This may be due to progesterone and usually goes away over time. You may feel bloated and uncomfortable, as if you have wind trapped. As your hormones level out, your energy levels and libido should increase. You should also notice greater mental clarity, less frequent mood changes, and a reduction in night sweats and hot flashes.
If you don't see a significant difference in your symptoms within two weeks, our providers can adjust the dose of hormones you take. Irregular vaginal bleeding or spotting is common in the first few months after starting hormone replacement therapy. This usually goes away after 6 months and is usually not a sign of anything serious. Some people may experience side effects or initial symptoms, such as breast tenderness or breast enlargement.
Other symptoms when starting hormone replacement therapy include nausea, headaches, or bloating. When you start hormone replacement therapy (HRT) to restore balance to your hormone levels, you may first wonder how long it takes for HRT to take effect. Progesterone is usually added to a regimen after hormone levels have stabilized after the initial period of initiation of estrogen and testosterone treatment. The initial prescription is usually a starting point, as health professionals monitor hormone levels using blood tests.
There may be a period of adjustment when you get used to HRT and side effects may occur early on. Starting hormone therapy at age 40, 50, or older may cause less drastic changes than those seen at the beginning of the transition at a younger age, due to cumulative lifetime exposure to testosterone and decreased responsiveness to hormonal effects as the age of menopause approaches. While gender-affirming hormone therapy generally improves mood, some people may experience mood changes or a worsening of anxiety, depression, or other mental health conditions as a result of changes associated with the onset of a second puberty. While some data suggests that stopping taking hormones for 3 to 6 months may cause your sperm count to return, it's best to assume that, within a few months of starting hormone therapy, you may lose the ability to produce sperm permanently and irreversibly.
While it is possible to make adjustments to medications and doses to achieve certain specific goals, to a large extent the way your body changes in response to hormones depends more on genetics and the age at which you start taking it, than on the specific dose, route, frequency, or types of medications you are taking. The risk of blood clots, heart attacks, strokes, diabetes, and cancer as a result of hormone therapy is minimal, but it can be high, especially for people with co-existing health problems or who start hormone therapy after age 50. If you think that hormone therapy hasn't given you the benefits you expected after 3 months, talk to your doctor or nurse about whether you can change the dosage or the way you take the medication.
