Hormones

Available medications in the UK

• Levothyroxine preparations: The first-line treatment including brands like Eltroxin and generic formulations
• Liothyronine options: T3 hormone replacement for specific cases where levothyroxine alone is insufficient
• Combination therapies: Specialist preparations combining T4 and T3 for complex cases

Dosing considerations and monitoring requirements

Thyroid hormone replacement requires careful individual dosing based on TSH levels, with regular blood tests typically every 6-8 weeks initially, then annually once stable. Factors affecting dosage include age, weight, pregnancy, and interactions with other medications or supplements.

Sex Hormones

Oestrogen therapies

Oestrogen is a crucial female hormone used in various therapeutic applications throughout the UK. Hormone replacement therapy (HRT) preparations help manage menopausal symptoms including hot flushes, night sweats, and bone density loss. Available formulations include tablets, patches, gels, and vaginal preparations, each offering different benefits for symptom management and patient convenience.

Contraceptive formulations containing oestrogen, such as the combined pill, provide reliable pregnancy prevention whilst offering additional benefits like cycle regulation and reduced menstrual pain. Treatment applications extend to managing conditions like endometriosis, polycystic ovary syndrome (PCOS), and certain cases of osteoporosis prevention.

Testosterone treatments

Testosterone therapy addresses hypogonadism and testosterone deficiency in men, with symptoms including reduced libido, fatigue, muscle weakness, and mood changes. Available options include:

• Gel preparations: Daily topical applications offering steady hormone levels
• Injection options: Long-acting intramuscular injections administered every 10-14 weeks
• Patch and implant alternatives: For patients requiring different delivery methods

Prescription requirements include confirmed diagnosis through blood tests and specialist consultation. Monitoring protocols involve regular prostate examinations, liver function tests, and haematocrit monitoring to ensure safe and effective treatment outcomes.

Diabetes and Blood Sugar Hormones

Insulin preparations available in the UK

The NHS provides access to various insulin formulations to meet individual patient needs. Rapid-acting insulins such as NovoRapid and Humalog are designed for mealtime glucose control, whilst long-acting preparations like Lantus and Levemir provide basal insulin coverage throughout the day. Mixed insulin options combine both rapid and intermediate-acting components, offering convenience for patients requiring simplified dosing regimens.

Other diabetes medications affecting hormones

GLP-1 receptor agonists, including Ozempic and Trulicity, enhance insulin secretion and slow gastric emptying. SGLT-2 inhibitors work by reducing glucose reabsorption in the kidneys. These medications are available through NHS prescription and require regular monitoring by healthcare professionals.

Blood glucose monitoring considerations

Regular monitoring is essential for all patients using diabetes hormones. NHS guidelines recommend specific testing frequencies based on treatment type and individual circumstances.

Storage and administration guidance

Proper storage in refrigerated conditions and correct injection techniques are crucial for maintaining hormone efficacy and patient safety.

Adrenal Hormones

Corticosteroid medications

Corticosteroid hormones are essential treatments for various inflammatory and autoimmune conditions. Prednisolone remains the most commonly prescribed oral corticosteroid in the UK, available in multiple strengths. Hydrocortisone preparations are used for both replacement therapy and acute treatment, whilst dexamethasone offers potent anti-inflammatory effects for specific clinical situations.

Conditions requiring hormone replacement

Adrenal insufficiency, including Addison’s disease, requires lifelong hormone replacement therapy. These conditions necessitate careful monitoring and patient education regarding emergency protocols.

Dosing schedules and withdrawal considerations

Corticosteroid dosing typically follows circadian rhythms, with higher doses administered in the morning. Gradual dose reduction is essential to prevent withdrawal symptoms and adrenal crisis.

Side effects and monitoring requirements

Long-term corticosteroid use requires careful monitoring for:

• Bone density changes and osteoporosis risk
• Blood pressure and cardiovascular effects
• Blood glucose levels and diabetes development
• Weight gain and metabolic changes
• Infection susceptibility and wound healing

Growth and Metabolic Hormones

Growth Hormone Therapies

Growth hormone treatments are essential for managing various conditions affecting normal growth and development. In paediatric applications, these therapies address growth hormone deficiency, Turner syndrome, and chronic renal insufficiency. Licensed preparations available through the NHS include somatropin formulations such as Genotropin, Humatrope, and NordiTropin, which require specialist endocrinologist supervision.

Adult growth hormone deficiency treatment focuses on improving quality of life, bone density, and metabolic function. These treatments require careful monitoring and are typically initiated in specialist centres with ongoing shared care arrangements between hospital consultants and GPs.

Metabolic Hormone Treatments

Thyroid-stimulating preparations include recombinant TSH (Thyrogen) used primarily for thyroid cancer monitoring and treatment protocols. Parathyroid hormone options encompass teriparatide (Forsteo) for severe osteoporosis treatment, requiring specialist bone clinic supervision.

• Specialist endocrinology referral required
• Regular monitoring of IGF-1 levels
• Shared care protocols with primary care
• Patient training for injection techniques

Reproductive and Fertility Hormones

Fertility Treatment Medications

Fertility treatments encompass a comprehensive range of hormonal preparations designed to support reproductive health. Gonadotrophin preparations including FSH (Gonal-F, Puregon) and LH combinations are fundamental for ovarian stimulation protocols. These medications require careful monitoring through fertility clinics with regular ultrasound scanning and hormone level assessments.

Ovulation induction therapies utilise clomifene citrate as first-line treatment, progressing to gonadotrophins for more complex cases. IVF protocol medications include GnRH agonists (buserelin, nafarelin) and antagonists (cetrorelix, ganirelix) for cycle control, alongside luteal phase support with progesterone preparations.

Contraceptive Hormone Options

Modern contraceptive options provide flexible hormone delivery methods. Combined preparations offer various formulations including traditional pills, patches, and vaginal rings. Progestogen-only options include daily pills, injections (Depo-Provera), implants (Nexplanon), and intrauterine systems (Mirena).

Emergency contraception includes levonorgestrel (available without prescription) and ulipristal acetate (prescription-only medicine) providing effective post-coital protection when used appropriately.

Menopause and Hormone Replacement Considerations

HRT preparations address menopausal symptoms through various delivery methods including tablets, patches, gels, and pessaries. Treatment selection considers individual risk factors, symptom severity, and patient preferences.

• MHRA safety guidelines compliance
• Annual review requirements
• Cardiovascular and breast cancer risk assessment
• Specialist menopause clinic referrals when appropriate