## 3 Conclusions  
Pharmaceuticals and steroid hormones are among the most significant micropollutants present in wastewater, posing a serious threat to the aquatic environment and public health. Steroid hormones are among the most studied pollutants due to their widespread use in hormone therapy and their natural secretion by living organisms. The occurrence of these compounds in watercourses not only affects aquatic organisms (causing endocrine disruption, for example), but also humans and plants. This article presents current methods for removing pharmaceuticals and hormones from wastewater. Although many of them, such as advanced oxidation processes (AOPs), adsorption on activated carbon, membrane filtration, and hybrid systems, show high efficiencies (often >90%), there are still important limitations. The main gaps concern the cost-effectiveness of large-scale implementation, the sustainability of the technology, the risk of secondary contamination, and the environmental impact. In particular, broad-spectrum purification methods are not sufficiently developed as most existing studies focus on a limited number of selected pharmaceuticals and steroid hormones. It is necessary to extend analyses to other classes and subclasses of these compounds to obtain a more complete picture of efficacy and risk. Based on the literature review and the current state of knowledge, the following conclusions are made:  
* The effectiveness of classical wastewater treatment plants is limited--many drugs, such as carbamazepine, ibuprofen, antibiotics, and beta-blockers, pass through biological systems virtually unchanged. * There is a lack of standardised analytical methods and environmental standards for many pharmaceuticals, making it difficult to monitor their presence and disposal efficacy  
\begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Combined** & **Mechanism of Action** & **Homone** & **Pharmaceutical** & **By-Product Details** & **Advantages** & **Disadvantages** \\
**Processes** & **Mechanism of Action** & **Removal [\%]** & **Removal [\%]** & **By-Product Details** & **Advantages** & **Disadvantages** \\ \hline \multirow{3}{*}{AOP + BAC ( bioactive carbon)} & Oxidation + biodegradation in biofiltration bed & 85 & 80 & Oxidised by-products biodegradable in BAC—minimal final toxicity & Toxicity & Media regeneration, microbial \\ \hline \multirow{3}{*}{Plasma + adsorption (AC/MOF)} & Plasma radicals + adsorption or MOF & & & Short-lived radicals (\(\bullet\)OH, NO\(\bullet\) and H\({}_{2}\)O\({}_{2}\)), aromatic fragments; possible nitrated products (with air plasma) & Innovative, fast, chemical-free method & Complexity, installation cost \\ \hline \multirow{6}{*}{Photocatalysis + membrane separation} & Photodegradation of micropollutants on & & & High efficiency, continuous operation, \(\sim\)85–90\% (e.g., ibuprofen and & Short-chain organic acids identified; most found to be non-toxic [1]) & \multirow{2}{*}{\ \begin{tabular}{} \end{tabular}  } & \multirow{2}{*}{ \begin{tabular}{} \end{tabular}  } \\  & & & & & \\ \cline{1-1} \cline{5-5} \cline{5-  
* The efficiency of conventional treatment plants is insufficient for the elimination of pharmaceuticals and hormones--it is necessary to implement advanced technologies and integrate them into hybrid systems. * Most of the research was limited to laboratory and pilot scales, so further research should be carried out on a larger scale, i.e., the technical scale. * Most of the methods were applied only using steroid hormones as a single contaminant in aqueous solution. However, wastewater is a complex mixture, and research should focus on the efficiency of removal in both synthetic and real wastewaters in the presence of other organic and inorganic contaminants. * Most studies have focused on the clearance of oestrogen hormones compared to progesterone and androgens. No new purification processes for progesterone and androgens have been studied. * Membrane systems remove hormones with greater efficiency.