HRT Education

If you experience new symptoms, significant side effects, or need a change in medication, your clinician may recommend starting a new visit so your situation can be fully reviewed.

You’re all set

We prescribed a personalized therapy plan to help manage your symptoms.

Your treatment plan was selected based on your health history, symptom profile, and safety screening.

How treatments work:

Systemic estrogen (± progesterone):

Replaces declining circulating estrogen levels throughout the body
Acts on brain (thermoregulation), bones, skin, and urogenital tissues
Most effective treatment for hot flashes and night sweats
Also helps prevent bone loss and can improve sleep and mood
Progesterone is added (if uterus present) to protect against endometrial hyperplasia/cancer from unopposed estrogen

Vaginal estrogen (local therapy):

Works by directly restoring estrogen levels in vaginal tissues.
Thickens the vaginal lining, increases blood flow, and improves natural lubrication.
Helps symptoms like dryness, irritation, pain with sex, and urinary urgency.
Very minimal systemic absorption → mostly stays local, so it doesn’t significantly raise overall body estrogen levels.

SSRIs/SNRIs (for menopause symptoms):

Work centrally in the brain by affecting serotonin (and sometimes norepinephrine).
Help stabilize the hypothalamic “thermostat,” which becomes sensitive during menopause.
Reduce frequency and severity of hot flashes and night sweats.
Also help mood symptoms (anxiety, irritability, depression) that can overlap with menopause.

How to take your medication

Take or apply exactly as prescribed.
If using a patch, apply to clean, dry skin and rotate sites.
If taking oral progesterone, take at bedtime unless otherwise directed.
Use vaginal estrogen as directed — dosing schedules vary.

Consistency is important. If you miss a dose, follow pharmacy instructions or message us for guidance.

What to expect

Symptom improvement often begins within 2–4 weeks
Full benefit may take up to 8–12 weeks
Mild breast tenderness or spotting in the first few months
Temporary bloating or mood changes

Many early side effects improve as your body adjusts.

Safety information

Hormone therapy may slightly increase risk of blood clots or stroke in higher-risk individuals
Risk varies based on age, timing since menopause, and route of therapy
Report new symptoms, side effects, chest pain, severe headaches, or unusual bleeding

Important: If You Have a Uterus

If you still have your uterus and are taking estrogen, you must also take progesterone (or use a progesterone-releasing IUD) to protect the uterine lining.

Estrogen alone can stimulate the lining of the uterus and, over time, increase the risk of endometrial hyperplasia (overgrowth of the lining) and uterine cancer.

Do NOT stop progesterone while taking estrogen unless specifically directed by your provider.

Progesterone is an essential part of safe hormone therapy for women with an intact uterus.

Ongoing monitoring is essential

Hormone therapy requires continued preventive care.

Maintain annual mammograms
Keep blood pressure and cholesterol up to date
Attend routine in-person primary care or gynecology visits
Update us if your health history changes

Continued prescriptions depend on maintaining recommended screenings and routine medical care.

Emergency care

Seek emergency medical attention immediately if you develop: chest pain, shortness of breath, leg swelling or pain, sudden severe headache, vision changes, weakness on one side, or severe unexplained bleeding.

For mental health emergencies, call the 988 Suicide and Crisis Lifeline.

Questions or concerns?

If you have questions about your medication, side effects, missed pills, or anything related to your treatment, please send us a message through your secure patient portal.

Using the portal keeps your health information private and allows your clinician to review your chart and respond safely. Messages are typically answered within 1–2 business days.