Hormonal homeostasis refers to the balance and regulation of hormones in the body. Hormonal disorders occur when there is an imbalance or dysfunction in the production, secretion, or signaling of hormones. Some of the most common hormonal disorders include diabetes, thyroid disorders, polycystic ovary syndrome (PCOS), and adrenal disorders.

The major hormones in females include estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. In males, the major hormones include testosterone, luteinizing hormone, follicle-stimulating hormone, and prolactin.

Hormones are chemical messengers that are produced by glands in the endocrine system and are released into the bloodstream to affect target cells and tissues throughout the body. Hormones are regulated by a complex feedback system involving the hypothalamus, pituitary gland, and the target glands themselves.

Factors that can affect hormonal balance in the body include stress, diet, exercise, sleep, medications, and medical conditions. Hormones can be classified based on their function, structure, and source. Energy hormones include cortisol, adrenaline, and glucagon. Sex hormones in males include testosterone and in females include estrogen and progesterone. The hormones that control happiness and mood include serotonin, dopamine, and oxytocin.

The hormones that control body temperature include thyroid hormone and cortisol. Hormones that burn fat include growth hormone, testosterone, and thyroid hormone. Stress hormones include cortisol and adrenaline. Prolonged exposure to stress hormones can lead to negative effects on the body, including increased blood pressure, decreased immune function, and increased risk of chronic diseases.

The biological hour refers to the time of day when certain hormones are released in the body. For example, cortisol is typically released in the morning, while melatonin is released at night to promote sleep. Hormones released during sleep include growth hormone and prolactin.

Hormones that control blood pressure include renin, angiotensin, and aldosterone. Hormones that control urination include antidiuretic hormone and aldosterone. Hormones that control digestion include gastrin, secretin, and cholecystokinin.

The vagus nerve is affected by hormones such as cortisol and adrenaline, which can influence its function. Top 10 hormone disorders with the highest mortality rate include thyroid cancer, pancreatic cancer, and pituitary tumors. The top 10 hormonal disorders with high cure rates include thyroid disorders, adrenal disorders, and polycystic ovary syndrome.

Diabetes is a hormonal disorder characterized by high blood glucose levels. It is classified into type 1 diabetes, type 2 diabetes, and gestational diabetes. Novel anti-diabetic treatments include glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors. Hormone replacement therapy is a treatment that involves replacing hormones that the body no longer produces, typically used in postmenopausal women. Long-term hormone therapy can have side effects such as an increased risk of breast cancer.

Growth hormones are hormones that stimulate growth, cell reproduction, and regeneration in humans and other animals. They can also burn fat and release energy. Prolactin is a hormone that stimulates lactation in females. The hormones responsible for lactation include prolactin, oxytocin, and estrogen.

Prolactin is a hormone that is primarily produced and secreted by the anterior pituitary gland in the brain. It is known to play a key role in the regulation of lactation and reproductive function in both males and females. Prolactin is regulated by a complex feedback system involving the hypothalamus, the pituitary gland, and target organs.

Prolactin secretion is primarily regulated by two hormones produced by the hypothalamus: dopamine and thyrotropin-releasing hormone (TRH). Dopamine is an inhibitor of prolactin secretion, meaning that it reduces the production and release of prolactin. On the other hand, TRH stimulates the production and release of prolactin.

There are also a number of factors that can stimulate prolactin secretion, including:

1. Suckling: Breastfeeding or nipple stimulation can increase prolactin secretion, which in turn promotes milk production.
2. Stress: Emotional or physical stress can increase prolactin secretion.
3. Sleep: Prolactin secretion is highest during sleep, particularly during the early morning hours.
4. Estrogen: High levels of estrogen can stimulate prolactin secretion.
5. Certain medications: Some medications, such as antipsychotics and antidepressants, can increase prolactin secretion.

Prolactinomas are a type of pituitary tumor that cause excessive prolactin secretion. The exact cause of prolactinomas is not known, but they are believed to result from genetic mutations or other changes in the DNA that cause uncontrolled cell growth. Prolactinomas can cause a variety of symptoms, including irregular menstrual cycles, decreased libido, infertility, and milk production in both males and females. Treatment for prolactinomas typically involves medication to lower prolactin levels, or in more severe cases, surgery to remove the tumor.

Genes can affect hormone production, regulation, and signaling. Genetic mutations can contribute to hormonal disorders such as thyroid disorders, adrenal disorders, and diabetes.

There are many genes that can affect hormone levels and contribute to hormonal disorders. Some examples of genes that are known to influence hormones include:

1. The genes that code for the receptors that hormones bind to on cells, which can affect how well hormones are able to communicate with cells.
2. Genes that code for enzymes involved in hormone synthesis and metabolism, which can affect the production and breakdown of hormones.
3. Genes that code for transcription factors, which are proteins that regulate gene expression and can affect the expression of genes involved in hormone production and signaling.
4. Genes that code for transporters, which are proteins that move hormones around the body and can affect how quickly hormones are cleared from the bloodstream.
5. Genes that are involved in the development and function of the endocrine system, which produces and regulates hormones in the body.

Examples of hormonal disorders that can be caused by genetic mutations include congenital adrenal hyperplasia, which is caused by mutations in genes involved in steroid hormone production, and familial hyperthyroidism, which is caused by mutations in genes involved in thyroid hormone production and signaling.

It’s important to note that hormonal disorders are often complex and can be caused by a combination of genetic, environmental, and lifestyle factors. Identifying the specific genes involved in a hormonal disorder can help with diagnosis and treatment, but it’s often just one piece of a larger puzzle.

Hormonal therapies are drugs that modify the levels or activity of hormones in the body to treat certain conditions, such as cancer, endometriosis, and hormonal imbalances. Some novel hormonal therapies include:

1. Abiraterone acetate: a drug used to treat advanced prostate cancer by inhibiting the production of androgens (male hormones).
2. Fulvestrant: a drug used to treat hormone receptor-positive breast cancer in postmenopausal women by blocking the activity of estrogen.
3. Relugolix: a drug used to treat advanced prostate cancer and uterine fibroids by reducing the production of the hormone, luteinizing hormone-releasing hormone (LHRH).
4. Elagolix: a drug used to treat endometriosis and uterine fibroids by reducing the production of the hormone, follicle-stimulating hormone (FSH).
5. Enzalutamide: a drug used to treat advanced prostate cancer by blocking the activity of androgens.
6. Palbociclib: a drug used to treat hormone receptor-positive breast cancer by inhibiting a protein called cyclin-dependent kinase 4/6 (CDK4/6) that helps cancer cells divide.
7. Ribociclib: a drug used to treat hormone receptor-positive breast cancer by inhibiting CDK4/6.
8. Bicalutamide: a drug used to treat advanced prostate cancer by blocking the activity of androgens.
9. Anastrozole: a drug used to treat hormone receptor-positive breast cancer in postmenopausal women by blocking the enzyme aromatase, which converts androgens to estrogen.
10. Letrozole: a drug used to treat hormone receptor-positive breast cancer in postmenopausal women by blocking aromatase.

Brief Novel Hormonal Therapies:

1. Abiraterone acetate: Inhibits the production of androgens, used to treat advanced prostate cancer.
2. Fulvestrant: Blocks the activity of estrogen, used to treat hormone receptor-positive breast cancer in postmenopausal women.
3. Relugolix: Reduces the production of LHRH, used to treat advanced prostate cancer and uterine fibroids.
4. Elagolix: Reduces the production of FSH, used to treat endometriosis and uterine fibroids.
5. Enzalutamide: Blocks the activity of androgens, used to treat advanced prostate cancer.

Prognostic View:

Novel hormonal therapies have shown promising results in the treatment of various conditions such as advanced prostate cancer, hormone receptor-positive breast cancer, endometriosis, and uterine fibroids. However, the long-term prognostic view for these therapies is still under investigation.

Any Changes:

Research on novel hormonal therapies is ongoing, and there may be new drugs or treatment approaches developed in the future.

Conditions That Are About to Be Cured:

It is difficult to predict which conditions will be cured by hormonal therapies in the future. However, ongoing research on these therapies may lead to new treatments and potential cures for various hormonal disorders and cancers.

Conditions That Are Heavily Investigated:

Hormonal therapies are currently heavily investigated for the treatment of advanced prostate cancer, hormone receptor-positive breast cancer, endometriosis, uterine fibroids, and other hormonal disorders such as polycystic ovary syndrome and hypothyroidism.

Common Hormonal Disorders in:

• USA: Polycystic ovary syndrome, hypothyroidism, diabetes, and obesity.
• UK: Polycystic ovary syndrome, hypothyroidism, and diabetes.
• Israel: Hypothyroidism, diabetes, and osteoporosis.
• Canada: Diabetes, hypothyroidism, and osteoporosis.
• Germany: Diabetes, hypothyroidism, and osteoporosis.
• Russia: Hypothyroidism, diabetes, and osteoporosis.
• China: Diabetes, hypothyroidism, and osteoporosis.
• India: Diabetes, hypothyroidism, and polycystic ovary syndrome.
• Australia: Diabetes, hypothyroidism, and osteoporosis.
• Greece: Diabetes, hypothyroidism, and osteoporosis.

There are many hormone analogues and drugs currently undergoing clinical trials for hormonal disorders. Some examples include:

1. Leuprorelin: A gonadotropin-releasing hormone (GnRH) analogue that is being investigated for the treatment of endometriosis, uterine fibroids, and prostate cancer.
2. Ospemifene: A selective estrogen receptor modulator (SERM) that is being investigated for the treatment of vaginal atrophy and dyspareunia.
3. Bremelanotide: A melanocortin receptor agonist that is being investigated for the treatment of hypoactive sexual desire disorder in premenopausal women.
4. Mirabegron: A beta-3 adrenergic receptor agonist that is being investigated for the treatment of overactive bladder syndrome.
5. Pasireotide: A somatostatin analogue that is being investigated for the treatment of acromegaly and Cushing’s disease.
6. Lenvatinib: A tyrosine kinase inhibitor that is being investigated for the treatment of differentiated thyroid cancer and hepatocellular carcinoma.
7. Adalimumab: A tumor necrosis factor (TNF) inhibitor that is being investigated for the treatment of hidradenitis suppurativa.
8. Abaloparatide: A parathyroid hormone-related protein analogue that is being investigated for the treatment of osteoporosis.
9. Dulaglutide: A glucagon-like peptide-1 (GLP-1) receptor agonist that is being investigated for the treatment of type 2 diabetes.
10. Clomiphene citrate: A selective estrogen receptor modulator (SERM) that is being investigated for the treatment of male hypogonadism.

It is important to note that these therapies are still under investigation, and their safety and efficacy in treating hormonal disorders have not been fully established.

Verified by: Rami Diab (May 5, 2023)

Citation: Rami Diab. (May 5, 2023). Hormonal Disorders Overview, Pathophysiology, Novel Therapies. Medcoi Journal of Medicine, 9(2). urn:medcoi:article22254.