HRT/TRT: a controversial choice

[Slacker78]

Hello folks, i'm not expert about this theme. I'm beginning to inform myself and studying.

I've found on the net some info and with them, many controversial opinions. I paste something i'd like to be discussed and clarified:


BENEFITS AND RISKS

Over the years, many studies have been carried out looking at the benefits and risks of HRT.

The main benefit is that it is a very effective method of controlling menopause symptoms. It can make a significant difference to a woman’s quality of life and wellbeing.

HRT can also reduce a woman’s risk of developing osteoporosis and cancer of the colon and rectum. However, long-term use is rarely recommended, and bone density will fall rapidly after HRT is stopped.

HRT slightly increases the risk of developing breast cancer, endometrial cancer, ovarian cancer and stroke. Other medicines are available to treat osteoporosis that do not carry the same level of associated risk.

Most experts agree if HRT is used on a short-term basis (no more than five years), the benefits outweigh the risks.

If HRT is taken for longer, particularly for more than 10 years, you should discuss your individual risks with your GP and review them on an annual basis.

Read more about the risks of HRT.

I ask to experts, what they think it about.

Thank you.

[MuscleInk]

Hello folks, i'm not expert about this theme. I'm beginning to inform myself and studying.

I've found on the net some info and with them, many controversial opinions. I paste something i'd like to be discussed and clarified:


Benefits and risks
Over the years, many studies have been carried out looking at the benefits and risks of HRT.

The main benefit is that it is a very effective method of controlling menopause symptoms. It can make a significant difference to a woman’s quality of life and wellbeing.

HRT can also reduce a woman’s risk of developing osteoporosis and cancer of the colon and rectum. However, long-term use is rarely recommended, and bone density will fall rapidly after HRT is stopped.

HRT slightly increases the risk of developing breast cancer, endometrial cancer, ovarian cancer and stroke. Other medicines are available to treat osteoporosis that do not carry the same level of associated risk.

Most experts agree if HRT is used on a short-term basis (no more than five years), the benefits outweigh the risks.

If HRT is taken for longer, particularly for more than 10 years, you should discuss your individual risks with your GP and review them on an annual basis.

Read more about the risks of HRT.

I ask to experts, what they think it about.

Thank you.

HRT and TRT, although used synonymously are not exactly the same thing. HRT generally refers to post menopausal therapy for women. TRT is referring to testosterone therapy for MEN.

Which would you rather have a discussion about and do you have any specific questions in mind?

Yes there are risks to TRT just as there risks to using anabolic steroids since the testosterone replacement IS an anabolic steroid .

[Slacker78]

HRT and TRT, although used synonymously are not exactly the same thing. HRT generally refers to post menopausal therapy for women. TRT is referring to testosterone therapy for MEN.

Which would you rather have a discussion about and do you have any specific questions in mind?

Yes there are risks to TRT just as there risks to using anabolic steroids since the testosterone replacement IS an anabolic steroid.

Yes. My specific questions are address towards the following perplexity ( forgive my inaccuracies ):

1) Regadless HRT or TRT, both is told are strongly not recommended for all life; as above is told not more 5 years.... e.g. many women with removal of ovaries cause of cancer, could find userful going for HRT... but should it be possible to go for HRT ( as TRT ) for all life ?

2) I think for women with breast cancer predisposition, could be harmful going for HRT; tumors sensitive to estrogens could explode by it. Further, is well know that long time estrogens exposure it's a great risk factor for developing a breast/ovarian cancer; infact the risk related to those ones had early menarche, is bound exactly to long estrogens exposure ( the same as late menopause ).

[MuscleInk]

The primary risks with any hormone manipulation are cardiovascular - blood clots, strokes, poor lipid levels (elevated LDL, low HDL), hypertension, bone weakening (more of an estrogen issue), and impaired wound healing and immune function (again, this has more to do with estrogen issues that testosterone ). Many of these risks can be managed by EFFECTIVE weight management and where indicated, drug intervention (for lipids, hypertension, etc.). One of the issues with hormone therapy, particularly in aging is that many people (exceptions apply to this forum of course) are sedentary and make poor life style choices. Unless someone has been living under a rock, we all know that exercise, better food choices, and moderation, are important for longevity. Unfortunately, too many people want a pill to fix everything. They don't exercise enough, don't consume enough fresh fruits and vegetables, they eat far too much simple sugar, and lack the necessary insoluble and soluble fiber to help with cholesterol and weight management.

The cacner risks (breast in women AND men; prostate for men) are more related to estrogen levels, however, elevated testosterone converted to DHT will readily bind to prostate androgen receptors and promote cell growth which in some cases may be mutagenic leading to growth of neoplasias (tumor cell lines).

With proper weight management and diet, which is what we preach around here more than ANYTHING else, many of the risks with hormone therapies can be adequately managed and in many cases, eliminated. Exercise, a healthy lifestyle choice and maintaining a LOW body fat (below 15%) are key to avoiding many affirmatives of aging and living longer.

[Slacker78]

The primary risks with any hormone manipulation are cardiovascular - blood clots, strokes, poor lipid levels (elevated LDL, low HDL), hypertension, bone weakening (more of an estrogen issue), and impaired wound healing and immune function (again, this has more to do with estrogen issues that testosterone ). Many of these risks can be managed by EFFECTIVE weight management and where indicated, drug intervention (for lipids, hypertension, etc.). One of the issues with hormone therapy, particularly in aging is that many people (exceptions apply to this forum of course) are sedentary and make poor life style choices. Unless someone has been living under a rock, we all know that exercise, better food choices, and moderation, are important for longevity. Unfortunately, too many people want a pill to fix everything. They don't exercise enough, don't consume enough fresh fruits and vegetables, they eat far too much simple sugar, and lack the necessary insoluble and soluble fiber to help with cholesterol and weight management.

The cacner risks (breast in women AND men; prostate for men) are more related to estrogen levels, however, elevated testosterone converted to DHT will readily bind to prostate androgen receptors and promote cell growth which in some cases may be mutagenic leading to growth of neoplasias (tumor cell lines).

With proper weight management and diet, which is what we preach around here more than ANYTHING else, many of the risks with hormone therapies can be adequately managed and in many cases, eliminated. Exercise, a healthy lifestyle choice and maintaining a LOW body fat (below 15%) are key to avoiding many affirmatives of aging and living longer.

Good answers bro.

But, for what concern breast cancer, which in most of cases strongly related to estrogens, an HRT would increase the risk to lead to cancer developing. It's established that a long estrogens exposure - in sensitive subjects - may increase the risk to get a cancer ( ovarian or breast cancer as we are talking about estrogens sensitive cancers ).

[MuscleInk]

Good answers bro.

But, for what concern breast cancer, which in most of cases strongly related to estrogens, an HRT would increase the risk to lead to cancer developing. It's established that a long estrogens exposure - in sensitive subjects - may increase the risk to get a cancer ( ovarian or breast cancer as we are talking about estrogens sensitive cancers ).

Yes, many of the ovarian and breast cancers are mediated by estrogen pathways, which is why many therapies for breast and ovarian cancers involve anti mitotic (chemotherapy) and aromatase inhibitors such as tamoxifen , femara, anastrazole, exemstane. Unfortunately, to say that these cancers are simply estrogen mediated, is a bit of an over simplification. There are many molecular pathways upstream and downstream in tumor pathology that are also targets for interrupting tumor cell growth. Tyrosine kinases are a popular target as are vascular endothelial growth factors. One of the reasons it is difficult to cure cancer is that cancer is like a dirty bomb. There are so many pathological mechanisms involved in attacking the host, that shutting down one or two pathways only slows disease progression. It doesn't arrest/stop it.

Many hormone therapies directed at estrogen and progesterone are marginally effective and eventually second and third line therapies become necessary as the cancer progresses. The key to successful cancer management is prevention and when that is not possible, early detection is the next best bastion of hope for eradicating the disease. In early stages (1a,b-2a,b) many tumors are localized and can be reduced in size through radiation, chemotherapy, targeted therapy, any combination of those, and then surgical resection (i.e. removing the tumor). If a surgical resection results in negative margins (meaning there are no remaining tumor cells in the surrounding peripheral tissue), the disease is generally "cured".

Unfortunately, many cancer patients remain asymptomatic until the reach stage 2b or 3a, at which time, the tumor lines innervate surrounding tissue, enter lymph nodes and travel through the lymphatic system to other viscera (usually liver and brain) and bone. This is called tumor metastasis, and once this happens, curing the disease is impossible and treatment focuses on increasing the life span of the patient for as long as possible until palliative care becomes the final option.

That's probably much more than you ever cared to know about tumor progression and pathology! lol.

[Slacker78]

That's probably much more than you ever cared to know about tumor progression and pathology! lol.

Aha...really i love medicine and cancer related arguments more than that you can think . Infact i assume that nanotecnology will be the absolute cure of the cancer and a tons of other diseases.

Really, i asked about this argument because my girl seems to have breast cancer familiarity; her grandmother at 70 years old died by breast cancer. My girl, had an early menarche at 9 years old age and now she's 38 years old. Last scan she had 3 little nodules to keep under control, although she has a very little breast ( i love big tits, but i love her too ) . Being early menarche is in itself a risk factor for breast cancer as well known, her cancer familiarity could be a further element which increase the risk factor. I well know that the first battle against cancer is smart prevention, which is translated in frequent check-ups. Now, returing to our main theme, in her case ( or equivalent cases ) HRT, could be harmful i suppose as long estrogens exposure could increase further the risk, making it raise to an higher level. This topic is aiming to acquire a new knowledge in itself either to help better my girl understanding better the theme. Knowledge application, is the most powerful tool we have.

So... HRT, does not would be an increased risk factor for breast/ovarian cancer ? Or with HRT, could be possible control better ( together diet, exercise and lifestyle) hormones balance to keep estrogens under a relative safe threshold ?

A potential removal of ovaries, for example, caused by a cancer, could force an HRT.... and this could lead to keep always the risk high, if HRT is a potential risk factor for women with cancer predispositions/familiarity.

[sfgiantsfan55]

just wanted to add that for every negative TRT article there are just as many positive ones. Low T center uses some guy named morgenthaler as their be all end all source..and hes like a harvard phD ....

Testosterone for Life: Abraham Morgentaler - Harvard Health Books - Harvard Health Publications

for what its worth

[jwh7699]

MuscleInk - What would you say is the cause of poor wound healing with TRT?


Thanks!!

[sfgiantsfan55]

your question wasnt directed at me, but (my 2 centavos) studies show that test increases protein synthesis which is a huge chunk of wound healing.

semi expert on this as i work in a burn center.

[jwh7699]

Test should increase wound healing, but what would cause a decrease in wound healing?

[Slacker78]

Test should increase wound healing, but what would cause a decrease in wound healing?

Excess of aspirin could increase INR ( prothrombin Time ). Many steroids users take aspirin at higher dosage because steroids decrease INR ( increasing blood coagulation speed ). Other drugs as antibiotics and gastroprotective ones increase INR. Low INR speed up wounds healing; High INR slow down them.

[jwh7699]

Thanks!! I don't want to take away from your thread. I will start a separate one.