Hormonal preparations

What are hormone preparations?

Hormones are messenger substances that control many processes in the body. These include thyroid hormones, sex hormones, stress hormones and many other functional groups. Most of these hormones can be substituted or added as medication and have very different effects depending on the dosage. Almost all hormone preparations require a prescription and can only be bought in pharmacies. Some hormone preparations are used to treat illnesses, while others are used, for example, to prevent conception.

When are hormonal preparations needed?

There are many areas of application for hormone preparations. The most common reasons for prescribing are to be found in hormonal contraception and in the treatment of menopausal symptoms.

Thyroid hormones are also used very frequently, as hypothyroidism is a common disease. For some cancers, hormone therapy or a blockade of natural hormones can also be used in treatment. The insulin used in diabetes therapy is also a hormone. Sex hormones are also used for conversion by transgender people. Growth hormones can be added to children with stunted growth. The list of possible indications for hormone therapy goes on forever.

In menopause

Menopause is the transition at the end of a woman's fertile period. The woman undergoes major hormonal changes during this time. The menstrual bleeding subsides and there are many bothersome symptoms. Many women experience hot flashes, mood swings, weight gain, and difficulty sleeping. These symptoms are caused by the sudden drop in estrogen in the body. This estrogen deficiency can be cushioned by the artificial administration of estrogen. The development of osteoporosis, i.e. fragility of bones, can also be reduced by taking hormones during menopause. However, this does not prevent menopause, but only alleviates the symptoms.

Find out more about the topic here: Menopause symptoms and hormone replacement therapy for menopause

For breast cancer

Some forms of breast cancer have specific docking points for hormones and need those hormones in order to continue to grow. These hormone docking sites can be blocked by certain anti-hormone therapies. The best known of these drugs is tamoxifen.

Without the growth stimulus from the estrogen, the tumor cannot grow. After the menopause, aromatase inhibitors can also be given in a targeted manner. These prevent the production of estrogen and not dock. Some drugs can also affect the production of precursor hormones, preventing the ovaries from receiving a signal to produce estrogen. These include the GnRH analogues.

Read more about the topic here: Hormone therapy for breast cancer

For prostate cancer

In the case of prostate cancer in the advanced stage, the treatment goal is often not the cure, but the growth retardation. The male sex hormone testosterone, like estrogen in breast cancer, can act as a growth stimulus for the tumor. There are docking sites for testosterone on the cancer cells. Hormone deprivation therapy can be done with both regular medication and removal of the testicles, since it is in the testes that most of the testosterone is produced. Not all prostate cancers are hormone-sensitive and can be controlled with hormone therapy.

For more information on the subject, see this article: Treating Prostate Cancer

With the pill

The birth control pill is a mixed preparation of an estrogen and a progestin. This combination plays a pregnancy to the body and prevents ovulation. In addition, the uterine lining becomes weaker and the cervical mucus is thickened.

There are also so-called mini pills, which only consist of a progestin and are supposed to make the mucus impermeable to sperm without preventing ovulation. If the hormone pills are taken exactly, this method of contraception is considered to be very reliable. Even young girls can already use the pill for contraception. The birth control pill is one of the most common reasons for hormone therapy.

Find out more about the following topic: What happens in the body when you take the pill?

For diseases of the thyroid gland

The thyroid is an organ that produces the hormones T3 and T4. These hormones must be replaced in the event of hypofunction or after the organ has been removed. Without hormone therapy, those affected have many symptoms, such as fatigue, weight gain, hair loss and cardiac arrhythmias. In most cases, hormone therapy is done with levothyroxine or similar agents. This is a preliminary stage of the actual hormones and is converted into the actual hormones by the body. If the thyroid is overactive, thyreostatics can reduce the production of hormones and thus control symptoms such as restlessness, sleep disorders and cardiac arrhythmias.

Here you can find out everything about the topic: Symptoms of an underactive thyroid

Active ingredients and effects

The active ingredients in hormone therapies are very different. In some cases it is the direct administration of artificially produced hormones. This works for example with testosterone, estrogen, progestin, insulin and cortisol.

In the case of hypothyroidism and some other diseases, a precursor of the respective hormone can be given and the body then has to convert this into the active form of the hormone. Another possibility is the stimulation of organs, which natural function is the production of the desired hormones or precursors. They can then increase production on their own.

In other diseases, such as cancer and hyperthyroidism, the amount of hormones or function should be reduced. For this purpose, docking sites can be blocked or antibodies against the respective hormones can be given. Surgical removal of hormone-producing tissues such as the testicles, thyroid gland or ovaries can also reduce the amount of hormones in the body. In some cases, modified substances can also be used that use the same docking points as the hormones, so that the real hormones no longer achieve their goal. The exact active ingredients in hormone therapy therefore depend on the intended effect.

Side effects of hormonal drugs

The side effects of the hormone preparations are as different as the active ingredients themselves. In many cases, the side effects are normal effects of natural hormones or lack of effects in anti-hormone therapies.

With estrogen preparations, possible side effects are mood swings, thromboses, weight swings, abdominal pain, headaches, breast tumors and cardiovascular diseases.
Preparations that reduce estrogen levels cause premature menopausal symptoms in young women. Fertility can be reduced and sleep disorders, depression and osteoporosis can occur.

You can find out more about the topic here: Side effects of the pill

Antiandrogens, i.e. hormone therapies against testosterone, can lead to a feminine appearance in men. Testosterone as hormone replacement therapy increases the likelihood of acne and oily hair.

There are hardly any known side effects of thyroid therapies with levothyroxine, but overdosing can lead to symptoms similar to those of hyperfunction. Insulin can lead to life-threatening hypoglycaemia in the event of an overdose or a poor diet. The possible side effects of the exact preparations can be read in the package insert and if you have any questions, those affected should contact their doctor.

Drug interactions

The interactions in hormone therapies are also very different depending on the preparation. Many hormones are converted by the liver and can therefore lose their effectiveness if antibiotics or other medications are taken. This is a risk for the contraceptive safety of the pill, for example. Some hormone therapies can also increase or decrease the effects of other drugs and thus lead to poisoning. Whether the individual medication is tolerable should be discussed with the attending physician.

Intolerance to hormonal drugs

Hormone therapy should not be used if there is an intolerance to components of the preparations. Important hormone therapies, for example as part of cancer therapies, may also be used when there are serious risks.

However, preparations like the pill should be treated more strictly as there are alternatives. Overweight women with bleeding disorders and smokers should not necessarily use the pill as the risk of thrombosis increases. Estrogen preparations should not be used in known breast or ovarian cancer, as this can increase tumor growth. Some hormone therapies, such as insulin for type 1 diabetics, are without alternative, even if there are intolerances.

For more information on thrombosis, see the following article: Causes of Thrombosis

Hormone preparations and alcohol - is that possible?

Most hormonal supplements, such as sex hormones and thyroid hormones, do not rule out alcohol consumption in moderation. Even insulin therapy does not mean that those affected have to give up alcohol completely, but side effects such as high hypoglycaemia can occur.

For hormone therapies, which are part of a combination therapy for serious illnesses, the attending physician should be asked whether the consumption of alcohol is a problem.

Alternatives to hormone therapies

There are numerous alternative contraceptive methods for the contraceptive pill that do not require any hormones. These include condoms, copper IUDs and many other options. Natural preparations often help with menopausal symptoms. Hormone therapies for cancer are not always successful and radiation, chemotherapy and surgery are alternatives.

However, there are no alternatives to some hormone therapies. These include insulin for type 1 diabetes and thyroid hormones after the thyroid has been completely removed.

Use during pregnancy and breastfeeding

All medications should be administered with caution during pregnancy and breastfeeding. Sex hormones can have a direct impact on maintaining a pregnancy. Many hormones can pass into the mother's cake as well as into breast milk and thus pose a danger to the child. Some hormones can also stop the flow of milk, making breastfeeding impossible. However, there is no alternative to hormones such as thyroid preparations and insulin, even during pregnancy. These children must be checked immediately after they are born to see if any further steps are required.

Read more about the topic here: Hypothyroidism in pregnancy

Effectiveness of the pill through hormone preparations

The pill is itself a hormone preparation. If the hormone levels change, such as through anti-hormone therapy for breast cancer, the effectiveness of the pill may be limited. Thyroid hormones usually have no effect on the effect of the pill, but the other way around, an increase in the dose of thyroid hormones may be necessary. Insulin does not affect the effectiveness of the pill. Depending on the hormone preparation, the interaction should therefore be discussed with the doctor and an additional method of contraception should be used.

Are there natural hormone supplements?

Hormones are the body's own substances and can also be produced chemically, but they are not foreign chemicals. Some herbal substances have some influence on hormone activity in the body. An example of this is the weaning effect of peppermint tea. However, full hormone supplements do not occur naturally.