Hormones & Endocrine

Hormonal interventions can produce large effects in defined deficiency or disease indications. Evidence and harms differ outside those populations and by route, dose, and monitoring; the score depends heavily on who was studied, for which indication, and under what conditions.

Strong evidence, route matters

Menopausal hormone therapy (estradiol, with progesterone where a uterus is present) has strong evidence for hot flashes and bone, but its risk profile depends on the route — oral estrogen raises clot risk more than transdermal, which is why "HRT" is not a single number. Testosterone replacement is well evidenced for hypogonadism (TRAVERSE, 2023, was cardiovascular-reassuring). Thyroid hormone replacement is straightforward when there is true deficiency.

The hair and libido corner

Finasteride and dutasteride (5-alpha-reductase inhibitors) have strong evidence for male-pattern hair loss; a minority report persistent sexual side effects, and uncertainty about persistence is reflected in the Safety score. PDE5 inhibitors such as tadalafil and sildenafil have extensive evidence and large reported benefits for erectile function, with well-characterised safety profiles. Topical and low-dose oral minoxidil occupy a separate hair-loss context.

How to read these

A high Benefit score describes effect size in the studied population and indication. Most entries are prescription treatments, and their labeled contexts commonly include diagnosis, laboratory assessment, or monitoring. The rankings show the evidence and cannot determine whether any individual matches the studied indication.