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Review

Hormone Replacement Therapy: Would it be Possible to Replicate a Functional Ovary?

1
Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B4 7ET, UK
2
Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5S 3H7, Canada
3
Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia, [email protected]
4
Embryonic Stem Cell Unit, King Fahad Center for Medical Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2018, 19(10), 3160; https://doi.org/10.3390/ijms19103160
Received: 7 August 2018 / Revised: 2 October 2018 / Accepted: 3 October 2018 / Published: 14 October 2018
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
Background: Throughout history, menopause has been regarded as a transition in a woman’s life. With the increase in life expectancy, women now spend more than a third of their lives in menopause. During these years, women may experience intolerable symptoms both physically and mentally, leading them to seek clinical advice. It is imperative for healthcare providers to improve the quality of life by reducing bothersome menopausal symptoms and preventing disorders such as osteoporosis and atherosclerosis. The current treatment in the form of hormone replacement therapy (HRT) is sometimes inadequate with several limitations and adverse effects. Objective and rationale: The current review aims to discuss the need, efficacy, and limitations of current HRT; the role of other ovarian hormones, and where we stand in comparison with ovary-in situ; and finally, explore towards the preparation of an HRT model by regeneration of ovaries tissues through stem cells which can replicate a functional ovary. Search methods: Four electronic databases (MEDLINE, Embase, Web of Science and CINAHL) were searched from database inception until 26 April 2018, using a combination of relevant controlled vocabulary terms and free-text terms related to ‘menopause’, ‘hormone replacement therapy’, ‘ovary regeneration’, ‘stem cells’ and ‘ovarian transplantation’. Outcomes: We present a synthesis of the existing data on the efficacy and limitations of HRT. HRT is far from adequate in postmenopausal women with symptoms of hormone deprivation as it fails to deliver all hormones secreted by naïve ovarian tissue. Moreover, the pharmacokinetics of synthetic hormones makes them substantially different from natural ones. Not only does the number and type of hormones given in HRT matter, but the route of delivering and their release in circulation are also imperative. The hormones are delivered either orally or topically in a non-physiological uniform manner, which brings along with it several side effects. These identify the need for a hormone delivery system which replicates, integrates and reacts as per the requirement of the female body. Wider implications: The review outlines the strengths and weaknesses of HRT and highlights the potential areas for future research. There is a tremendous potential for research in this field to understand the collective roles of the various ovarian hormones and to devise an auto-regulated hormone delivery system which replicates the normal physiology. Its clinical applications can prove to be transformative for postmenopausal women helping them to lead a healthy and productive life. View Full-Text
Keywords: hormone replacement therapy; menopause; ovary hormone replacement therapy; menopause; ovary
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MDPI and ACS Style

Agarwal, S.; Alzahrani, F.A.; Ahmed, A. Hormone Replacement Therapy: Would it be Possible to Replicate a Functional Ovary? Int. J. Mol. Sci. 2018, 19, 3160. https://doi.org/10.3390/ijms19103160

AMA Style

Agarwal S, Alzahrani FA, Ahmed A. Hormone Replacement Therapy: Would it be Possible to Replicate a Functional Ovary? International Journal of Molecular Sciences. 2018; 19(10):3160. https://doi.org/10.3390/ijms19103160

Chicago/Turabian Style

Agarwal, Swati, Faisal A. Alzahrani, and Asif Ahmed. 2018. "Hormone Replacement Therapy: Would it be Possible to Replicate a Functional Ovary?" International Journal of Molecular Sciences 19, no. 10: 3160. https://doi.org/10.3390/ijms19103160

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