Hormone Therapy Side Effects

“Any side effects usually improve over time,
so it’s a good idea to carry on with your treatment
for at least 3 months if possible”.1

Umbrella

What may the Hormone Therapy Side Effects Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Estrogen
  • Hormone Replacement Therapy (HRT) Side Effects
  • Hormone Therapy (HT) Side Effects
  • Menopausal Hormone Therapy (MHT) Side Effects
  • Oestrogen
  • Progestin/Progestogen

Side Effects or Not

Can hormone therapy (HT) have side effects?

Yes. In Hormone Therapy for Menopause Symptoms: How Can I Reduce Side Effects of Hormone Replacement Therapy (HRT)? the (United States) Cleveland Clinic explain:

“Typically, side effects resolve on their own within a few months. In most cases, these side effects are mild and don’t require stopping your HRT. If your symptoms bother you, ask your healthcare provider about adjusting either the dosage or the form of the HRT to reduce the side effects. Never make changes to your medication or stop taking it without talking to your provider”.2

In Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT) the (United Kingdom) NHS elaborate on:

“Like any medicine, the hormones used in hormone replacement therapy (HRT) can cause side effects. But it’s common to have no side effects or only mild ones.

Any side effects usually improve over time, so it’s a good idea to carry on with your treatment for at least 3 months if possible.

Side effects of HRT can be similar to menopause symptoms, so it might not be your HRT that’s causing it.

There are different types of HRT and it can take time to find the right dose and type that works for you.

To help with side effects, a GP might suggest changing your dose, the type of HRT you take or how you take it. For example, switching from tablets to patches”.3

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Different Differences

Can the side effects of oestrogen differ from the side effects of progestogen?

Yes. In Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT) the NHS include the “Side Effects of Oestrogen” and the “Side Effects of Progestogen”.

In Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT): Side Effects of Oestrogen Tablets, Patches, Gel and Spray the NHS include information about Brand names: Oestrogel, Evorel, Sandrena, Lenzetto, Estradot, Progynova.

Side Effects

What can HT side effects include?

In Treatments for Menopause: Menopausal Hormone Therapy (MHT) – Possible Side Effects of MHT the (Australian) Jean Hailes for Women’s Health (JH) note:

“Everyone responds differently to MHT. Some women may not experience any side effects, while others may have:

  • Nausea
  • Fluid retention
  • Headache
  • Bloating
  • Breast enlargement and discomfort
  • Vaginal bleeding
  • Weight gain.

Most symptoms settle within the first three months”.4

In Hormone Therapy for Menopause Symptoms: Risks/Benefits – What Are the Side Effects of Hormone Replacement Therapy (HRT)? the (United States) Cleveland Clinic explain:

“The most common side effects of hormone replacement therapy are:

  • Irregular vaginal bleeding
  • Breast tenderness
  • Mood swings

Less common side effects of hormone replacement therapy include:

  • Bloating
  • Headaches
  • Skin discoloration
  • Increased breast density, making mammogram interpretation more difficult
  • Skin irritation under the estrogen patch”.5

Side Effects of Oestrogen

What can side effects of oestrogen include?

In Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT): Side Effects of Oestrogen the NHS elaborate on:

“Side effects of taking oestrogen can include:

  • Headaches
  • Breast pain or tenderness
  • Unexpected vaginal bleeding or spotting
  • Feeling sick (nausea)
  • Mood changes, including low mood or depression
  • Leg cramps
  • Mild rash or itching
  • Diarrhoea
  • Hair loss

They will often go away after a few weeks”.6

Side Effects of Progestogen

What can side effects of progestogen include?

In Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT): Side Effects of Progestogen the NHS explain

“Side effects of taking progestogen can include:

  • Changes in your periods, including spotting or bleeding between periods
  • Headaches
  • Breast pain or tenderness
  • Feeling sick (nausea)
  • Diarrhoea
  • Feeling tired or dizzy
  • Mood changes, including low mood or depression
  • Mild rash or itchy skin
  • Acne

As with side effects of oestrogen, these will usually go away after a few weeks. There are things you can do to help cope with them”.7

Vaginal Bleeding

What is the association between vaginal bleeding and HT?

In Treatments for Menopause: Menopausal Hormone Therapy (MHT) – Possible Side Effects of MHT the JH explain:

“Many women who start MHT will have new vaginal bleeding, like “re-starting” your menstrual periods. This bleeding usually stops after a couple of months. If you have vaginal bleeding more than 6 months after starting MHT, or vaginal bleeding that becomes heavier or goes for longer than a period, you should go back to see your doctor”.8

Weight Gain

Is there an association between weight gain and HT?

In Hormone Replacement Therapy (HRT): Side Effects – Weight Gain and HRT the NHS note:

“There’s little evidence that most types of HRT make you put on weight.

You may gain some weight during the menopause and as you get older, but this often happens whether you take HRT or not.

Exercising regularly and eating a healthy diet should help you to lose any unwanted weight”.9

Temporary or Not

Are HT side effects temporary?

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy, published online 30 October 2023, the authors explain:

“Initiating treatment with low-dose MHT will minimize the likelihood of adverse effects. Common adverse effects of estrogen include nausea (mostly limited to oral therapy) and breast tenderness. Breakthrough bleeding is not unexpected in the first 3 months of continuous-combined estrogen–progestogen therapy, and occasionally heavy bleeding can occur. Progestogen therapy may cause low mood or irritability. When this occurs either the dose needs to be reduced or another progestogen tried. Micronized progesterone may improve sleep and sometimes causes somnolence, and so should be taken at bedtime. Changing from one regimen to another in many cases will alleviate adverse effects.

Potential adverse effects of tibolone include fluid retention, mild weight gain and initial vaginal bleeding or spotting”.10

Health Care Provider

What if I need help with my HT side effects?

If you need help with your HT side effects, it may be in your best interest to choose to talk to your health care provider about this.

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy the authors elaborate on:

“Optimally, women using systemic MHT should have a medical review at 3 months to assess symptom relief and side effects. This is also an opportunity to discuss any patient concerns and ensure correct use of the prescribed therapy”.11

In Postmenopausal Bleeding: Living With – When Should I Contact My Doctor? the (United States) Cleveland Clinic also note:

“Contact your healthcare provider if you experience any vaginal bleeding:

  • More than a year after your last menstrual period
  • More than a year after starting hormone replacement therapy (HRT)”.12

Health Topics A-Z

Where may I find Health Topics A-Z related to Hormone Therapy Side Effects?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

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Links

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  11. Compounded Bioidentical Hormone Therapy [Video]
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  15. EMAS On-Demand Webinars [European Menopause and Andropause Society] [Multiply Languages]: FDA Decision on MHT Warnings – A Live EMAS Roundtable
  16. FDA Direct: Removing Black Box Warnings for HRT (Part 1/2)
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  32. Hormone Replacement Therapy (HRT): Continuous Combined Hormone Replacement Therapy (HRT) Tablets, Capsules and Patches – Side Effects of Continuous Combined HRT
  33. Hormone Replacement Therapy (HRT): Oestrogen Tablets, Patches, Gel and Spray – Side Effects of Oestrogen Tablets, Patches, Gel and Spray
  34. Hormone Replacement Therapy (HRT): Sequential Combined Hormone Replacement Therapy (HRT) Tablets and Patches – Side Effects of Sequential Hormone Replacement Therapy (HRT)
  35. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT)
  36. Hormone Replacement Therapy (HRT): Tibolone – Side Effects of Tibolone
  37. Hormone Replacement Therapy (HRT): Utrogestan (Microsecond Progesterone) – Side Effects of Utrogestan
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  58. The 2023 Practitioner’s Toolkit for Managing Menopause
  59. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy
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  70. World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy [Multiply Languages]
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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy. Page Last Reviewed: 03 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/ Accessed: 17 March 2026
  2. Hormone Therapy for Menopause Symptoms: How Can I Reduce Side Effects of Hormone Replacement Therapy (HRT)? 12 March 2024. Cleveland Clinic https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms Accessed: 17 March 2026
  3. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy. Page Last Reviewed: 03 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/ Accessed: 17 March 2026
  4. Treatments for Menopause: Menopausal Hormone Therapy (MHT) – Possible Side Effects of MHT. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/treatments-for-menopause/#section-menopausal-hormone-therapy-mht Accessed: 17 March 2026
  5. Hormone Therapy for Menopause Symptoms: Risks/Benefits – What Are the Side Effects of Hormone Replacement Therapy (HRT)? 12 March 2024. Cleveland Clinic https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms#risks-benefits Accessed: 17 March 2026
  6. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy – Side Effects of Oestrogen. Page Last Reviewed: 03 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/ 17 March 2026
  7. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy – Side Effects of Progestogen. Page Last Reviewed: 03 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/ Accessed: 17 March 2026
  8. Treatments for Menopause: Menopausal Hormone Therapy (MHT) – Possible Side Effects of MHT. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/treatments-for-menopause/#section-menopausal-hormone-therapy-mht Accessed: 17 March 2026
  9. Hormone Replacement Therapy (HRT): Side Effects – Weight Gain and HRT. Page Last Reviewed: 03 January 2023. NHS https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/side-effects/ Accessed: 17 March 2026
  10. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy. First Published Online 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 17 March 2026
  11. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Managing Clinical Side Effects of MHT Therapy. First Published Online 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 17 March 2026
  12. Postmenopausal Bleeding: Living With – When Should I Contact My Doctor? Last Reviewed: 15 January 2024. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding Accessed: 17 March 2026
Topic Last Updated: 17 March 2026 – Topic Last Reviewed: 17 March 2026

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