Introduction
The use of hormone replacement therapy (HRT) in women and men has been viewed differently over the latest decades. Early studies have stated that HRT had many potential benefits to female health, including the prevention of osteoporosis and the decrease in symptoms of menopause (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Later, the standard for prescribing HRT changed, highlighting the potential dangers of the therapy and shifting the focus towards natural herbs and nonpharmacologic solutions (Holloway, 2010).
Nonetheless, the use of medications still has to be reviewed, since alternative treatments are not always effective or allowed for patients. The analysis of recent research suggests that HRT should be discouraged in women with suspected or known breast cancer, heart problems, and some other conditions (Arcangelo et al., 2017; Pizot et al., 2016). HRT can be utilized for some patients but should not be viewed as the primary treatment option.
Scenario Review
The questions posed in the case require significant consideration because the patient’s individual characteristics can affect the way they will respond to the treatment. First of all, the reasons behind the patient’s inquiry should be addressed. If it is a woman with menopause, then the severity of the symptoms may signal the need to initiate HRT. If it is a man with hypogonadism, the late-onset of the disorder and the research on this procedure has to be considered (Mäkinen & Huhtaniemi, 2011).
In order to determine whether HRT is an appropriate suggestion, one should also review the patient’s history to locate any contraindications. For example, female patients with a history of breast or estrogen-based cancer should not participate in HRT due to the increased risk of cancer progressing (Holloway, 2010). Thus, if a patient has multiple contraindications and does not have severe symptoms, they may benefit from alternative treatments.
Strengths and Limitations
As it is noted above, the benefits and drawbacks of HRT are connected to people’s personal health history. The primary strength of HRT lies in its ability to manage severe symptoms of menopause (Holloway, 2010). If a female patient has premature menopause and is otherwise healthy, the use of HRT may provide her with more positive than negative results (Lobo, Pickar, Stevenson, Mack, & Hodis, 2016). Moreover, HRT can decrease the risk of colon cancer and delay the development of comorbidities that often follow early menopause. On the other hand, the start of HRT may lead to alternative treatments becoming ineffective for women.
For instance, Pizot et al. (2016) argue that physical exercise can lower the risk of breast cancer only for those women who did not initiate HRT. Other limitations may include old age, the lack of symptoms, and the history of deep vein thrombosis.
Final Recommendations
The final recommendations to the patient need to be based on specific patient factors. If the woman requesting HRT has premature menopause and has severe symptoms that may affect her future health, then the benefits of HRT may outweigh its risks. However, if the female patient has contraindications such as breast or ovarian cancer, then HRT cannot be administered. Similarly, male patients’ history of alternative treatments, age, and severity of symptoms should be taken into consideration.
Some patients may benefit from utilizing alternative treatments such as physical exercise and herbal supplements. Otherwise, if a female patient stops supplemental hormones due to their being ineffective, she may find that other treatments do not have an effect as well. Therefore, HRT should be administered on the basis of thorough investigation and elimination of all possible risks to the patient’s health.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Holloway, D. (2010). Clinical update on hormone replacement therapy. British Journal of Nursing, 19(8), 496–504.
Lobo, R. A., Pickar, J. H., Stevenson, J. C., Mack, W. J., & Hodis, H. N. (2016). Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis, 254, 282-290.
Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202.
Pizot, C., Boniol, M., Mullie, P., Koechlin, A., Boniol, M., Boyle, P., & Autier, P. (2016). Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies. European Journal of Cancer, 52, 138-154.