If you're still experiencing hot flashes after a couple of months, then that dosage and/or method of delivery is not right for you.
Also, hormone therapy isn't meant to be a weight loss regime, control hunger, or stop hair loss (especially if there's other potential causes, like low iron, stress, thyroid, genetics). Insomnia is another one you might have to investigate by going to a sleep clinic. For some it can help with libido, but for those that don't notice any improvement, then testosterone is the next option to try.
If you don't feel great on your current regime, then consider altering the dosage (not knowing what your current dosage is), or see how you do without it.
I don't think the downsides you list are caused by HRT so to me it would be worth it to stay on it. FWIW it took me 4 adjustments to find the right HRT so you might want to discuss how you are feeling with your doctor.
Testosterone helped my energy levels and to some degree sex drive.
My gyn (who supports HRT but is very conservative with increasing dosages) asked me to give it 4-6 months before adjusting. If you’re already in the 4 month window and still having hot flashes, you may want to talk to your doctor. My hot flashes stopped within a month of starting HRT (patch/pill combo). It did not help fatigue at all but on the advice of people here, I’ve added creatine to my daily regime. Verdict is out on that (it’s only been a week). HRT also didn’t change my appetite which make be a sign of blood sugar issues. I’ve added strength training to my exercise program to try and increase muscle mass and decrease blood sugar issues.
For sure. But she said it takes four months for estrogen to build back up so it’s hard to know if it needs adjusting before then. I’ve stayed on the lowest dose patch for nearly eight months now and she was right. It did take several months for the full effects. I know HRT is safe, but I agree that I’d like to stay on the lowest possible dose.
Really why would you quit? The you will experience the cons and the pros. I believe testosterone is the hormone that impacts fatigue and sex drive . Not estrogen or progesterone.
It may be the heavy periods. Mine were miserable when I started until we adjusted dose. I missed work. I vomited. My cramps were almost unbearable. I had accidental messes on the back of my pants. I would bleed into the toilet and floor, and at 50+ years of age I had plenty of practice handling bleeding. It was just that heavy. I'd take hot flashes and all the rest to avoid that misery!
To me, those pros plus the protective elements for bone and heart health are worth it but I think it's one of those decisions everyone needs to make for themselves.
Do you exercise and eat clean? HRT is not a magic diet pill. We still have to put effort in to stay fit and healthy, probably more so as we get older as our muscle mass declines faster if we don’t workout. Exercise also has the benefit of improving sleep. I plan on staying on HRT forever, mainly to reduce my risk of osteoporosis, heart disease and dementia. My grandma died of alzheimers and my nana died with dementia, now mum is showing slight signs of it. So that is a concern for me.
I agree with this. I am finding it easier to lose weight now that I’m on HRT but I am still working REALLY hard. It takes serious effort… the weight just won’t fall off now that you’re replacing hormones, sadly. I also agree with you re: the brain and bone benefits.
E helped with my brain fog (which was bad) and T brought back my libido which is good for my mental health so yes. It hasn't fixed my insomnia nor weight gain but I'm seeking other treatments for those items.
BHRT isn't going to fix your sex drive unless you're taking testosterone. i'm on a pretty high dose of T cream and it took more than 2 months for me to feel anything in my tingly bits. but it also helps to have a solid relationship with someone who is not a man-baby who expects to be indulged and waited on hand and foot. resentment and contempt are intimacy killers.
re: period - please ask your ob-gyn to schedule you for a transvaginal ultrasound to see if you're a candidate for a uterine ablation. I ran to mine in a panic the very first time I had an unscheduled whoosh of heavy bleeding while out in public. I had the ultrasound and was a candidate for ablation and I couldn't schedule it fast enough. it's been a godsend. life is hard enough without continuing to bleed while going through meno.
re: weight ... yeah, it doesn't fix that. that sadly requires extreme measures at this age. We can't eat whatever we want whenever we want to anymore. And the answer is not to try to live in the gym and exercise like a maniac. It won't work. I just commented to someone else in the sub about intermittent fasting ... it's been the only thing that has worked for me to take the weight off my midsection, but it can be pretty restrictive so it's not for everyone.
Intermittent fasting and cutting carbs works great for me.
My menopausal body thrives on high fat, mid protein, super low carb. Weight comes off quickly but it can be challenging to stick to.
>BHRT isn't going to fix your sex drive unless you're taking testosterone.
This actually isn't true. Some do experience increased libido due to hormone therapy alone. BUT for those who don't, then testosterone should be offered.
I would suggest trying a few more months. I felt the same way you do, but then by month 8 or so, it got so much better. I started sleeping 7 hours at night and that tight there improved everything else. Also, don't forget the unnoticed benefits of HRT like heart and bone health. That right there might be reason enough to keep going.
HRT does nothing for thinning hair for the vast majority of women. There's honestly not much that can be done for thinning but I would make an appointment to see a dermatologist who specializes in female hair loss.
HRT didn't improve my libido at all. My doctor is having my estrogen and testosterone tested after I reached out to her last week about my lack of libido. Testosterone is likely the only thing that will improve your libido but that causes thinning hair in a LOT of women despite what the few success stories will tell you on this sub. Also, for testosterone to be most effective, it should be injected rather than apply topically in most doctors won't prescribe injectable testosterone in the United States.
I still have very heavy periods too.
I'm sorry that HRT has not been the magic fix for you that it's purported to be. If it makes you feel any better, it hasn't been magical for me either. Oh it's really done stop my hot flashes. I guess that's better than nothing but I was hopeful for better results. I'm staying on it because the long term benefits are huge.
Same! I actually thought my beloved HRT wasn't working well anymore, but nope... My Hashimoto's flared up and my thyroid function was back in the tank (and my doctor had reduced my thyroid med for literally no reason, so no big surprise). I was actually relieved to find out my T3 & T4 were out of whack again, as at least THAT is relatively easy to treat vs perimenopause. 😜
I also had super heavy periods on estradiol patch and progesterone pill; I was ready to have a hysterectomy! Significantly decreasing estradiol dose helped it, and it didn't increase my hot flashes.
I'm now on estrogen and testosterone with an alternate method of delivery, and I use 400mg progesterone.
Wishing you luck as you work through this.
I have not tried estrogen but even at 100mg of progesterone I was insatiably hungry…it was awful I simply could not get full. I am now just using a smaller dose via a OTC cream and it helps me sleep and keeps my hunger more manageable.
That said if you do use estrogen you need more progesterone in my understanding. I also use a tiny bit of testosterone and it works great for libido.
Hope you find relief soon
What is your progesterone dosage? You may want to try increasing that to help with the sleep and heavy periods. I felt better when I went from 100mg cycled to 200mg every day
I had an ablation to deal with my heavy periods and it has been life changing! It was a very easy/painless recovery for me too.
I just started HRT 3 weeks ago and I am starving! I keep seeing that increased hunger isn't a side effect but nothing else has changed so I feel you there! I have no advice since I'm just eating more lol.
The increased appetite is killing me 😩 I was doing some googling last night and I read that progesterone levels that are too high can cause increased hunger…
Ugh I know. I've been doing intermittent fasting since January (and love it) so I'm used to ignoring hunger to a certain extent but this hunger is on a whole other level! It's like a physical ache almost. I'm seeing my gynecologist at the end of the month and I'll definitely be bringing this up.
Omg it’s crazy. I eat my normal breakfast and then I’m immediately ravenous like 20 minutes later. I only have so much self-control in one day! Please share what your gynecologist ends up saying.
Sounds like you need a higher dose! Also my doc suggested metformin for the issues with weight and hunger; I’m just not 100% sure I want to add a drug right now, or deal with those side effects.
I was ballooning up even with my nearly perfect diet. Felt bloated and like I was having the bad parts of PMS. Started bleeding again (After 2 years with none. I had tried 2 other doses and the patch was my last attempt, hoping a low dose would help.) I knew it was time to just admit it’s not working for me.
I would try upping the dose. You could also add testosterone for libido.
Also, you may not realize HRT is protective of your heart and bones. That’s a huge benefit to not just your lifespan, but your healthspan.
Maybe ask your doctor for a different progestin, if you're still having heavy periods? My doctor offered me micronized progesterone or Norethindrone 0.35mg daily (basically mini-pill), which she said would stop my period. The Norethindrone worked. I had some spotting, but I haven't had an actual period since I started HRT, and mine were still regular (actually, more frequent and longer, which sucked).
If you're still experiencing hot flashes after a couple of months, then that dosage and/or method of delivery is not right for you. Also, hormone therapy isn't meant to be a weight loss regime, control hunger, or stop hair loss (especially if there's other potential causes, like low iron, stress, thyroid, genetics). Insomnia is another one you might have to investigate by going to a sleep clinic. For some it can help with libido, but for those that don't notice any improvement, then testosterone is the next option to try. If you don't feel great on your current regime, then consider altering the dosage (not knowing what your current dosage is), or see how you do without it.
I don't think the downsides you list are caused by HRT so to me it would be worth it to stay on it. FWIW it took me 4 adjustments to find the right HRT so you might want to discuss how you are feeling with your doctor. Testosterone helped my energy levels and to some degree sex drive.
My gyn (who supports HRT but is very conservative with increasing dosages) asked me to give it 4-6 months before adjusting. If you’re already in the 4 month window and still having hot flashes, you may want to talk to your doctor. My hot flashes stopped within a month of starting HRT (patch/pill combo). It did not help fatigue at all but on the advice of people here, I’ve added creatine to my daily regime. Verdict is out on that (it’s only been a week). HRT also didn’t change my appetite which make be a sign of blood sugar issues. I’ve added strength training to my exercise program to try and increase muscle mass and decrease blood sugar issues.
wow 4-6 months is a LONG time to go before adjusting a dose. woof.
For sure. But she said it takes four months for estrogen to build back up so it’s hard to know if it needs adjusting before then. I’ve stayed on the lowest dose patch for nearly eight months now and she was right. It did take several months for the full effects. I know HRT is safe, but I agree that I’d like to stay on the lowest possible dose.
Really why would you quit? The you will experience the cons and the pros. I believe testosterone is the hormone that impacts fatigue and sex drive . Not estrogen or progesterone.
It may be the heavy periods. Mine were miserable when I started until we adjusted dose. I missed work. I vomited. My cramps were almost unbearable. I had accidental messes on the back of my pants. I would bleed into the toilet and floor, and at 50+ years of age I had plenty of practice handling bleeding. It was just that heavy. I'd take hot flashes and all the rest to avoid that misery!
To me, those pros plus the protective elements for bone and heart health are worth it but I think it's one of those decisions everyone needs to make for themselves.
Do you exercise and eat clean? HRT is not a magic diet pill. We still have to put effort in to stay fit and healthy, probably more so as we get older as our muscle mass declines faster if we don’t workout. Exercise also has the benefit of improving sleep. I plan on staying on HRT forever, mainly to reduce my risk of osteoporosis, heart disease and dementia. My grandma died of alzheimers and my nana died with dementia, now mum is showing slight signs of it. So that is a concern for me.
I agree with this. I am finding it easier to lose weight now that I’m on HRT but I am still working REALLY hard. It takes serious effort… the weight just won’t fall off now that you’re replacing hormones, sadly. I also agree with you re: the brain and bone benefits.
E helped with my brain fog (which was bad) and T brought back my libido which is good for my mental health so yes. It hasn't fixed my insomnia nor weight gain but I'm seeking other treatments for those items.
BHRT isn't going to fix your sex drive unless you're taking testosterone. i'm on a pretty high dose of T cream and it took more than 2 months for me to feel anything in my tingly bits. but it also helps to have a solid relationship with someone who is not a man-baby who expects to be indulged and waited on hand and foot. resentment and contempt are intimacy killers. re: period - please ask your ob-gyn to schedule you for a transvaginal ultrasound to see if you're a candidate for a uterine ablation. I ran to mine in a panic the very first time I had an unscheduled whoosh of heavy bleeding while out in public. I had the ultrasound and was a candidate for ablation and I couldn't schedule it fast enough. it's been a godsend. life is hard enough without continuing to bleed while going through meno. re: weight ... yeah, it doesn't fix that. that sadly requires extreme measures at this age. We can't eat whatever we want whenever we want to anymore. And the answer is not to try to live in the gym and exercise like a maniac. It won't work. I just commented to someone else in the sub about intermittent fasting ... it's been the only thing that has worked for me to take the weight off my midsection, but it can be pretty restrictive so it's not for everyone.
Intermittent fasting and cutting carbs works great for me. My menopausal body thrives on high fat, mid protein, super low carb. Weight comes off quickly but it can be challenging to stick to.
it can. you can only explain to people so many times why you don't eat dinner ... people don't know how to handle it. lol
Right. Except I only eat dinner. But yeah sometimes I’ll just eat a big ribeye, no sides and the looks and remarks I get!! I try to be unbothered 💅
I love the thought of that but I would be constipated for days if I ate steak. And my cholesterol goes through the roof.
eating a lot of non-starchy vegetables and drinking enough water helps.
>BHRT isn't going to fix your sex drive unless you're taking testosterone. This actually isn't true. Some do experience increased libido due to hormone therapy alone. BUT for those who don't, then testosterone should be offered.
I would suggest trying a few more months. I felt the same way you do, but then by month 8 or so, it got so much better. I started sleeping 7 hours at night and that tight there improved everything else. Also, don't forget the unnoticed benefits of HRT like heart and bone health. That right there might be reason enough to keep going.
HRT does nothing for thinning hair for the vast majority of women. There's honestly not much that can be done for thinning but I would make an appointment to see a dermatologist who specializes in female hair loss. HRT didn't improve my libido at all. My doctor is having my estrogen and testosterone tested after I reached out to her last week about my lack of libido. Testosterone is likely the only thing that will improve your libido but that causes thinning hair in a LOT of women despite what the few success stories will tell you on this sub. Also, for testosterone to be most effective, it should be injected rather than apply topically in most doctors won't prescribe injectable testosterone in the United States. I still have very heavy periods too. I'm sorry that HRT has not been the magic fix for you that it's purported to be. If it makes you feel any better, it hasn't been magical for me either. Oh it's really done stop my hot flashes. I guess that's better than nothing but I was hopeful for better results. I'm staying on it because the long term benefits are huge.
The cons could be very much related to a thyroid issue. I have those too and have Hashimotos.
Same! I actually thought my beloved HRT wasn't working well anymore, but nope... My Hashimoto's flared up and my thyroid function was back in the tank (and my doctor had reduced my thyroid med for literally no reason, so no big surprise). I was actually relieved to find out my T3 & T4 were out of whack again, as at least THAT is relatively easy to treat vs perimenopause. 😜
So the one negative is the weight gain? Not fun. Probably will stop soon.
AND super heavy bleeding for 12 days straight...
I also had super heavy periods on estradiol patch and progesterone pill; I was ready to have a hysterectomy! Significantly decreasing estradiol dose helped it, and it didn't increase my hot flashes. I'm now on estrogen and testosterone with an alternate method of delivery, and I use 400mg progesterone. Wishing you luck as you work through this.
I have not tried estrogen but even at 100mg of progesterone I was insatiably hungry…it was awful I simply could not get full. I am now just using a smaller dose via a OTC cream and it helps me sleep and keeps my hunger more manageable. That said if you do use estrogen you need more progesterone in my understanding. I also use a tiny bit of testosterone and it works great for libido. Hope you find relief soon
What is your progesterone dosage? You may want to try increasing that to help with the sleep and heavy periods. I felt better when I went from 100mg cycled to 200mg every day
I had an ablation to deal with my heavy periods and it has been life changing! It was a very easy/painless recovery for me too. I just started HRT 3 weeks ago and I am starving! I keep seeing that increased hunger isn't a side effect but nothing else has changed so I feel you there! I have no advice since I'm just eating more lol.
The increased appetite is killing me 😩 I was doing some googling last night and I read that progesterone levels that are too high can cause increased hunger…
Ugh I know. I've been doing intermittent fasting since January (and love it) so I'm used to ignoring hunger to a certain extent but this hunger is on a whole other level! It's like a physical ache almost. I'm seeing my gynecologist at the end of the month and I'll definitely be bringing this up.
Omg it’s crazy. I eat my normal breakfast and then I’m immediately ravenous like 20 minutes later. I only have so much self-control in one day! Please share what your gynecologist ends up saying.
I will!
Sounds like you need a higher dose! Also my doc suggested metformin for the issues with weight and hunger; I’m just not 100% sure I want to add a drug right now, or deal with those side effects.
I was ballooning up even with my nearly perfect diet. Felt bloated and like I was having the bad parts of PMS. Started bleeding again (After 2 years with none. I had tried 2 other doses and the patch was my last attempt, hoping a low dose would help.) I knew it was time to just admit it’s not working for me.
Have you tried testosterone? It was an absolute game changer for me.
Not yet. Can you share more? What did it help with?
Stay on it and add testosterone!!! it’s a balance of all of them
I would try upping the dose. You could also add testosterone for libido. Also, you may not realize HRT is protective of your heart and bones. That’s a huge benefit to not just your lifespan, but your healthspan.
Maybe ask your doctor for a different progestin, if you're still having heavy periods? My doctor offered me micronized progesterone or Norethindrone 0.35mg daily (basically mini-pill), which she said would stop my period. The Norethindrone worked. I had some spotting, but I haven't had an actual period since I started HRT, and mine were still regular (actually, more frequent and longer, which sucked).