Talk:Hormone replacement therapy

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Does this passage really belong to this article ?

HRT is also used by transsexuals to aid them in attaining the secondary sex characteristics of their desired gender.

For male-to-female transsexuals, HRT includes antiandrogens in addition to the estrogens and progestagens mentioned above. For female-to-male transsexuals, HRT consists only of androgens.

someone wrote the above Q, and I think I might agree. Shouldn't such info be at hormone therapy? Martin 17:17 4 Jun 2003 (UTC)

Actually, hormone therapy specifically refers to the use of hormones in the treatment of disease or cancer and also covers other types of hormones like growth hormone. Compare to chemotherapy. HRT does apply to TSs, not only because that is the term always used, but because one is literally replacing androgens with estrogens. Also, since HRT continues throughout a TSs life, including following SRS or castration, it doesn't really make sense to switch between terms. But no, hormone therapy is something completely different. Can we add this back in? Thanks, Paige 17:35 4 Jun 2003 (UTC)

Also, male-to-female transsexual HRT is very much like HRT for postmenopausal women (even more so if menopause was induced by hysterectomy). Transsexual HRT has benefited much from research into postmenopausal HRT. I specifically added the bit about TS HRT because, as Paige stated, it is used exclusively in that context. -- Kimiko 17:42 4 Jun 2003 (UTC)

I'd advise create a separate article Hormone Replacement Therapy in transsexuals then.

As I said, especially for male-to-female HRT there is very much overlap with postmenopausal HRT. After completion of a second puberty, it is even identical to HRT for non-transsexual women who have had hysterectomy. -- Kimiko 17:55 4 Jun 2003 (UTC)

Strange - I've always heard it referred to as "taking hormones" or "hormonal treatment" or "hormone therapy" - never as HRT. Still, I bow to your superior knowledge - please do re-add it. If you could fix the intro as well, that'd be good :) Martin 20:20 4 Jun 2003 (UTC)

HRT is the medical term. I've heard "hormone therapy" and the others, but not very often and only as a short or colloquial form of "HRT". Then again, I'm not (post)menopausal. -- Kimiko 21:13 4 Jun 2003 (UTC)

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I´m not sure about the terminology but IMO "hormone replacement" covers many more things such as corticoid replacement in Addison´s disease, Thyroxin in hypothyoidism, etc. etc. (perhaps even insulin in diabetes?) Are there other articles or should these matters be added here? Kosebamse 20:33 4 Jun 2003 (UTC)

All of those actually fall under hormone therapy, which is a VERY wide feild and growing rapidly. P.S. Many thanks to Martin and whomever else set up that page! Paige 20:56 4 Jun 2003 (UTC)

I think this may reflect usage in the transexual community, but may not reflect the way the terms are used by the medical community. Certainly the definition of "replacement" as meaning "replacing androgens with estrogens" is not the medical meaning. -- Someone else 21:08 4 Jun 2003 (UTC)

Yes, HRT is the medical term, also used among transsexuals. The 'replacement' in HRT refers to the replacement of hormones that are not produced by the body in sufficient quantities. -- Kimiko 21:13 4 Jun 2003 (UTC)

Oh I see. Didn´t note the subleties of "replacement". In medicine you would probably talk about "substitution", meaning replacing something that is deficient with something of similar effect (e.g. insulin in diabetes, cortisol in Addison´s). So if (or rather, iff) "replacement" does actually have that narrow meaning the other stuff should go somewhere else. Kosebamse 21:15 4 Jun 2003 (UTC)

HRT is the term generally used in medicine for substitution/replenishment of sex hormones. See for example a search of "HRT" on PubMed.

Yes, but "Hormone Replacement Therapy" is but a special instance of "hormone replacement therapy". The same phrase means different things in different contexts. -- Someone else 21:25 4 Jun 2003 (UTC)

Use of the term 'hormone replacement therapy' seems to be rare outside this context. Without further qualification, HRT almost always refers to replacement of sex hormones (usually of the female kinds, but try searching for "HRT testosterone male"). -- Kimiko 21:42 4 Jun 2003 (UTC)

Well but I think "hormone substitution treatment" or something like that would be more precise for the other examples, so I guess we could put these to "hormone therapy" or rather to a page to be linked from there. Kosebamse 21:30 4 Jun 2003 (UTC)

The phrase hormone substitution treatment is certainly not a widely used one. "Hormone replacement therapy" is an ambiguous phrase, referring popularly to "estrogen therapy" and referring medically to any hormone prescribed for a deficiency. I don't see any rationale to separating them, especially as it tends to obscure the fact that it's an ambiguous phrase. -- Someone else 21:39 4 Jun 2003 (UTC)

re latest edition of the article text. Neat solution to this talk page controversy. -- Kimiko 21:52 4 Jun 2003 (UTC)

Agree. So if get you right we should just leave things here? What then (if anything) should go to hormone therapy? Kosebamse 21:49 4 Jun 2003 (UTC)

Other hormone treatments, as indicated by SE's latest edit. For example, insulin, TSH and GH. -- Kimiko 21:52 4 Jun 2003 (UTC)

With the header as it stands now, explaining that the phrase has more than one meaning, it's a reasonable compromise to have this article focus on the more common meaning and have other stuff elsewhere. Though I'd be happier if the other were "hormone replacement therapy" and this were "Hormone Replacement Therapy" <G> (ah, the joys of case-sensitivity) -- Someone else 21:53 4 Jun 2003 (UTC)

Agreed. But having HRT (caps) and hrt (lower case) with different subjects would be way to confusing for casual readers. Heck, it would confuzzle me too. -- Kimiko 21:58 4 Jun 2003 (UTC)

Oh, I wasn't suggesting we do it, only saying I'd be happier if we did. ;) -- Someone else 22:01 4 Jun 2003 (UTC)

Case sensitive disambiguation is the work of the Devil! Martin

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I'm somewhat distressed by the less-than-NPOV tone of this paragraph:

It has become increasingly clear that oral progestin and equine estrogen pills can increases a number of risks, including the risks of exacerbation of existing liver or gallbladder problems and of dangerous blood clots. Long term use of equine estrogens probably also increases the risk of breast cancer. In women with a uterus, therapy with equine estrogen, unopposed by progesterone, may also increase the risk of uterine cancers. This combination can also effect blood triglyceride levels and so may increase the risk of cardiovascular problems. Although HRT with progestins and equine estrogens was once widely thought to promote cadiovascular health in women, on February 4, 2004, the American Heart Association released guidelines stating that it should no longer be considered as an agent to increase heart health or to decrease the chances of cardiovascular disease.

Some of this content is correct (the AHA guidelines about not using estrogen or HRT for heart health reasons), but some of it is highly slanted against equine estrogens (to be fair, several studies have shown that plant estrogens such as Estrace have less of the inherent risks of Premarin, forming the basis for much of the over-the-counter "menopausal therapies") and the "It has become increasingly clear..." intro smacks of agenda-speak. Perhaps better editing would help ("A number of recent medical studies over the past ten years have found...")? Scarletsmith 18:41, 19 January 2006 (UTC)

[edit] Male HRT

Hormone Replacement Therapy (HRT) - Delighted that there is material on this subject. This text, however, reflects the old convention that HRT was strictly applicable to females. The endrocronologists and others working in this field have expanded it to cover the treatment of males and even refer to the age problem of males as "andropause". There are now "andrologists" and others treating "andropause" with HRT. Need an expert to redo this subject.

[edit] Celebrity Endorsements

There's no citation for Patti Labelle's endorsement of "natural" progesterone, and I can't find one. I did find this (her renouncement of her paid endorsement for HRT): http://www.yourlawyer.com/articles/read/5929

Moreover, I'm not sure celebrity endorsements are appropriate--borders on advertising. Suzanne Somers is troubling--she profits from books touting "natural" hormones. And she had breast cancer...she did not take her doctors' advice to stop taking the "natural" hormones once she was diagnosed. She did, however, get part of her breast removed and undergo radiation. She also took birth control pills for 20 years... Cindery 23:35, 28 July 2006 (UTC)

==NPOV regarding "natural" hormones==

HRT is commonly understood to refer to hormone replacement therapy for menopause, involving drugs approved by the FDA. (None of the so-called "natural" hormones were ever approved for use by the FDA for HRT.) This page reads like "HRT vs. "natural" hormones," not as an entry on HRT. (And with a pretty obvious bias in favor of "natural" hormones--the page seems designed to promote "natural" hormones.) "Natural" hormones could be a small subsection of this article, or provide link to page on "natural" hormones. But is is not NPOV re HRT to compare "natural" vs. synthetic all the way through as main thrust.Cindery 23:45, 28 July 2006 (UTC)

[edit] Testesterone Update

New data from the Nurse's study is now available re testerone and HRT. (It is linked to breast cancer, heart disease, etc.) This needs to be updated here, perhaps with a testerone subsection? Cindery 23:45, 28 July 2006 (UTC)