Hormone Replacement Therapy
In recent years, hormone replacement therapy has become a controversial issue. When
prescribing therapies, advanced practice nurses must weigh the strengths and
limitations of the prescribed supplemental hormones. If advanced practice nurses
determine that the limitations outweigh the strengths, then they might suggest
alternative treatment options such as herbs or other natural remedies, changes in diet,
and increase in exercise.
Consider the following scenario:
As an advanced practice nurse at a community health clinic, you often treat female (and
sometimes male patients) with hormone deficiencies. One of your patients requests that
you prescribe supplemental hormones. This poses the questions: How will you
determine what kind of treatment to suggest? What patient factors should you
consider? Are supplemental hormones the best option for the patient, or would they
benefit from alternative treatments?
Hormone Replacement Therapy
In their line of their duty, advanced practice nurse (APN) are confronted with issue of
dispensing supplemental hormones to patients in hormone replacement therapy (HRT).
However, administration of supplemental hormones requires the APN to weigh the strengths
and weaknesses of the prescribed medication. Therefore, the following discussion will
engage in reviewing some of these strengths and weaknesses of HRT. In addition, the paper
will indulge to discuss why APN should not support HRT based on the strength and
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weaknesses of the practice. The paper will conclude by illustrating some of the alternative
treatment to HRT for treating patients with hormone deficiencies.
APNs use HRT to treat women who are going through menopause and those who had
already gone through menopause (post-menopausal).HRT is commended by boosting the
quality of life post-menopause and it relieves much of the varied unbearable menopausal
symptoms. It also rejuvenates well-being of a woman by shielding her from feeling blue
always. Estrogen used in HRT is significantly proved to enhanced short-term memory.
Mäkinen & Huhtaniemi (2011) have concluded that there is distinct difference in short-term
memory between women who had active ovaries or were on postmenopausal, as compared to
menopausal women without HRT or ovaries (Arcangelo & Peterson, 2013). Most
importantly, HRT is presumably best bet against osteoporosis. This is because estrogen
amplifies bone mass by catalyzing the activities of the functions of osteoclasts (a cell that eat
old bone so that new bone can start to form). Finally, HRT is commended for its importance
in reducing CVDs (cardiovascular diseases). This is brought in by the fact that estrogen
enables lipid metabolism that plays a crucial role in preventing CVDs to affect the health
status of a women-undergoing menopause.
However, limitations of HRT enter in the realm of the practice of HRT to challenge
its strengths. One of these limitations is that it accelerates the risk of endometrial cancer,
mostly when estrogen is dispensed without any progestin or progesterone (Arcangelo &
Peterson, 2013). Another limitation is that HRT increases the risk of blood clots, stroke, heart
attack, ovarian cancer if taken together with progestin and oral estrogen (Mäkinen &
Huhtaniemi, 2011). More to worry about is that women undergoing HRT may experience
pain in their breasts, and to some extent may suffer bloating and fluid retention, nausea,
HORMONE REPLACEMENT THERAPY 3
depression, and other mood swings. Finally, women who take progestin and estrogen in
cycles may experience monthly vaginal bleeding, or spotting when taken on daily purposes.
From the above analysis of strengths and weaknesses of HRT, APN should not
support HRT. This is because its disadvantages are such serious as compared to its benefits.
This is because repercussions from the treatment are adverse and may include breast cancer,
ovarian cancer, stroke, blood pressure. This is incomparable to its benefits that include
outliving hot flashes and night sweats as well as easing vaginal symptoms of menopause such
as dryness, itching, burning and discomfort with intercourse. According to (Mäkinen &
Huhtaniemi (2011), limitations will always arise whether estrogen is dispensed together with
progestin and progesterone or not.
Considering the adverse effects of HRT, APN should prescribe alternatives to HRT
for women with hormone deficiencies. These alternative treatments comprises of herbal
medicine, nutrition, homeopathy, exercise and other modalities (Drugs.com, 2012). The
reason why APN should recommend this alternatives to HRT rather that hormones
supplements is because they offer a great help to alleviate most of the symptoms of
menopause and guide a woman to health. In addition, this approach will assist women to
accept changes that occur naturally in the menopause.
In summary, HRT is associated with strength and weaknesses. These aspects help
APN to decide whether to dispense supplemental hormones to a woman. However, if the
limitations outweigh the strengths, APN will result to use other alternative medications.
Alternative treatment to HRT is to enable woman to accept the natural and physiological
changes occurring in their body, rather than resulting to look for supplemental hormones.
HORMONE REPLACEMENT THERAPY 4
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013).Pharmacotherapeutics for advanced
practice: A practical approach (3 rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
hypogonadism: Current concepts and controversies—A mini-review. Gerontology,
HORMONE REPLACEMENT THERAPY