FAQ about starting hormone therapy

Navigating Hormone Therapy: What to Expect

Starting hormone therapy can come with some temporary side effects, and I know that can be a little unsettling. Hopefully, this page helps answer some of the most common questions and reassures you that, in most cases, things settle down with time.

Spotting & Light Bleeding

If you’re within a few years of your last period, light bleeding may occur. I know—seeing blood again after thinking you were done with periods can be alarming! But don’t panic. The shift in hormones can stimulate the endometrial lining, causing a little shedding. This can show up as bright red, dark brown, or even tan discharge. Mild uterine cramping and breast tenderness can also happen, but these symptoms usually resolve within a month or two. Hang in there—the benefits are coming!

Breast Tenderness

This is a common early side effect. If it’s mild, give it some time—it usually improves. If it’s making daily life uncomfortable, adjusting the dose may help.

Vaginal Discharge Changes

Some women notice an increase in vaginal discharge, which can be concerning. But remember—your vagina is self-cleaning! This extra moisture is actually a good thing. It helps maintain a healthy vaginal pH, reduces odor, and improves lubrication, which can prevent that dreaded post-sex “rug burn” feeling. If you’re using vaginal estradiol, adjusting the dose slightly (up or down) can help based on your symptoms.

How Long Should You Stay on HRT?

Give it a solid six months to see if you notice the benefits. If after that time you’re not feeling an improvement in your quality of life, it may not be the right fit for you. But if you love how you feel—keep going! There’s no set age when you have to stop HRT. The benefits—stronger bones, brain protection, heart health, and mood stability—continue as long as you stay on it.

The bottom line? You’re in control. HRT is a personal decision, and we’re here to help you figure out what works best for you.

Stay strong, stay balanced, and always advocate for your health.

Andrea Driggs, DNP
Women's Health Nurse Practitioner