Hormones are chemical messengers that are produced by specialized cells in the body. Although there are many characteristics of hormones, the most widely acknowledged one is that once they are produced by the specialized cells, they are shed in blood and they are transported to where they are needed, where they are detected, and they direct the body to carry out specific actions. An example is the follicle stimulating hormone (FSH) produced by the pituitary gland and once it reaches the ovaries, it directs maturation of the ova in readiness for ovulation.
Hormone production can stop as a result of various pathological issues such as diseases, deformities, or accidents. The consequences of lack of hormones can be devastating and the medical fraternity has argued on the pros and cons of hormonal replacement therapy (HRT). HRT involves giving medications that contain the hormones that the body needs so that the body can get a replenishment of what is lacking. Among the most common conditions that require HRT is menopausal symptoms. The argument has been on whether the benefits outweigh the side effects.
Menopause is the end of a woman’s reproductive phase when ovulation and menses cease. Menopause sets in on average from 45 to 50 years and the woman can still live for even 30 more years in the postmenopausal state (Panay 2013). When a patient presents in the clinic with the menopausal syndrome, there are several symptoms that lead the clinician to drawing conclusions on the cause, such as hot flushes, amenorrhoea, mood changes, and insomnia. Others may experience weakening of the membranes lining the genitor-urinary system, where the vagina, vulva, and urethra lose the ability to retain moisture. The vagina looses elasticity and shortens. The urethra is easily irritable as the walls get thinner, causing more discomfort. The severity of these symptoms determines the immediate measures that the clinician takes (Panay and Fenton 2008). The history of the patient is important in determining the cause of action, for example, the weight of the patient, age of the patient, and any history of heart conditions, clotting disorders, and fibroids.
When a patient presents with symptoms, the final decision on whether to initiate HRT or to make use of other remedies such as herbal treatment should be an agreement between her and the medical officer. Age is a major determinant in the mode of therapy because young women below the age of 45 years who experience menopause have a higher risk of coronary heart diseases, Parkinson’s disease, and osteoporosis, not unless they get oestrogen therapy. The patient is, therefore, better treated with HRT involving the use of oestrogen if they are in this age bracket (Sassarini and Lumsden 2010). Inducement of oestrogen therapy is the most common HRT used, and it is known to reduce the symptoms such as vaginal dryness and discomfort during intercourse, but again if these are the only symptoms, a topical remedy can be used instead of HRT. With patients who appear obese, the clinician is advised to re-examine any need for HRT since it may increase the risk of obesity and heart related conditions. For such patients whose risk appears higher, the recommendation to take phytoestrogens available in natural foods is more feasible (Poole and Peterson 2013).
The use of HRT should be as a result of the need to treat the symptoms or reduce the risk of certain diseases that may arise as a result of hormonal imbalances. It is advisable that the nursing officer should have ample discussion with the patient band give advice, and in the process assist the patient to make a decision, unless the symptoms are so severe that there is an urgent need to initiate prompt HRT to alleviate them and give the patient quality life.