Women's Health

How Long After Starting HRT Do You Feel a Difference?

Are you new to HRT? Wondering how long after starting you’ll notice a difference? This article goes over everything you need to know.
Dr. Nayan Patel

Bioidentical hormone replacement therapy (BHRT) is a medically-guided treatment option used to help balance hormones in the body, particularly in those experiencing hormonal imbalances or deficiencies. Drawing similarities from the hormonal changes a person may experience during puberty, it can take years for the body to change from a child to a fully developed adult body. However, BHRT does not take years — in as little as a few weeks or a couple of months, a person may notice positive changes as their hormones are restored.

In this post, we'll discuss everything you need to know about HRT, including how long it typically takes to feel a difference and when to expect noticeable results.

What Is Hormone Replacement Therapy (HRT)?

The goal of BHRT is to bring balance back to your hormones. This can include hormones in the form of pills, injections, patches, or creams.

Bioidentical hormone replacement therapy (BHRT) differs from traditional types of HRT. Bioidentical hormones are chemically “ identical” to the hormones produced by the human body and are often synthesized from phytonutrients (plant-based nutrients). 

In contrast, hormones used in other forms of HRT are synthetic. These types of nonbioidentical hormones are not identical to human physiology but are commonly used in hormonal birth control, such as “the pill,” rings, shots, implants, and hormonal IUDs.

Bioidentical hormones can be prescribed for men or women at many stages in life. Many individuals begin to notice hormonal changes during menopause in women or andropause in men (the male equivalent of menopause). 

Menopausal symptoms include hot flushes, low libido, and mood swings. Meanwhile, men can experience symptoms like fatigue, decreased libido, and loss of muscle mass. Abdominal weight gain, affectionately called the “mid-life middle,” is a common symptom experienced by both men and women. Other hormonal deficiencies that can be treated with BHRT include thyroid or adrenal hormone issues, or any of the following health conditions:

  • Polycystic ovary syndrome (PCOS): a condition that can cause high levels of testosterone in females, resulting in abnormal hair growth and acne
  • Sarcopenia: loss of muscle mass
  • Uterine fibroids
  • Low testosterone in men and women
  • Endometriosis: a condition that involves uterine tissue growing outside the uterus
  • Adrenal fatigue

Ultimately, BHRT can help to bring hormones back into balance. The aim is to restore the body to its natural state of equilibrium, also called homeostasis.

That said, it's important to keep in mind that it's not a cure-all for all conditions, and everyone’s body is different. For most, HRT can take up to 90 days to show noticeable results, and it's likely that you will need to change or optimize treatment over time to adapt as your hormones reach a state of balance. 

Unlike a “water pill,” where a person may experience 10 pounds of water weight loss overnight (and risk electrolyte and water imbalances), BHRT requires consistency and time for safe and long-term results. Seeking guidance from providers trained in BHRT and personalized programs at Thrivelab can help you finally get back to your natural rhythm of life.

What Are the Different Types of Hormones Used in HRT?

BHRT involves a combination of hormones. Many individuals who have had a poor experience with hormone replacement therapy in the past were prescribed monotherapy: only one hormone, such as estrogen (for women) and testosterone (for men). 

Instead, BHRT is like a symphony. All the instruments (in this case, hormones) must be in-tune and harmonized. Otherwise, the out-of-tune violin might steal the show (and not in a good way). 

Below, we will discuss the most common types of bioidentical hormones.


Estrogen is a sex hormone that is primarily produced in the ovaries, although it is also produced in smaller amounts in other tissues, such as the adrenal glands and fat cells. It plays a critical role in women's reproductive health and has numerous other functions throughout the body. 

In women, one of the most important functions of estrogen is to regulate the menstrual cycle and support fertility. It helps to thicken the lining of the uterus to prepare for pregnancy and also plays a role in breast growth and the distribution of body fat. 

Estrogen also supports bone health — think of it as building a stronger bone matrix that can help prevent bone fractures. It is heart-healthy and helps to maintain balanced cholesterol levels. Estrogen is also linked to cognitive function (fast brain processing) and mood regulation (congruent responses to the ups and downs of life).

In men, (yes, men have estrogen too) estrogen is essential for modulating sexual response and creating sperm and also heavily influences mood regulation.

Estrogen levels naturally deplete as we age during phases like perimenopause, menopause, and andropause. However, hormonal birth control, excess use of testosterone replacement in men, and medical conditions, such as polycystic ovary syndrome or thyroid dysfunction, can also cause estrogen imbalance.

Imbalances in estrogen levels can have significant health impacts, so getting your hormones checked on a regular basis is essential to maintaining health. In women, for example, low levels of estrogen can lead to menstrual irregularities, hot flashes, and bone loss. While for men, unbalanced estrogen can lead to infertility, cognitive decline, and a disarrayed mood. 

Excessive levels of estrogen, also called estrogen dominance, may contribute to an increased risk of blood clots and other health issues. 


For women, progesterone is predominantly produced in the ovaries after ovulation, although it is also produced in smaller amounts in other tissues, such as the adrenal glands and placenta. It plays a critical role in women's reproductive health and has numerous other functions throughout the body.

One of the most important functions of progesterone is to support pregnancy. It helps to thicken the lining of the uterus to prepare for the implantation of a fertilized egg and maintain the pregnancy by relaxing the muscles of the uterus. Progesterone also plays a role in regulating the menstrual cycle and preparing the breast tissue for lactation.

However, imbalances in progesterone levels can have significant effects on women's health. For example, low levels of progesterone can lead to infertility, miscarriage, and irregular menstrual cycles. On the other hand, excessive levels of progesterone can cause mood swings, bloating, and breast tenderness. Factors that can cause imbalances in progesterone levels can be anything from stress, aging, hormonal birth control, pre existing medical conditions such as polycystic ovary syndrome or thyroid dysfunction.

Progesterone is thought to be primarily a female hormone, yet men need progesterone to create testosterone. In men, progesterone is produced in the testes and adrenal glands, playing a role on the central nervous system (which regulates sleep), the immune system, heart health, kidney function, fat deposits, the lungs, and behavioral responses.

Progesterone is a building block for many hormones, such as cortisol and testosterone. It also contributes to building bone mass and takes part in regulating blood sugar, brain activity, and functions throughout the body to ensure a healthy balance. It is a precursor to testosterone, and low levels can often result in a lack of sex drive. 

Other Hormones

Other types of BHRT can include:

  • Thyroid hormones, which help to regulate metabolism, energy levels, and body temperature
  • Testosterone, which is responsible for libido and muscle mass.
  • Melatonin, which helps to regulate the body's sleep-wake cycle
  • Cortisol, which plays a role in stress response and resilience
  • Human Chorionic Gonadotropin (hCG), which helps to regulate hormones during pregnancy
  • DHEA, called the “fountain of youth,” which nourishes the adrenal glands and the brain. 

Choosing the right combination of hormones is key to getting the most out of BHRT. Therefore, it's important to work closely with an experienced healthcare professional to determine the best course of treatment for you.

Who Should Consider BHRT?

Many people are suffering from hormonal imbalances. After an appointment with their primary care provider or gynecologist, they may be left with unanswered questions, like “ Why am I still feeling horrible?” As many as 1.3 million people are misdiagnosed for hormonal imbalances. 

Many people ask what the cause of hormonal issues is. This can be summed up in two words: endocrine disruptors. 

Endocrine disruptors are chemicals found in food, water, pollutants in the air, toxins in household cleaning products, and chemicals in hair, skin, and makeup products. Endocrine disruptors are hormone-disrupting substances that can wreak havoc on our health. 

Even if you aren’t currently experiencing symptoms of a hormonal imbalance, you are most likely at risk for exposure to endocrine disruptors due to the prevalence of these chemicals in our day-to-day environment. That’s why it is important to be proactive with your health and address full-body holistic support for optimal wellness. 

Those who report adverse symptoms from endocrine disruptors may have one or many of these uncomfortable and even debilitating symptoms:

  • Reduced libido
  • Hot flashes and night sweats
  • Hair loss
  • Joint pain
  • Mood swings
  • Sleep disturbances
  • Vaginal dryness
  • Osteoporosis
  • Weight gain
  • Low energy levels
  • Erection issues 
  • Vaginal bleeding
  • Difficulty concentrating
  • Skin dryness
  • Depression and anxiety
  • Irregular menstrual cycles
  • Memory loss
  • Brain fog
  • Loss of muscle mass

If you're feeling any of these symptoms and want to see if bioidentical hormone replacement therapy is right for you, book an appointment with us and speak with a board-certified healthcare professional. 

A Thrivelab provider can determine if you have a hormonal imbalance by taking a close look at your symptoms, medical history, discussing your lifestyle and habits, and performing lab tests, including blood, urine or saliva tests.

Does BHRT Have Any Side Effects?

An experienced provider will collaborate with you to determine if BHRT is a safe option. They will actively listen to your concerns and complete a thorough health history to better understand your health profile.

If your doctor determines that BHRT is a good option for you, it can help support your overall quality of life. An experienced provider will work with you to balance your hormones and prevent unwanted side effects. Hormone excess is often due to a lack of follow-up with their healthcare provider.

An experienced provider knows that everyone's body is different, therefore your treatment plan should reflect that. Your unique hormone expression is called your “bio-identity.” This means that the hormones that may be best for you may be different from another person who is of a similar age and sex. Some people may benefit from low doses, while others may see greater effects of HRT while taking high doses. 

Our hormones are not static; they change in response to internal and external day-to-day life, our stress levels, with women’s cycles and so much more. Knowing this, a provider must be willing to remain in close communication with you as you learn your “bio-identity.” 

It’s important to meet regularly with your doctor to discuss progress, perform routine lab work and optimize medication as your hormones balance, change and evolve over time. A tailored approach to bioidentical hormone replacement therapy requires sensitive and nuanced care.

How Long Does It Take To Start Feeling Results?

Remembering that time is medicine and factoring in your unique bio-identity, you may notice subtle effects within days of using BHRT, though it may take up to 90 days to start feeling the full effects of BHRT. 

Factors that can impact the time and effectiveness of BHRT include:

Your Body Chemistry

Your bio-identity impacts your metabolism and your gene expression. This varies from person to person and is different between you and your family members. 

Discovering your hormonal bio-identity requires the willingness to work with a trained provider to determine what is right for you. Hormone levels often need to be adjusted or changed over time, especially for a patient’s first 6 months on BHRT. The dynamic nature of hormone replacement therapy requires close communication and monitoring.

The most important tool for success is your feedback about how you are feeling. That’s why Thrivelab offers 45-minute consultations - three times longer care than what a patient would typically experience in a traditional doctor’s office. We want to hear about your concerns, monitor your progress, and give you the answers you need to pursue holistic wellness.

Individual Health Factors

Other individual health factors, such as age and pre-existing conditions, can also affect how quickly you see results from BHRT. Additionally, the severity of your condition and how long you've been experiencing symptoms can also determine the timeline for seeing results. Typically, the earlier you start, the better the results.

Always disclose your full medical history to your healthcare professional.

Diet and Lifestyle Habits

An experienced provider will review your foundational health pillars, including sleep, stress, diet, exercise, and lifestyle habits. These are foundational because they play a major role in how quickly you experience results from BHRT. 

For instance, eating an anti-inflammatory diet, such as the Paleo diet (which avoids known inflammatory foods such as dairy and gluten), has been shown to decrease inflammation and improve inflammatory markers. Optimizing movement, stress management and sleep are just as important as a healthy diet. Once your hormones are optimized, you may notice you have the energy to exercise regularly again. You may be able to manage stress and cope with the demands of life better. In order to feel your best and get the most out of BHRT and encourage faster results, taking care of your body and mind in all facets of life is essential.

Thrivelab takes a holistic approach to HRT, and our patient care can help guide you through lifestyle recommendations that will allow you to reap the greatest benefits.

Commitment and Consistency

It's important to be consistent with your treatment and take all the necessary steps, such as checking in regularly with your provider and staying on top of any lifestyle changes that may be necessary. By committing to treatment, you can ensure that your hormone levels remain balanced, which will help to keep you on track for seeing the results you want. 

Ultimately, there is no one-size-fits-all answer to how long it takes to start noticing the effects of BHRT. It's important to discuss your treatment plan and timeline with a trained healthcare professional who can provide personalized guidance and help you achieve the best possible results in a timely manner. 

What If You Don’t Notice a Difference During BHRT?

Even if you've been on the same treatment regimen for a few months and haven't seen any improvements, that doesn't necessarily mean it's not working.

Many people experience different levels of hormonal fluctuations, and you may need to raise or lower your dose or switch hormones altogether in order to find the right balance for your body. For example, if you have tried oral hormones in the past without success or with harsh side effects, you may benefit from a topical hormone instead. 

Additionally, it's important to keep in mind that BHRT is a long-term commitment. If you're feeling frustrated, talk to your provider about any of the aforementioned choices that may help speed up the process. 

What Can You Expect After One Month of Treatment?

Hormones work from the inside out. Once you've been on BHRT for a month, you may begin to see some subtle changes. 

Mood-related symptoms like anxiety, irritation, or impatience may begin to subside. Sleep disturbances begin to improve, and you may notice small improvements in the symptoms you were originally experiencing, such as hot flashes or mood swings, and a general increase in energy levels.

Many women report improvements in their menstrual cycle with more regularity. Men may notice increases in their sex drive and improved mood. Energy levels often improve with a noticeably shortened recovery time. 

Ultimately, the goal is for your body to feel balanced and healthy. So, it's important to keep a close eye on how you're feeling and address any new or worsening symptoms with your healthcare provider.

What Can You Expect After Three Months of Treatment?

After three months of HRT, you may begin to notice more substantial changes. Female patients experience benefits of HRT like renewed energy, mental clarity, increased sexual desire, and younger, firmer-looking skin. Male patients experience leaner muscle mass, increased stamina, and better blood circulation.

Many people notice higher energy levels and a general sense of well-being, both physically and mentally. 

For example, with the use of bio-identical testosterone, there may be improved muscle mass, which results in improved metabolic rate and increased strength. Increases in libido are also common, along with improved glycemic control and better metabolism of food. Body composition and weight loss changes may also be noticeable at this time. 

The Bottom Line

Working with a trained provider, commitment to consistency, and time are the three keys to noticeable differences with the use of BHRT. Your unique bio-identity is another factor that determines when you will experience the full benefits of BHRT. 

Your provider will help support you in being consistent with your use of BHRT for maximum benefit. Your commitment must also be coupled with a collaborative provider relationship so that your hormones are paired with positive lifestyle changes. 

Note that the results that you notice within the first month are just the tip of the iceberg, and to reach your desired outcome, you may need a full six months. 

Ultimately, it's important to have realistic expectations and take things one step at a time. Talk to your healthcare provider about what you can do to achieve the best results in the most timely manner.

Here at Thrivelab, our goal is to empower you to take control of your health and make informed decisions — that's why we offer personalized HRT plans tailored specifically to your needs and health goals. If you're ready to feel and perform at your best, book your appointment with a board-certified provider today.


  1. 1. Hormone therapy: Is it right for you? | Mayo Clinic 
  2. 2. Estrogen & The Heart: Risks, Benefits & Side Effects | Cleveland Clinic 
  3. 3. Andropause: Current concepts | PMC 
  4. 4. Endometriosis | NHS 
  5. 5. The role of estradiol in male reproductive function | PMC 
  6. 6. Progesterone: the forgotten hormone in men? | Pubmed 
  7. 7. Progesterone in Men | Clinicum St. Georg 
  8. 8. Contributor: In the Misdiagnosis of Menopause, What Needs to Change? | AJMC 
  9. 9. Endocrine Disruptors | Pubmed 
  10. 10. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults | Pubmed 
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