Definition & Overview
Hormonal therapy is a broad term applied to the use of hormones in treating several medical conditions. The most common types are oncologic hormone therapy for cancer patients and hormone replacement therapy, which treats conditions caused by deficiency or the lack of a particular hormone in the body.
Hormones are molecules or substances that carry chemical messages to other parts of the body via the bloodstream. They are produced by various glands and are responsible for numerous physiological functions and processes including growth, metabolism of food, reproduction, sexual function, and the regulation of body temperature. Among the most common hormones are amino acids, polypeptides, proteins, eicosanoids, peptides, and steroids.
Depending on the condition being treated, hormonal therapy uses several mechanisms of action. Some hormones are administered to block other hormones from binding to their receptors, limiting their effects on certain processes. Other hormones suppress the production of specific hormones while others eliminate or modify the structure of receptors to prevent them from binding to a targeted hormone. During hormone replacement therapy, the body receives the hormone it lacks to make sure its physiologic functions are not disrupted.
Who Should Undergo and Expected Results
Hormonal therapy can be recommended to:
- Some cancer patients, especially those whose cancer tissues are determined to be responsive to hormones. These include the prostate, breast, adrenal cortex, and endometrium. In some cases, hormonal therapy is done in conjunction with other types of pharmacotherapy modalities like chemotherapy and biotherapeutics.
- Those with Klinefelter syndrome, a condition afflicting males and is characterised by sterility, increased breast growth, and muscle weakness
- Those with Turner syndrome - Female patients diagnosed with Turner syndrome may also be advised to undergo this procedure. These patients typically exhibit short and webbed neck with swollen hands and feet.
- Those with Addison’s disease, in which there is a lack of steroid hormones produced by the adrenal glands. Symptoms of this condition include low blood pressure, an unusual craving for salt, hyperpigmentation or darkening of the skin, weight loss, and abdominal pain
- Children with growth hormone deficiency – These patients are typically placed on hormone replacement therapy to avoid growth failure, poor bone density, and hypoglycemia
- Menopausal women - The treatment can be recommended for women experiencing the adverse effects of menopause to manage symptoms such as hot flashes and vaginal dryness.
- Males with low levels of testosterone
- Those who undergo sex or gender reassignment - Sex or gender reassignment processes also involve hormonal therapy to encourage the manifestation of desired sexual characteristics.
The efficacy of hormone therapy for treating cancer depends on the severity of the condition. Early stages of cancer have a greater chance of improvement and treatment compared to those in advanced stages. In some cases, cancer patients have greater survival rate when a combination of chemotherapy and hormonal therapy is administered.
Those undergoing hormone replacement therapy report significant improvement of their symptoms. For example, children diagnosed with Klinefelter or Turner syndromes typically attain normal adulthood while menopausal women report improvement in their condition following their treatment.
This type of procedure is considered long-term, usually lasting from several months to several years.
How is the Procedure Performed?
There are several ways of administering or introducing hormones into the body. Some patients are prescribed oral medication while some therapies are injected subcutaneously. Some hormones are also injected intramuscularly. Gel patches and sprays containing the needed hormone are also available.
Though indirect, the removal of ovaries in women and testicles in men is also considered a type of hormonal therapy since this surgical intervention results in the reduced capability of the body to produce certain hormones from these organs.
Possible Risks and Complications
The use of hormones to treat breast cancer usually results in hot flashes, night sweats, and mood changes. Patients also report stiffness and joint pain as well as nausea and headaches.
Meanwhile, male patients undergoing hormonal therapy for prostate cancer also experience hot flashes along with decreased sexual desire, increased risk of osteoporosis and loss of bone density. Other complications include erectile dysfunction, weight gain, anaemia, and even memory loss.
Those taking hormones for replacement may experience bloating, leg cramps, indigestion, nausea, and recurrent headaches. There are also some cases in which the body develops some form of resistance to long-term hormone therapy. When this happens, physicians may ask the patient to switch to another type of hormone or another therapy modality altogether.
Facts about menopausal hormone therapy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/resources/heart/menopausal-hormone-therapy-facts.
AskMayoExpert. Menopausal hormone therapy: What factors influence the risk to benefit ratio associated with menopausal hormone therapy? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.