Hormonal Replacement Therapy

Women\’s and Men\’s Health

Breast cancer is not just a disease that strikes at women. It strikes at the very heart of who we are as women: how others perceive us, how we perceive ourselves, how we live, work, and raise our families—or whether we do these things at all.
–Debbie Wasserman Schultz

This sentiment that Schultz expressed is true for many disorders associated with women’s and men’s health such as hormone deficiencies, cancers, and other functional and structural abnormalities. Disorders such as these not only result in physiological consequences but also psychological consequences such as embarrassment, guilt, or profound disappointment for patients. For these reasons, the provider-patient relationship must be carefully managed. During evaluations, patients must feel comfortable answering questions so that you, as a key health-care provider, will be able to diagnose and recommend appropriate treatment options. Advanced practice nurses must be able to educate patients on these disorders and help relieve associated stigmas and concerns.

This week, as you examine women’s and men’s health issues, you focus on treatments for hormone deficiencies and cancer. You also explore preventive services for women’s and men’s health.

Learning Objectives
By the end of this week, students will:
Evaluate the strengths and limitations of hormone replacement therapy
Evaluate treatments for hormone deficiencies
Analyze preventive services for women’s and men’s health
Analyze drug treatments for cancer patients
Evaluate implications of cancer drug treatments on patients
Understand and apply key terms, concepts, and principles related to prescribing drugs to treat disorders associated with women’s and men’s health

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?
To prepare:
Review Chapter 56 of the Arcangelo and Peterson text, as well as the Holloway and Makinen and Huhtaniemi articles in the Learning Resources.
Review the provided scenario and reflect on whether or not you would support hormone replacement therapy.
Locate and review additional articles about research on hormone replacement therapy for women and/or men. Consider the strengths and limitations of hormone replacement therapy.
Based on your research of the strengths and limitations, again reflect on whether or not you would support hormone replacement therapy.
Consider whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies.
With these thoughts in mind:
Write description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.

READING REQUIREMENT
Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Chapter 33, “Prostatic Disorders and Erectile Dysfunction” (pp. 527-544)
This chapter examines the causes, pathophysiology, and drug treatment of four disorders: prostatitis, benign prostatic hyperplasia, prostate cancer, and erectile dysfunction. It also explores the importance of monitoring patient response and patient education.

Chapter 34, “Overactive Bladder” (pp. 545-564)
This chapter describes the causes, pathophysiology, diagnostic criteria, and evaluation of overactive bladder. It also outlines the process of initiating, administering, and managing drug treatment for this disorder.

Chapter 55, “Contraception” (pp. 959-970)
This chapter examines various methods of contraception and covers drug interactions, selecting the most appropriate agent, and monitoring patient response to contraceptions.

Chapter 56, “Menopause” (pp. 971-994)
This chapter presents various options for menopausal hormone therapy and examines the strengths and limitations of each form of therapy.

Chapter 57, “Osteoporosis” (pp. 985-994)
This chapter covers various options for treating osteoporosis. It also describes proper dosages, potential adverse reactions, and special considerations of each drug.

Chapter 58, “Vaginitis” (pp. 995-1006)
This chapter examines various causes of vaginitis and explores the diagnostic criteria and methods of treatment for the disorder.
Holloway, D. (2010). Clinical update on hormone replacement therapy. British Journal of Nursing, 19(8), 496–504

This article examines the purpose, components, and administration of hormone replacement therapy (HRT). It also presents benefits, risks, potential side effects, and alternative treatment options of HRT.

Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202. This article examines the role of testosterone levels in the development of hypogonadism. It also explores health issues that are impacted by testosterone levels and the role of testosterone replacement therapy.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

U.S. Preventive Services Task Force. (2014). The Guide to Clinical Preventive Services: Section 2. Recommendations for Adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.

Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.


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