Same day appointments available. Check out our payment options.

What Causes Feet Swelling on Hormone Replacement Therapy Patients?

Testosterone has numerous favorable impacts. Testosterone therapy increases bone strength and density. It promotes induction of hematopoiesis, stimulation of sexual function and libido, cardioprotection, and muscular strength. Men's testosterone levels decrease as they age. Any man with comorbidity that prevents TRT should know all the potential risks.

So what causes swelling feet in hormone replacement therapy patients? Swelling of the feet, legs, and ankles can emerge while taking hormone treatments like steroids, contraceptives with estrogen, an aromatase inhibitor, and androgens. Fluctuating progesterone and an estrogen level can cause decreased blood flow in the legs, resulting in feet and ankle swelling.

Hormones Involved in Testosterone Replacement Therapy

Testosterone replacement therapy treats a low testosterone level in men. It also enhances puberty in circumstances where it has been halted. Testosterone deficiency can cause different symptoms such as decreased sex drive, erectile dysfunction, anxiety, male attributes loss, and fragile bones. 

Procedures of testosterone replacement involve patches, infusions, gels, and medicines. The usual drug class prescription for testosterone replacement is androgens. Furthermore, the following medications and their core components can help increase testosterone production:

  • Transdermal skin patch: Androderm is a skin patch applied on the upper body or arm once a day. 
  • Gels: AndroGel and Testim are clear testosterone gel packets. Applied once a day for the testosterone to penetrate directly through the skin. AndroGel, Axiron, and Fortesta are also available to provide the prescribed hormone levels. Natesto is a gel applied inside nasal passages.
  • Oral patch: Striant is a tablet that adheres to the upper gums above the incisor, which is the tooth to the right or left of the two front teeth. This drug therapy is taken twice daily; it constantly generates testosterone into the blood vessels via the oral tissues.
  • Implants and injections: Testosterone is infused straight into the muscle fibers or embedded in the soft tissues as pellets. The body slowly absorbs the testosterone into the bloodstream.

Oral testosterone is accessible. Moreover, several specialists believe that taking oral testosterone can cause liver disease. Few procedures, including skin patches, gels, orally dissolving tablets, or injections, circumvent the liver and deliver testosterone straight into the blood. In addition, tamoxifen inhibits estrogen's negative responses at the hypothalamus and pituitary gland, which increases testosterone biosynthesis.

Balancing the Benefits and Risks of Hormone Therapy

Senior handsome sportman doing stretching and balancing yoga exercise at home

It's hard to anticipate the results of hormone therapy because each man is unique. Countless men report increased energy, sexual drive, and erection quality. In some men, testosterone improves bone mass, muscular strength, and insulin levels.

Men regularly encounter a change in overall mood as a result of testosterone replacement therapy. It is remarkably subjective whether these effects are barely perceptible or a significant boost.

A University of California-San Diego endocrinologist specializing in testosterone deficiency estimated that one in every ten men is "delighted" about their response to hormonal therapy -- and the rest "don't notice much". The majority of men have positive but variable reactions to testosterone replacement therapy.

For women with menopause, the two prevailing certified indications for HRT prescriptions are menopausal symptom relief and treatment of osteoporosis. HRT risks include an increased risk of breast cancer, blood clot, and possibly heart failure. 

Although the benefits surpass the risk for men and women, alternative therapies for either symptom control or bone defense may be advised for others. The common adverse effects of testosterone replacement therapy are hot flashes, itchiness, or discomfort at the spot where the testosterone adheres.  

Nevertheless, there is proof that testosterone use may increase the risk of blood pressure, heart attack, or stroke. Since vast clinical trials have not yet been conducted, researchers acknowledge the uncertainties of the benefits and risks of long-term testosterone treatment.

Researchers believe that testosterone can exasperate a few health issues:

  • Sleep apnea: Testosterone replacement therapy can aggravate this condition. Men may find it hard to identify this by themselves, but their sleeping partners can usually tell. Polysomnography (sleep study) may be necessary to confirm a diagnosis.
  • Prostate cancer: Testosterone can promote the growth of prostate cancer. Before beginning testosterone replacement therapy, most specialists suggest a prostate cancer assessment. Men who have prostate cancer or have lifted prostate-specific antigen (PSA) levels should certainly avoid testosterone therapy.
  • Benign prostatic hypertrophy (BPH): The prostate naturally occurs in response to testosterone stimulation. Numerous men's prostates enlarge as they grow older, squeezing the tube that transports urine (urethra) and adrenal gland. As a consequence, urinating becomes challenging. Testosterone therapy can aggravate this condition, known as benign prostatic hypertrophy.
  • Blood clots: The FDA necessitates that testosterone replacement products include a disclaimer about the risk of vein clotting. It may increase the likelihood of deep vein thrombosis and pulmonary embolism, a possibly deadly clot in the lungs. 
  • Brands already carried a notice about the risk of a blood clot caused by polycythemia, which is an unusual increase in the production of red blood cells that can occur with testosterone treatment. The caution has been expanded to include men without polycythemia.
  • Congestive heart failure: Taking testosterone replacement can exacerbate the situation in men with severe congestive heart failure.

Massive clinical trials will take years to produce results on the long-term advantages and risks of testosterone therapy. Like any medication, men and doctors must decide whether the potential benefits supersede the risks.

Home Treatments for Swelling Feet, Legs, and Ankles

Middle age man drinking a glass of water with a happy face

Oedema occurs when there's excess fluid in tissues. While edema usually goes away on its own, some home treatments can help reduce swelling and improve comfort. 

1. Purchase compression socks

Anyone can purchase compression socks at a drugstore, a grocery store, or even online. Begin with compression socks measuring 12 to 15 mm or 15 to 20 mm of mercury. They are available in various weights and compressions. It may be wise to start with lightweight socks and work the way up to the type that offers the most relief.

2. Drink 1 to 2 liters of water daily

Though it may appear counterintuitive, drinking plenty of fluids aids in the reduction of swelling. When the body is dehydrated, it holds onto the liquid that it does have. Swelling is exacerbated as a result of this.

3. Raise the feet above the heart level

When sleeping, prop the feet up on cushions, pillows, or items such as phone books. Elevating the feet numerous times a day can also help reduce leg cramps.

4. Foot massage

Massage can help with swollen feet and relieve stress. Massage the feet toward the heart with firm thrusts and pressure (or have someone massage them). It can support moving the fluid out of the area and lessen the swelling.

5. Transform eating habits

Decreasing sodium intake can aid in the reduction of swelling in the body, including the feet. Choose low-sodium versions of favorite foods and stop putting salt in foods.

6. Soak feet for 15 to 20 minutes in a cool Epsom salt bath

Magnesium sulfate (Epsom salt) may help with more than just muscle aches. It may also help to alleviate swelling and inflammation. According to the hypothesis, Epsom salt brings out toxins and promotes relaxation.

7. Lose weight for people with obesity 

Obesity can decrease blood circulation, resulting in inflammation of the lower extremities. It can also cause extra stress on the feet, arising in pain while walking. It can lead to a more sedentary lifestyle, which can lead to fluid retention in the feet.

When Should a Patient See a Doctor About Swelling Feet, Legs, or Ankles?

Shot of a mature man using a cellphone while relaxing on a sofa at home

While feet swelling is usually not a serious concern, it can be an underlying severe condition. The following are some guidelines to help determine when swelling necessitates a visit to the doctor or the urgent care facility. 

If any of the following symptoms are present, see the doctor right away:

  • swollen heart or kidney disease
  • liver disease and are experiencing leg swelling
  • swollen areas that are red and warm
  • pregnant and have sudden or severe swelling
  • have tried natural remedies, but they haven't worked, and the swell is getting terrible

Having any of the symptoms listed in addition to foot, leg, and ankle swelling, should go to the hospital right away:

  • joint pain
  • pressure, and tightness in the chest
  • confusion
  • lightheadedness
  • faintness 
  • difficulty in breathing or shortness of breath
  • dizziness

Other Common Causes of Swollen Feet

Foot, leg, and ankle swelling may originate from various factors. Lifestyle can be the cause of swelling like:

  • weight gain or obesity
  • prolonged periods of standing or sitting

Some potential causes of foot, leg, and ankle inflammation involve medical conditions or physical changes, like:

  • Hormonal changes: These natural changes can occur during pregnancy and menstruation. Puberty can also cause hormonal imbalance.
  • Blood clot formation in the leg: When a blood clot forms in a varicose vein in the leg, it can obstruct blood flow, causing swelling and irritation.
  • An infection or injury: A foot, leg, or ankle injury or infection causes excessive blood flow to the area. It manifests as swelling.
  • Lymphedema: It is also called lymphatic obstruction -- the clogging of the lymphatic system. This system consists of lymph nodes and blood vessels that transport fluid across the body. Lymphatic obstruction is caused by tissues becoming swollen with fluid results in arms and leg swelling.
  • Venous insufficiency: Inflammation of the ankles and feet is a common symptom of venous insufficiency. It is a disorder wherein blood does not move sufficiently up the blood vessels from the legs and feet to the heart. 

When these valves are damaged or deteriorated, blood flows back down the blood vessels. Then, fluid accumulates in the soft tissue of the ankles and feet. Skin changes, skin ulcers, and infection can result from chronic venous insufficiency.

Start Your Hormone Replacement Therapy at Revitalize You MD

Hormone replacement therapy is an option for both men and women dealing with hormone imbalance. Before proceeding, a patient must be examined by healthcare experts to determine the best HRT medications.

Revitalize You MD is home to the most qualified medical practitioners and certified health professionals who can counsel you on hormone therapy. Reach out to us and know more about how our HRT treatments can help you.


The staff is great, the products work!! I am very pleased with my results!

Johari Davis


  • This field is for validation purposes and should be left unchanged.



amex as payment option