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Hormone Therapy

Hormone-Replacement Therapy (HRT) is a medication containing one or more female hormone, usually estrogen and progestin.  Commonly prescribed HRT drugs include Premarin, Provera, and Prempro.  HRT is often prescribed to treat symptoms of menopause such as hot flashes,  vaginal dryness, mood swings, and sleep disorders.  HRT may also be taken to protect against osteoporosis.  However, HRT may increase risks of breast cancer, heart disease, ovarian cancer, bladder cancer, blood clots, and stroke.  

Approximately 10,000 actions in various federal and state courts have been brought against several pharmaceutical companies by women alleging personal injury or economic loss related to the use of estrogen and progestin medications prescribed to treat the symptoms of menopause.  These hormone-replacement cases allege a variety of personal injuries including breast cancer, ovarian cancer, stroke and heart disease.  By the end of 2013, Pfizer had settled or entered into agreements to settle nearly all of the hormone-replacement actions pending against it and its affiliated companies for a total amount of approximately $1.7 billion. 

[1] NIH, Hormone Replacement Therapy.
[2] Pfizer Annual Report 2013.

Hormone Therapy for Prostate Cancer, also called androgen deprivation therapy or "ADT", can block the production and use of male sex hormones called androgens.  Testosterone and dihydrotestosterone (DHT) are the most abundant androgens in men.   Androgens are required for the normal growth and function of the prostate,  the gland that helps make semen.  Androgens promote the growth of normal prostate cells, but also promote the growth of any cancerous cells.  Early in their development, prostate cancers need relatively high levels of androgens to grow.  Most prostate cancers, however, eventually become "castration resistant" to low levels of androgen and continue to grow even when androgen levels in the body are extremely low or undetectable.

Because androgens are used by organs other than just the prostate, blocking the production of androgens (either with hormone therapy or by surgical castration) can have a wide range of effects including lowered libido, erectile dysfunction, hot flashes, loss of bone density, bone fractures, loss of muscle, changes in blood lipids, insulin resistance, weight gain, mood swings, fatigue, and growth of breast tissue.  In addition, the drugs taken as part of hormone therapy can cause side effects:
  • Antiandrogens block the action of male hormones but can cause diarrhea, breast tenderness, nausea, hot flashes, loss of libido, and erectile dysfunction.  The anti androgen flutamide may damage the liver.  
  • Drugs that stop the adrenal glands from making androgens (i.e. the androgen synthesis inhibitors ketoconazole, aminoglutehimide, and abiraterone acetate (Zytiga®)) can cause diarrhea, itching, rashes, fatigue, erectile dysfunction, and liver damage.
  • Estrogens avoid bone loss, but they increase the risk of cardiovascular side effects, including heart attacks and strokes.  
[1] NIH, Hormone Therapy for Prostate Cancer.

Alerts

Research Alert: Primary ADT Doesn't Increase Survival Rate for Men With Prostate Cancer
03/23/2014

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FDA approves AVEED, Endo's Testosterone Drug for Men
03/08/2014

FDA Says Facebook Page for Tirosint Violates FD&C Act
02/28/2014


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