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

Swati Agarwal1,2, Faisal A Alzahrani3,4, Asif Ahmed5,6

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Current hormone replacement therapy (HRT) for menopause is limited. Future research should focus on stem cell-based ovarian regeneration for a more natural hormone delivery system.

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Area of Science:

  • Reproductive endocrinology
  • Regenerative medicine
  • Biotechnology

Background:

  • Menopause affects over a third of women's lives, often with debilitating physical and mental symptoms.
  • Current hormone replacement therapy (HRT) has limitations and adverse effects, necessitating improved treatments.
  • Preventing postmenopausal disorders like osteoporosis and atherosclerosis is crucial for long-term health.

Purpose of the Study:

  • To review the efficacy and limitations of current hormone replacement therapy (HRT).
  • To explore the role of other ovarian hormones and compare with in-situ ovaries.
  • To investigate stem cell-based ovarian regeneration for a functional HRT model.

Main Methods:

  • Comprehensive literature search of four databases (MEDLINE, Embase, Web of Science, CINAHL) up to April 2018.
  • Inclusion of terms related to menopause, HRT, ovary regeneration, stem cells, and ovarian transplantation.
  • Synthesis of existing data on HRT efficacy, limitations, and alternative approaches.

Main Results:

  • Current HRT inadequately replicates natural ovarian hormone secretion and pharmacokinetics.
  • Non-physiological hormone delivery (oral/topical) in HRT leads to side effects.
  • There is a need for a hormone delivery system that mimics physiological requirements.

Conclusions:

  • HRT's strengths and weaknesses are outlined, identifying areas for future research.
  • Understanding collective ovarian hormone roles is key for developing better systems.
  • Stem cell-based ovarian regeneration holds potential for transformative clinical applications in postmenopausal women.