HT
9 mins

How long does it take for HT to work?

byDr. Nick Morse

You’re probably eager to see quick results and improved symptoms once you decide to start hormone therapy (HT). But how long after starting HT will you feel a difference? Read on to find out what to expect.

How does HT work?

HT is the most effective treatment available for menopause symptoms including hot flashes, night sweats, mood swings, and vaginal changes.

Menopause symptoms are caused by fluctuating and – eventually – low levels of estrogen.

As the name implies, HT works by replacing the estrogen that your body no longer produces. Types of HT include:

  • Oral HT – tablets
  • Transdermal HT – patches, sprays, and gels
  • Vaginal HT – vaginal creams, gels, pessaries, and rings

Read our guide to the different types of HT for menopause.

How long after starting HT do you feel a difference?

Everyone’s experience of taking HT is different. Some may feel a difference within a few days, while for others it might take weeks or even months.

Side effects are common when starting HT treatment. These tend to wear off as your body gets used to the hormones. Read the leaflet that comes with your medication for full details about possible side effects and contact your healthcare provider if you are concerned.

In general, head to the ER if you notice:

  • Shortness of breath or difficulty breathing
  • Chest pain
  • Swelling, redness, or pain in one or both legs
  • Signs of very high blood pressure, including headaches, blurred vision, seeing flashing lights, and dizziness
  • New headaches
  • Any other serious or worrying symptoms 

How long does it take for HT to work?

Everyone’s experience will be different. While you may start feeling a difference within a few days or weeks, it usually takes longer for HT to achieve its full effects.

Six weeks is a reasonable trial period for starting or changing systemic HT (pills, patches, sprays, and gels). If you do not experience any improvement by this point, or troublesome side effects are not getting better, speak to your doctor. They may change your dose or carry out further tests to rule out other causes of your symptoms.

Vaginal HT can take slightly longer to work. You are likely to see an improvement in the first three months, but it can take longer. This is due to the speed at which structural changes can happen in the vagina and genital area during menopause. The more severe your symptoms, the longer it can take to work.

How long do HT patches take to work?

It takes a variable amount of time for HT patches to work, just like other forms of HT. Some will see the first signs of improvement within days or weeks, while others may need to wait a couple of months. 

How long does it take for estrogen gel to work?

Estrogen gel, also known as Oestrogel or Estrogel, works in the same way as other types of HT. You might notice a change within the first few days or weeks, although it’s common to need a few months to see the full effect of treatment.

Why does HT not work immediately?

There are several reasons why your HT may not work immediately. 

  1. It takes time for the hormones to build up to an effective level and to reverse the changes caused by months or even years of low estrogen levels.
  1. Menopause symptoms are complex. While low estrogen levels are largely responsible, the way you experience these symptoms will be affected by many different factors. These include stress, mental well-being, and your general health. You may notice that your hot flashes improve more quickly than symptoms which have multiple contributing factors like mood swings, poor sleep, and aches and pains.
  1. Your symptoms may improve slowly, in which case it becomes more difficult to see the change, and may even seem like your HT isn’t doing much. Symptom tracking can help you to monitor your progress and see how effective your HT really is. You might be pleasantly surprised!

Read more about menopause symptom tracking

What should I do if my HT isn’t working?

It’s normal practice to check in with your healthcare provider around three months after starting or changing HT for a medication review. But, if you are not seeing good improvement by six weeks, you should consider reaching out to them. They might suggest an increased dose or different type of HT if your symptoms are still troubling you.

Occasionally, your healthcare provider may want to revisit your diagnosis if HT really doesn’t help at all. Many different medical conditions can cause symptoms that mimic menopause – they might want to run some tests to rule out other underlying conditions. 

It’s also worth checking that you’re taking your HT correctly. This is especially the case for transdermal HT, such as patches, gels, and sprays. These can sometimes be affected by your:

  • Skincare routine
  • Daily activities
  • Where on your body it’s applied

Check the instructions in your medication pack for further details – and follow the instructions closely.

Find out what to look out for if you think your HT is not working for you.

Final word

After starting HT, it can take a while to feel a difference. You can expect to see significant improvement in your symptoms by the time you have been on treatment for three months, but ask your healthcare provider for advice if things haven’t improved at all after six weeks.

Find out more about menopause on our blog or in our symptoms library