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How Long Does It Take to Reach Female Estrogen Levels on Hormone Replacement Therapy?

As we age, our bodies go through changes like hormonal imbalance that leads to different health concerns and painful symptoms. For some women, hormone replacement therapy is the best way to restore the estrogen levels in their bodies and relieve symptoms that come with estrogen deficiency.

But how long does it take for the female estrogen levels to return to normal after taking HRT? Different types of HRT take different times to affect the body’s hormone levels, but most of them work within a few weeks. Since the body takes time to adjust to the HRT, it might take around a few months for patients to feel the full effects of menopausal hormone therapy.

6 Types of Hormone Replacement Therapy and How Long Before They Take Effect

Estrogen is an important hormone in the body that affects female development and the menstrual cycle. Its production in the female body naturally declines over time, but around 1% of women experience premature menopause and decreased estrogen levels earlier than normal. This puts them at risk of different health conditions including neurological diseases, cardiovascular diseases, several cancer types, osteoporosis, and more.

To prevent these risks and restore the normal level of estrogen in the body, women are often recommended to undergo hormone replacement therapy. This treatment comes in different types which take different times to take effect.

Type of HRTHow It WorksHow Long Before It Works
PillsThis type of oral HRT is often taken once a day without food. The dosage depends on the doctor’s prescription.The effects of estrogen pills become noticeable after about 4 months of regular intake. The doctor might also lower the recommended dosage several times during treatment.
PatchesThe patch is placed on the skin around the abdomen area for a few days before needing a replacement.Patches take a few weeks to show the initial effects. If there isn’t any kind of improvement after consistently using patches for 3 months, it might be time to change the dosage or switch to another kind of HRT.
Estrogen GelThe medication is applied on and absorbed through the skin. The hormones enter the bloodstream to stabilize the estrogen level. It takes a few weeks for the initial results and about three months for the full effects to show.
Vaginal RingsThe small ring is inserted into the vagina to deliver the hormones directly into the reproductive organ.It takes about 2 to 3 weeks for the ring to restore vaginal tissues and relieve different symptoms.
Vaginal CreamThe cream is directly applied to the top wall of the vagina where it directly delivers estrogen.Vaginal cream takes around 3 to 4 weeks to treat vaginal atrophy and other menopausal symptoms.
Hormone Pellet TherapyThis type of HRT uses compounded hormones that are inserted underneath the skin of the gluteal area to deliver consistent doses of hormones into the bloodstream.It takes around 7 to 10 days for the medication to work after pellet insertion.

1. Pills

Oral HRT is the most common form of estrogen therapy. Some of its popular examples include conjugated estrogen, estratab, and estradiol. They’re usually taken once a day without food, but some patients have complicated intake schedules because of the dosage prescribed by their doctor.

Estrogen pills are helpful when it comes to relieving different menopausal symptoms, such as hot flushes and vaginal dryness. They also help reduce the risk of osteoporosis by increasing bone density. Pills also have the most studies to prove their effectiveness than other types of HRT.

Aside from the usual risks associated with taking estrogen therapy, oral estrogen is especially hard on the liver. Patients who have a history of liver problems should try other estrogen treatments to avoid the risk of severe liver damage. Oral estrogen might also cause stomach problems if it’s taken with other medications. It also increases the body’s cholesterol level since it’s metabolized in the liver.

2. Patches

Woman Applying Patch On Her Arm At Home

Vivelle Dot, Estraderm, Climara, and Alora are some examples of skin patches that help restore the estrogen levels in perimenopausal and menopausal women. Menostar is another example of an estrogen patch, but it only works for hormone deficiency, not other menopause symptoms. Skin patches are usually placed on the lower stomach and changed once or twice a week.

Estrogen patches are safer for people with liver problems because they bypass the liver and go directly into the patient’s bloodstream. It’s also a lot more convenient because patients don’t need to remember specific schedules when they have to take a pill.

While they have their own set of advantages, estrogen patches also share the same risks and side effects associated with oral estrogen pills and other estrogen replacement therapies. The patch might also lead to skin irritation in rare cases, which is why it’s important to inform the doctor immediately about unusual symptoms.

Patients with estrogen patches are also asked to avoid high temperatures and direct sunlight. Heat causes the patches to release the estrogen too quickly, which gives the patient a high dose at the start and a low dose later on.

3. Estrogen Gel

Estrogen gels like Divigel directly enter the bloodstream once they’re absorbed through the skin. They’re usually applied once a day on one arm of the patient — from their shoulder down to their wrist. They’re also deemed safer for patients with cholesterol and liver problems since they bypass the liver.

Topical gels also have the same slight risk of different medical conditions as other menopausal hormone therapy. Another problem associated with topical estrogen gels is that they’re likely to get washed or rubbed off even before the skin fully absorbs the medication. It’s important to let the gel dry first before putting on clothes.

4. Vaginal Ring

The estradiol vaginal ring is inserted into the patient’s vagina to deliver hormones directly to the estrogen receptor. It’s an effective device that restores the estradiol levels of the body and relieves the symptoms of atrophic vaginitis, which includes inflammation, drying, and thinning of the vaginal wall. This condition makes urinary functions and sexual intercourse painful for many patients.

The ring is usually inserted by the physician, but patients may also put it in place as long as they strictly follow the directions that come with the prescription. The ring should remain in place for 90 days before needing a replacement.

A vaginal ring is a convenient option for patients who can’t take estrogen pills because of liver problems and estrogen patches because of skin irritation. However, this treatment also comes with certain risks like endometrial cancer, so make sure to consult with a medical professional to find out if this is the best treatment for you.

5. Vaginal Cream

A vaginal cream is similar to topical estrogen gel, but it’s applied directly to the vaginal area instead of the arm. This is a great option for menopausal women who experience different signs of vaginal atrophy. The dosage depends on the specific product, but patients should apply the cream according to their schedule — this might be daily or a few times a week.

Vaginal creams are more effective in relieving vaginal symptoms associated with menopause than other types of estrogen therapy. However, they aren’t as helpful in other symptoms like hot flashes. They’re also not recommended for long-term use because they increase the risk for serious conditions like stroke, cardiovascular disease, endometrial cancer, and ovarian cancer.

6. Hormone Pellet Therapy

This type of bioidentical hormone therapy uses man-made hormones derived from plants to restore the low estrogen levels in the body. During the procedure, the doctor creates a small incision on the buttocks or the upper hip of the patient. The pellets are placed underneath the skin using a trocar. Doctors usually place around 10 to 12 pellets per treatment, which lasts for up to 4 months.

Some of the most common hormones matched in BHRT are estrogen, testosterone, and progesterone. Combining testosterone pellets with estrogen during a BHRT procedure helps patients increase their libido. It also fights bone loss and improves muscle mass.

While some manufacturers of bioidentical hormones claim that their products are much safer than other types of estrogen replacement therapy, there isn’t enough evidence to back this claim. Both BHRT and traditional HRT have almost the same risks and side effects.

3 Phases of Restoring Hormone Balance With HRT

HRT Hormone Replacement Therapy written in notebook on white table

Answering a question about how long it takes for HRT to show results is difficult because there isn’t an exact moment when the hormone fluctuation stops. The results start showing gradually, but the entire process can be broken down into three phases.

1. Preparation and Diagnosis

Menopausal symptoms usually occur in menopausal women, but women below 40 years old may also start to experience hormone fluctuation and other painful symptoms. If you start feeling symptoms caused by hormonal changes, it’s better to consult with a medical professional immediately to get a proper diagnosis and treatment.

Talking to a doctor about the patient’s symptoms and medical history helps patients find the best treatment that suits them. It’s important to remember that although HRT helps relieve menopausal symptoms, it also comes with certain risks. Consulting with a doctor helps patients determine if the benefits outweigh the risks.

2. Initiation of Treatment

It’s only normal for patients to be eager about the results after they started with a treatment plan. However, HRT isn’t a quick fix for hormone imbalance and other associated symptoms. The therapy was made to slowly restore the body’s natural hormone alignment and avoid serious complications.

Patients are also expected to experience a few mild side effects in the duration of the treatment. This includes bloating, aggression, irritability, acne, and breast tenderness. These symptoms are typically resolved after the hormone levels are back to normal.

People have different ideas of “feeling back to themselves,” but some patients experience improvements even just a few days after the treatment. Others might need longer to experience the full effects, but it shouldn’t be a reason to increase your dosage without consulting with a medical professional.

Aside from attending regular checkups, it’s also important to put yourself in a healthy healing environment. This enhances the treatment’s impact and improves the patient’s overall well-being.

3. Self-Care

Overall health and hormonal balance are easily influenced by how patients take care of themselves. A good night’s sleep, a balanced diet, and regular exercise are keys to maintaining a healthy mind and body. Although these steps sound simple enough, self-care might be difficult to prioritize if you’re struggling with different hormone-related symptoms like fatigue.

Hormone replacement therapy provides a holistic approach to a patient’s health. After therapy restores the body’s hormone levels to normal, patients have the energy and motivation to take better care of their bodies. Doctors often recommend different exercises and dietary choices alongside HRT to make the treatment more effective for the patients.

How Long Should You Undergo HRT?

Hormone replacement therapy is only recommended for a menopausal woman with severe menopausal symptoms or a patient who can’t produce estrogen after going through a surgical procedure to remove the ovaries. Women who started taking HRT because of premature menopause may continue the treatment until they naturally expect menopause, but most patients only undergo HRT for about 5 years.

Although HRT is extremely effective, it’s also associated with serious risks. The dosage prescribed by the doctor must be low enough to relieve symptoms without affecting the patient’s overall health.

Most patients are reluctant to stop HRT once they start it because they’re afraid that the symptoms might return, which is why doctors suggest easing off HRT first before completely stopping the treatment.

Easing off the Estrogen Therapy

Doctors often recommend easing off estrogen therapy instead of abruptly stopping the treatment. This allows the body to adjust properly to the hormone fluctuation. The most common method of easing off estrogen replacement therapy is to lower the dosage every week or take the medication less frequently. Another way is to switch between different kinds of HRT, like changing from pills to patches for example.

If the patient starts experiencing menopausal symptoms again while easing off the estrogen dosage, most doctors suggest increasing the dosage for some time before tapering it down again. Progesterone treatments don’t need to be tapered off when combined with estrogen treatments, but it’s still best to consult with a medical professional first about the situation.

HRT isn’t recommended for postmenopausal women over the age of 60 unless there are no other treatments available for their condition. Make sure to talk to a physician first to make an informed decision about the treatment.

Long-Term Effects of HRT

Like other medical treatments, the risks with HRT also increase the longer patients take them. Most women who use HRT for menopausal symptoms don’t develop serious complications, but others are more vulnerable to some health risks. Women with a history of cancer, liver disease, cardiovascular disease, or unexplainable vaginal bleeding might need to look for other treatments to avoid complications.

Side Effects and Risks

Different women undergo different hormone replacement therapies that are customized for their needs. During the treatment, most patients experience mild side effects, such as:

  • Nausea
  • Bloating
  • Breakthrough bleeding
  • Breast tenderness

These symptoms typically go away as the body’s progestogen, progestin, and estrogen levels return to normal. But if the symptoms persist, it’s better to call the doctor to make necessary adjustments to the treatment.

As effective as they are in relieving painful symptoms and reducing the risk of some health conditions, HRT also increases a patient’s risk of developing other diseases, such as:

  • Deep Vein Thrombosis — Blood clots might form inside the veins during HRT. The risk increases for patients who take oral HRT instead of patches or topical creams. Patients who combine progestogen with oestrogen also experience an increased risk of blood clots.
  • Heart Disease and Stroke — Women in their 60s who are taking combined HRT have an increased risk of developing heart disease or stroke. On the other hand, women who take HRT around the normal time of their menopause experience a lower risk of developing these conditions.
  • Breast Cancer — Breast cancer risk is higher for patients who take combined HRT instead of estrogen alone. Women over 50 years old who have been using HRT for less than five years have a significantly lower risk of developing breast cancer.

Safe and Effective Hormone Replacement Therapy at Revitalize You MD

Hormone replacement therapy in itself is already associated with many risks, but it’s still one of the best treatments that restore hormonal balance in the body. One of the best ways to ensure that you’re getting safe and effective HRT is to find a trusted provider who prioritizes their patient’s needs.

Here at Revitalize You MD, we make sure that each of our HRT patients is getting the best care and treatment they deserve for a quick recovery and relief from menopausal symptoms. Call us now to book an appointment with one of the country’s leading HRT experts.


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