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Doctors' Answers to "Frequently Asked Questions" - Hormones

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Growth Hormones [posted 1/14/99]
Question: I was wondering where I could receive growth hormones to make myself taller? I have seen web sites that sell them, but am not sure if it is a prescribed drug or not.

Answer: Prescription only, check with an endocrinologist. I'd call them first and see what the doctor's philosophy is. Some will not prescribe it for any purpose, others for "height challenged". They will only work if your growth plates are open. These close in men by 25 and women by 16-18 depending on onset of menses.

Effedrine Usage [posted 11/5/98]
Question: What is effedrine used for by doctors? I want to use it for gym but I am not sure if I should.

Answer: Ephedrine is a hormone made by the adrenal and is used medically to raise blood pressures etc. There would be few uses in a gym except to enhance performance, this drug raises heart rate, blood pressure, etc for a short time. It will enhance performance,but, potentially stress your heart while it is in your system. Very short acting.

Estrogen Creams [posted 8/13/98]
Question: I have seen ads for estrogen creams to be applied topically to breasts in order to increase breast size. Do these work?

Answer: No, systemic estrogen can.

Androderm Patches [posted 8/4/98]
Question: I am a 37 year old male who current uses Androderm patches to help increase my sex drive which has been diminished due to antihypertensive drugs. I have used the patches for over a year, and am tired of the adhesive rings which they leave once you remove the patches. I've started cutting open the patches and rubbing the solution on my arms or legs before I go to bed at night. Am I absorbing any of the testosterone (or too much) by using this method? If this isn't wise, is it possible to get the testosterone in a cream from somewhere such as a compounding pharmacy?

Answer: The testosterone can be administered as an every 3-4 week shot, which is how it was done prior to the patches. Also, some patients "prime" the area with steroid cream for a week prior to the patch and this helps the ring occasionally. As to your method, I have no way of guessing without checking your testosterone levels.

Not Enough Estrogen [posted 7/31/98]
Question: I had a hysterectomy 3 years ago. My doctor tried the patches, which were not giving me enough Estrogen. Then I tried Estrace and other mixtures of this kind, but still not enough Estrogen. I am now on Premin 1.25 and still experiencing hot flashes at night, sore joints, and vaginal dryness. My doctor thinks that I am not absorbing Estrogen. What other ways can I get Estrogen?

Answer: Why not just increase the dosage to 2.5 mg? Anyway, topical vaginal cream is available for the dryness. Clonidine can block the hot flashes. If you are just not receiving enough estrogen, increase the dosage until your symptoms abate - a very simple solution.

Growth Hormone
Question: I am interested in knowing if growth hormone can be called a positive result in a urine test. I am interested in using growth hormone, but my job tests for steroids and growth hormone. I have read the ioc drug manual and they say it is impossible to detect.

Answer: Human growth hormone will not be picked up in most urine drug screens. It is a natural hormone and will be present in all urine in minor amounts. Growth hormone will only help if your growth plates on the ends of your bones are open. If closed, (in men in the early 20s) there will be no increase in height. There will be no age reversal.

Ces Conjugated Estrogens
Question: Please advise what the subject medication consists of.

Answer: I can help with conjugated estrogens, but I don't understand the ces part.

Question: I have been taking estrogen for the past eight years. I had a complete hysterectomy eight years ago because of severe endometriosis. I would like to know if it is good for me to be on estrogen replacement this long. If so, what are some alternatives that I could take? I was using the ClimeraPatch, but it bothered my skin. The doctor just prescribed Ogen 1.25 for me.

Answer: In general, estrogen is a very beneficial drug for most women and should be taken for lifetime unless their are undesirable side effects. The only major risk is cancer of the uterus(which you no longer have) elevated blood pressure, and increased risk of phlebitis. There is a possible risk of increased breast cancer, but so far all the studies(at least 8 major studies) have shown little or no effect in increasing breast cancer(indeed a couple that the risk is slightly less). There have been many studies documenting the beneficial effect of estrogen. Your highest risk for death or disability is a stroke or heart attack(still the number one risk for women-not cancer) and estrogen is the only drug which will decrease the risk of coronary disease. One major study of nurses showed that regular use of estrogen increased both the longevity 10% and increased the quality of life as well(less disability, pain etc.). That was an amazing study. Indeed, if men could take estrogen we'd all live to 100 and be healthy. There are some holistic alternatives to estrogen and some organic methods to decrease some of the side effects of withdrawal, but as you can see I am generally in favor of estrogen. There are some women who should not take estrogen. These are women who have had breast cancer already, women who develop major elevated blood pressure on estrogen or who develop significant phlebitis.

Hormone replacement therapy
Question: Please provide the pros and cons for using only estrogen versus a combination of estrogen/progesterone after ovaries removed. I have read that there is a better balance provided for the body if the combination of estrogen/progesterone is used. Any information will be appreciated.

Answer: I wish I could tell you the answer. Unfortunately, this has never been adequately researched. It is clear that all woman with intact uterus linings need progesterone to cycle the lining and prevent uterine cancer. However, since you no longer have a uterus, progesterone is not an issue-- concerning uterine cancer. There are some who advocate cyclic progesterone to decrease breast cancer risk. Although theoretical arguments can be made there is no evidence of any direct benefit; however, research is lacking here. I usually recommend that women without a uterus do not take progesterone.

Question: I had a hysterectomy almost a year ago. I was not placed on ERT's right away. After 4 months of craziness and hot flashes, I was started on the Vivelle Patch and dosages increased every couple of month's. Since being on the patch, I have experienced all the negative Estrogen effects, including weight gain, enlarged breasts, slight depression, headaches, increase need for sweets, and no libido. I read seratonin levels can be checked and altered to help combat the effects of ERT's. Is this true? If so, what do you recommend?

Answer: Serotonin levels can be checked and will be elevated with drugs like Elavil. Whether this will be effective depends on your initial levels. It also sounds like your estrogen dosage needs to be watched closely to ensure that you are not over replaced. Lower dosage may help your problems markedly.

Progesterone after hysterectomy
Question: I recently had a hysterectomy and bilateral oophectomy and there was cancer in the uterus. I have a very strong family history of cancer and some history of heart disease. Concurrent with the original symptoms that led to the hysterectomy, high blood pressure has begun. My concerns are how to best avoid the risk factors (osteoporosis, heart disease and others). Due to the cancer, I am unable to consider estrogen for at least a year. I understand that 20% of bone mass can be lost in the first 2 years after a hysterectomy. My blood pressure medicine has already been changed to Clonidine, to supposedly help with hot flashes. It seems virtually impossible to consume 2000 mg of calcium in my diet on a daily basis. That would be a lot of food. I have begun taking supplements. Specifically I am seeking information about progesterone. I have found a lot of information, but am seeking studies my doctor will respect. He told me I no longer needed it because I didn’t have a uterus anymore. Can progesterone help with my calcium uptake? Are there other benefits of taking progesterone?

Answer: Studies so far have not demonstrated a major beneficial effect of progesterone. However, there have been relatively few studies and not followed for long periods. I would recommend that you get a base line bone density. If this is very low start a drug like Fosamax or possibly calcitonin replacement. If the density is high repeat in a year when you start estrogen. It is true that estrogen deficiency will accelerate bone loss and that replacement after 6-12 months will never recapture this loss. Focus on weight bearing exercise, ensuring adequate Vitamin D intake and adequate calcium. Most physicians recommend 1500 mg or so a day of calcium. Excess calcium will not help your bones, but a deficiency clearly will.

Female hormone replacement therapy
Question: Could you please tell me if there is a medical specialist who can measure female hormones? What are these doctors called?

Answer: These hormones are measured all the time by either endocrinologists, internists, or gynecologists. The measurement may be a 24 hour urine collection, measuring serum levels of hormones or pituitary hormones responsible for triggering estrogen production.

Question: My doctor has suggested giving me an injection of testosterone to increase my libido. Does this work? What are pros and cons of this? I am 43 years old.

Answer: In adults, testosterone is responsible for maintenance of libido. Libido is also regulated by psychic factors. Hence if testosterone deficiency is thought to be the cause then administration of the hormone is the answer.

Question: Does estrogen help to prevent strokes and heart attacks?

Answer: Estrogen decreases all intravascular and coronary events. It apparently does this through its effect on “good” cholesterol, although research into other effects is currently in progress.

Question: I am a biotechnology student and I have a question concerning a hormone called vasopresin. Is it true that it may have a positive influence on the remembering process and does it have any side-effects?

Answer: Vasopressin is a hormone produced by the hypothalmus and then converted to AVP. AVP is used to concentrate urine and its absence leads to very dilute urine and the inability to concentrate urine. Different drugs affect AVP, the most common being alcohol. Alcohol inhibits AVP leading to dilute urine(and subsequent dehydration) following alcohol, which is part of the "hangover" effect. Other drugs which affect AVP release are nicotine, morphine, and antidepressants. I know of no effect on memory.

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