face), the clitoris becomes larger, potentialy shrinking of the breasts and in some cases, baldness. (Wikipedia, 2007).
The reversible changes are as follows: Increased libido, change in body fat distribution, ovulation and menstruation stop, upper body muscle development, increased perspiration along with stronger body odour, acne, coarse skin, change in cholesterol and red blood cell count.
male to female
Unfortunately the transition from male to female is substantially more difficult than female to male because it is a lot easier to add male features with testosterone as opposed to taking them away. Males are given estrogens which allows them to obtain certain female features.
The irreversible ones are: breast development, enlarged nipples and occasionally stretch marks.
The reversible changes are: weakened libido, change in body fat distribution, skin changes, reduced body hair, lessened body odour and persperation and change in size of reproductive organs.
Benefits
Hormone Replacement Therapy offers emotional benefits for both types of users. Menopausal symptoms are tolerable without medication and hermaphrodites generally spend their lives either cross dressing or hiding their true identity. Essentially, Hormone Replacement Therapies are last ditch efforts and should be used with caution to reap the emotional benefits they have to offer (change in gender appearance and reduced menopausal symptoms)
Disadvantages
Hormone Replacement Therapy offers a vast range of disadvantages, hence the reason their use was banned from the U.S.
When given estrogen to help menopausal symptoms, (as seen before) the results proved an increase in heart problems, the risk of stroke and a two-fold increase in blood clot sufferers. These disadvantages alone are enough to scare people out of using them, however the negative effects of HRTs use with gender reassignment issues are rather substantial compared to these. They are:
Increased cardiovascular risks/problems
Baldness along with increased body hair elsewhere
Cessatation of menstruation
Increased size of clitoris
Polycystic Ovary Syndrome (in the use of androgens)
Lack of function in reproductive organs making child bearing nearly impossible
Increased risk of osteoporosis
Severe drug interactions
Sleep apnea
Increased red blood cells
Change in skin texture
Liver damage
Headaches
Social Responsibility Of Manufacturer
Every manufacturer is expected to offer the information regarding HRTs positive and negative effects. Doctors are expected to discuss the potential problems related to their long term use, and advise avoiding HRTs until there is no other option.
Supervision of Use of Manufacturer
HRTs are available through prescription only and require a severe need for the medication. Also in transgendered individuals, they must undergo extensive therapy and psychological examination in order to ensure there is no potential for need of reversal.

References
The Canadian Encyclopedia. (2007). Hormone Replacement Therapy Controversy. Historica Foundation. Retrieved November 30, 2007, from http://thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=M1ARTM0012308
Wikipedia. (2007). Hormone Replacement Therapy (trans). Wikimedia. Retrieved November 30, 2007, from http://en.wikipedia.org/wiki/Hormone_replacement_therapy_(trans)