What Are The Side Effects Of Hormone Replacement
Anti-Aging & Regenerative Associates
Home » FAQs » What Are the Side Effects of Hormone Replacement?
Because there are different types of hormone therapy, treatments may differ in the kinds of side effects they might have. However, some main side effects of hormone replacement therapy include:
- Heart attack or stroke for people with heart conditions
- An increased chance of developing breast cancer
- An increased chance of developing dementia for women aged 65 and older
The U.S. Food and Drug Administration lists common side effects for different types of HRT treatments.
For example, it is generally advised that women who have not had a hysterectomy should not take estrogen-only medications as this type of HRT can increase their chances of developing endometrial cancer. However, this side effect does not occur with estrogen plus progesterone medications.
Other side effects of estrogen-only, progesterone-only, and estrogen-progesterone combination medicines include:
- Higher chance of developing gallbladder disease
- Increased cholesterol levels, which can lead to pancreatic issues
- Problems in the liver
- High blood pressure, which can lead to headaches
- Vision loss as a result of blood clotting in the eye
- Severe allergic reactions
Other less serious side effects can also occur and range from stomach cramps to vaginal yeast infections. You can discuss more about these side effects with a physician before starting HRT treatment.
Pregnancy And Fertility During And After Chemo
If you think you might want to have children in the future, its important to talk to your cancer care team about this before starting chemo. You need to know if treatment will affect your fertility. See Female Fertility and Cancer for more information.
Many of the drugs used to treat cancer can harm an unborn baby. Because of this, women are usually advised to use birth control to keep from getting pregnant during treatment. Even if you think you can’t get pregnant, you should talk to your doctor about this. It’s important to know what kind of birth control is best and safest for you to use. If you want to get pregnant, talk with your doctor about how long you should wait after treatment is over.
After chemo, it may still be possible for some women to get pregnant. Keep in mind that, even if youre still having monthly periods, its hard to say if you will be able to get pregnant. Women who dont want to become pregnant should use birth control, even after having chemo, and should talk to their doctor about how long birth control will be needed.
What Does Hormone Therapy Do
Hormone treatments alter the number of hormones in your body in various ways. You could have testing to check if your cancer is susceptible to hormones. Your doctor may advise hormone treatment to:
- Stop the body from producing a hormone.
- Modify the way a hormone functions in the body.
- Prevent a hormone from attaching to cancer cells
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How To Take It
The standard first-choice gender-affirming hormone treatment for those receiving estrogen hormone therapy involves estrogen in combination with anti-androgens.
A doctor may also monitor health to ensure the body is absorbing medication and to help identify potential health problems.
Estrogen hormone therapy may involve:
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. You should have a complete physical exam, including blood pressure measurements, breast and pelvic exams, and a Pap test at least yearly. Follow your doctor’s directions for examining your breasts report any lumps immediately.
If you are taking hormone replacement therapy to treat symptoms of menopause, your doctor will check every 3 to 6 months to see if you still need this medication. If you are taking this medication to prevent thinning of the bones , you will take it for a longer period of time.
Before you have any laboratory tests, tell the laboratory personnel that you take hormone replacement therapy, because this medication may interfere with some laboratory tests.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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Hormone Replacement Therapy For Transgender Women
Estrogen and testosterone-blocking medications help transgender women develop a more feminized appearance in line with their gender identity while transitioning. It reduces the discomfort of gender dysphoria, the distress caused by having a gender identity that differs from the sex you were assigned at birth. Many transgender women experience less emotional distress, improved personal relationships, and a better overall quality of life as a result of hormone replacement therapy.
Feminizing hormone replacement therapy causes a variety of physical changes like breast development and facial and body hair reduction. You may also experience a loss of muscle tone and changes in your body shape as the body redistributes fat cells.
Hormone Replacement Therapy Update
To learn more about women’s health, and specifically hormone replacement therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health started a large study in 1991 .It was called the Women’s Health Initiative . The hormone trial had two studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. Both studies were concluded early when the research showed that hormone replacement did not help prevent heart disease and it increased risk for some medical problems.
The FDA states that hormone therapy should not be taken to prevent heart disease.
These products are approved therapies for relief from moderate to severe hot flashes and symptoms of vaginal dryness. Although hormone therapy may help prevent osteoporosis, it should only be considered for women at high risk of osteoporosis who cannot take non-estrogen medicines. The FDA recommends hormone therapy be used at the lowest doses for the shortest duration needed to achieve treatment goals. Postmenopausal women who use or are considering using hormone therapy should discuss the possible benefits and risks to them with their healthcare provider.
The National Heart, Lung, and Blood Institute offers the following suggestions for women who are deciding whether or not to use postmenopausal hormone therapy:
Always see your healthcare provider for more information.
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Does Menopause Cause Bone Loss
The lower estrogen levels of menopause can lead to progressive bone loss that is especially rapid in the first five years after menopause. Some bone loss in both men and women is normal as people age. Lack of estrogen after menopause adds another strain on the bones in addition to the usual age-related bone loss. When bone loss is severe, a condition called osteoporosis weakens bones and renders them susceptible to breaking.
Choosing The Right Hrt For You
It is important to find the correct HRT to help your symptoms.
A low dose of HRT hormones is usually prescribed to begin with. If you need to, you can increase your dose at a later stage.
Once you’ve started HRT, it’s best to take it for a few months to see if it works well for you. If not, you can try a different type or increase the dose. It’s really important that you talk to your GP if you have any problems with HRT.
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Is It Safe For Women Who Have Had A Cancer Diagnosis To Take Mht
One of the roles of naturally occurring estrogen is to promote the normal growth of cells in the breast and uterus. Some cancers also use estrogen to promote their growth. Thus, it is generally believed that MHT may promote further tumor growth in women who have already been diagnosed with breast cancer. However, studies of MHT use in breast cancer survivors have produced conflicting results, with some studies showing an increased risk of breast cancer recurrence and others showing no increased risk of recurrence .
Feminizing Hormone Therapy And Fertility
Gender-affirming hormone replacement therapy may affect your fertility, as it impacts sperm production. While some transgender women can produce sperm again after stopping hormone treatment, research indicates that this may not be the case universally, and there is a risk of permanent infertility with long-term use of hormones. If you would like to have biological children, ask your doctor about your options with freezing your sperm before starting hormones.
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Hormone Replacement Therapy Helps Women Going Through Menopause
Hormone replacement therapy, also known as menopausal hormone therapy , is a female hormone therapy treatment used to help women ease their menopausal symptoms, including osteoporosis. According to the Mayo Clinic, HRT functions as a replacement for the estrogen a menopausal womans body is no longer making.
The National Cancer Institute also explains that women who took local forms of HRT did not have higher risks of several side effects associated with systemic hormone therapy. Also, both people who did and did not take local HRT had similar risks of stroke, cancer, and blood clotting, implicating that this form of HRT does not have a noticeably higher risk of developing these conditions.
Effectiveness For Metastatic Breast Cancer
When evaluating potential treatments for metastatic breast cancer, itâs important to know that the goals of therapy are different than with early stage cancers. With early stage breast cancer, the goal is ultimately a cure . Metastatic breast cancer is, at this time, incurable. For this reason, the goal of treatment is to extend survival and improve or maintain quality of life.
For premenopausal women, the effectiveness of ovarian suppression therapy must be weighed against any side effects that lessen quality of life.
An older review of premenopausal women with breast cancer found that combining ovarian suppression therapy with tamoxifen improved overall survival. Given the advantage of an aromatase inhibitor over tamoxifen in early stage breast cancer, this may be beneficial as well.
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What Are The Side Effects Of Hormone Therapy
The side effects of hormone therapy depend largely on the specific drug or the type of treatment . The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy .
Hot flashes, night sweats, and vaginal dryness are common side effects of all hormone therapies. Hormone therapy also may disrupt the menstrual cycle in premenopausal women.
Less common but serious side effects of hormone therapy drugs are listed below.
Tamoxifen
- breathing problems, including painful breathing, shortness of breath, and cough
- loss of appetite
Feminizing Hormone Replacement Therapy Medication And Timing
While your healthcare provider will help you develop an individualized treatment plan, feminizing hormone therapy often begins by taking 100 to 200 milligrams daily of a diuretic called spironolactone to begin blocking male hormone receptors and suppress testosterone production. Some individuals begin taking estrogen immediately, in tandem with spironolactone, to further reduce testosterone production and develop more feminine characteristics. In other cases, estrogen is introduced after several weeks of spironolactone use. Your doctor will recommend the best plan for your needs.
There are various methods for administering estrogen, including orally, by injection, or as a cream, gel, spray, or patch. Commonly used forms of estrogen during a male-to-female transition include:
- Patches: 17B-Estradiol patch
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Managing The Side Effects Of Hormone Therapy
Before hormone therapy begins, talk with your doctor about what side effects could happen and how they can be managed. Ask questions about anything that is unclear to you. This will help you feel more prepared if you start experiencing those side effects. Let your health care team know about any new or worsening medical problems you have as soon as possible. This is important to do even if you do not think your symptoms are serious or related to your hormone therapy. Tracking your side effects can make getting the relief you need easier. One way to track side effects is using the free Cancer.Net Mobile app. You can securely record when side effects occur and their severity, and you can easily share these details with your health care team to describe your experience.
Some people may need to take hormone therapy for a long time. Working with your health care team to manage side effects can help maintain quality of life while on this kind of extended cancer treatment.
What Is Hormone Imbalance What Does It Do
Hormones control everything, including sleep schedules, metabolic activity, and hunger. Therefore, you can create a hormonal imbalance if you do not stay on top of your diverse physiological needs, from sleep to nutrition. Additionally, as we age, various life stages can cause changes in our hormones.
A hormonal imbalance can result in stress, a raised or lowered body temperature, and reproductive system issues. The bodys endocrine system is so precise that even a minor imbalance in hormone secretion can significantly impact how we feel.
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Hormone Replacement Therapy For Transgender Men
Hormone replacement therapy for transgender men during a female-to-male transition also combats gender dysphoria, leading to reduced emotional discomfort and better overall mental health.
During the process, you will take testosterone, which decreases estrogen production and suppresses menstruation. Testosterone is typically administered by injection or as a gel applied to the skin . In some cases, it may be applied as a patch or pellets positioned under the skin. If you have a persistent menstrual flow, your doctor might recommend taking progesterone to control it.
You may observe some of the following physical changes within several months of starting hormones, though individual responses to treatment varies:
- Deepening of the voice
- Abnormal cholesterol levels
- High blood pressure
Masculinizing hormone replacement therapy may also increase your risk for type 2 diabetes and cardiovascular disease.
You are more likely to experience one or more of these health complications if you have had breast cancer or have a history of blood clots. It may be unsafe to continue with hormone treatment if you are pregnant or breastfeeding. Be sure to discuss the potential risks and benefits of hormone replacement therapy with your doctor, and make sure they are aware of your full medical history.
When Can People Take It
The age at which people can access gender affirming hormone therapy varies globally.
For example, in Europe, many countries allow people aged 1418 to access it. However, in some countries, such as the Netherlands, people can access it from the age of 12 years with parental consent.
In some other European countries, access depends on the maturity of the person who would like to receive the therapy.
In the U.S., most people can access estrogen hormone therapy at the age of 18 years, when they are capable of consent. At 17 years old, a person may have access, but they will require a parent or guardian to accompany them to appointments. At the age of 16 years or younger, additional paperwork is necessary to access such therapy.
People using estrogen and anti-androgens as part of their hormone treatment may notice:
- drier and thinner skin with smaller pores
- changes in the odors of sweat and urine
- a reduction in sweat production
- the development of breast buds beneath the nipples that will develop into breasts as treatment progresses
- a more feminine facial appearance
- an increase in fat around the hips and thighs
- a loss of muscle mass in the arms and legs
- a reduction in strength
Research also indicates that cross-sex hormone treatment changes the structure of the brain to bring trans people closer to their identified gender.
These changes could potentially affect a persons verbal and spatial abilities and the way they interact with others.
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Other Problems From Hormone Pellet Therapy
Whether using pellets or topical treatment, hormone replacement therapy with bioidentical hormones is a safe effective treatment for hormone imbalance symptoms. The pellets do add some increased risk of side effects as noted above. In addition to the side effect noted above, the most common problem I have seen with hormone pellet therapy is the very high levels of hormones that are maintained. This typically occurs from poor monitoring of the hormone levels. As a result we see women with testosterone levels that are as high as men and men that have testosterone levels that are well above the upper reference range.
Now this can happen from time to time with any method of hormone treatment. With pellet therapy it seems to be a more common occurrence rather than an exception. This may occur from infrequent lab testing or checking when the hormone levels would naturally be running out and hence lower. This lower lab test then justifies a higher milligram pellet dose. While a more frequent lab monitoring may resolve this, pellet therapy is rarely monitored this way. For some excessively high hormone levels can make you feel just as poorly as low. If you started hormone pellet therapy and you dont feel any better or feel worse consider having the levels checked a month after pellet insertion.