What to Expect in the First 90 Days of HRT
Starting hormone replacement therapy (HRT) is a big step toward restoring balance, relieving symptoms, and feeling like yourself again. Whether you’re using HRT for perimenopause, menopause, or hormone optimization, the first 90 days are a foundational period of change and adjustment.
Here’s a week-by-week breakdown of what you might experience physically, emotionally, and clinically during the first three months of HRT.
Weeks 1–2: Initial Adjustments Begin
What’s happening in your body:
Your body is beginning to respond to the introduction (or increase) of hormones like estrogen, progesterone, and possibly testosterone.
Depending on your delivery method (pill, cream, patch, injection, pellet, troche), the rate of absorption and onset of effects may vary.
Common experiences:
Mild symptom fluctuations (e.g., hot flashes may start to improve or temporarily intensify before calming).
Some women experience a mood or energy boost within the first 1 to 2 weeks. Others may feel very little, yet or even feel more tired.
Initial side effects: breast tenderness, mild bloating, light spotting (if uterus is present), or headaches.
Tips:
Be patient…your body is recalibrating.
Track your symptoms daily to monitor progress.
Stay hydrated and get adequate sleep.
Weeks 3–4: Early Benefits Start to Show
What you may notice:
Improvement in sleep quality and reduced night sweats.
A decrease in mood swings or anxiety for some users.
Libido may begin to improve if testosterone is included.
You might still experience:
Ongoing breast tenderness or fluid retention.
Minor mood shifts as hormone levels continue to stabilize.
Clinical checkpoint:
Your provider may request a symptom review or check-in to ensure your treatment is well-tolerated.
No lab work is typically done yet unless there’s a concern.
Weeks 5–8: Body and Brain Start Syncing
This is often the “turning point” window.
Hot flashes and sleep disturbances often show significant improvement.
Mood, focus, and memory may start to stabilize noticeably.
Vaginal dryness may begin to ease (if using local estrogen or systemic therapy).
Energy levels and exercise recovery may improve.
Hormonal side effects may still include:
Acne or mild hair shedding (more common with testosterone or DHEA).
Slight spotting (if using progesterone or still have a uterus).
What to do:
Keep up with symptom journaling.
Bring any bothersome symptoms or concerns to your provider; minor adjustments may be necessary.
Weeks 9–12: Time to Reassess and Fine-Tune
By the 3-month mark, your body has had time to reach a new hormonal baseline.
You may feel:
More “like yourself” again, emotionally, mentally, and physically.
Consistently improved sleep, mood, sexual function, and energy.
Fewer intense ups and downs in symptoms.
Clinical checkpoint:
Follow-up labs are often drawn around 10–12 weeks (especially for testosterone or compounded HRT).
Your provider will evaluate your symptom tracking and lab results to adjust your dose, if needed.
What’s next:
Adjustments to route or dose may be made to improve efficacy or reduce side effects.
Most patients move to quarterly or semi-annual follow-ups after this point.
Final Thoughts: Patience and Partnership Are Key
HRT is not a quick fix; it’s a recalibration of your body’s internal systems. The first 90 days are about discovering how your body responds, identifying what’s working, and making any necessary tweaks with your provider’s guidance.
Stick with it, ask questions, and stay consistent. The payoff? A healthier, more vibrant you—now and in the years to come.
Want to Learn More?
Contact Balance & Restore Wellness to schedule your personalized consultation and start your journey to feeling like you again.
