Common Side Effects when using HRT
Understanding the Side Effects of HRT: What to Expect and How to Manage Them
Hormone Replacement Therapy (HRT) can be life-changing for many women navigating the challenges of perimenopause and menopause. It helps ease symptoms like hot flushes, night sweats, mood swings, and brain fog by replenishing declining hormone levels. But like any treatment, HRT can come with side effects - some mild, some more noticeable. Thankfully, for most ladies, these side effects generally settle after three months.
Common Side Effects of Oestrogen
Oestrogen is often the main component of HRT. While many tolerate it well, some may experience side effects as detailed within the table.
Common Side Effects of Progestogen
If you still have a uterus, progestogen is added to protect the womb lining. Possible side effects are shown in the Progestogen table.
Some women are particularly sensitive to progestogen and may benefit from body identical options like micronised progesterone (e.g. Utrogestan) or a hormonal coil.
Bleeding
Light bleeding can be quite common when starting HRT or adjusting the dose, and it usually settles within 3 to 6 months. However, if the bleeding is heavy, happens after sex, or continues beyond six months, it’s important to speak to your GP, as they may recommend an examination or further tests to rule out other causes.
Combined HRT?
Combined HRT (oestrogen and progestogen) can cause a mix of the usual side effects mentioned earlier. It’s also quite normal to have some irregular bleeding during the first 4 to 6 months, particularly with continuous use.
When to Seek Help
Most side effects are temporary, but you should speak to a healthcare professional if:
- Bleeding continues beyond 6 months
- Side effects are severe or impact your quality of life
- You’re unsure whether symptoms are from HRT or menopause itself
| Possible Oestrogen side effects | Try any of the below suggestions to help with side effects |
|---|---|
| Fluid retention | Reduce dose |
| Breast tenderness/swelling | Change route |
| Headchaes/increase in migraines | Change method |
| Nausea/Dyspepsia | Try & work out which hormone is causing the effect |
| Bloating | |
| Itching | |
| Leg cramps | |
| Irregular vaginal bleeding (esp. in the first few months) | |
| Dizziness | |
| Mood changes |
Many of these symptoms improve as your body gets used to the treatment, but if they continue, adjusting the dose or trying a different form - like switching from tablets to patches or gel - can often make a difference.
| Possible progestogen side effects | Try any of the below suggestions to help with side effects |
|---|---|
| Fluid retention | Change type |
| Breast tenderness/swelling | Reduce dose (only under specialist guidance) |
| Headaches | Change route |
| Mood swings | Alter duration |
| PMT-like symptoms | |
| Acne/greasy skin | |
| Change in vaginal discharge | |
| Dizziness | |
| Itching | |
| Spotting or bleeding between periods |
Conclusion
While responses to HRT can vary from person to person, some side effects may resolve naturally over time, whereas others may require adjustments. Our goal is to see noticeable improvement within approximately three months.
HRT is a highly individual experience - what works well for one person might not be the best fit for another. Finding the right type, dose, and way of taking it can take time, but with the right guidance, it can be truly life changing. If you’re thinking about starting HRT or having trouble with side effects, get in touch with us and we can help you explore your options with confidence and support.
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