How Long Does It Take for HRT to Make a Difference - Stella
7 mins

How long does it take for HRT to work?

byDr. Lucy Wilkinson

If you’ve decided to start hormone replacement therapy (HRT), you’re probably eager to see quick results and improved symptoms. But how long after starting HRT will you feel a difference? Read on to find out what to expect.

How does HRT work?

HRT is the most effective treatment available for menopause symptoms including hot flushes, night sweats, mood swings and vaginal changes.

Menopause symptoms are caused by fluctuating and – eventually – low levels of oestrogen.

As the name implies, HRT works by replacing the oestrogen that your body no longer produces. Types of HRT include:

  • Oral HRT, tablets
  • Transdermal HRT, patches, sprays and gels
  • Vaginal HRT, vaginal creams, gels, pessaries and rings

Read our guide to the different types of HRT for menopause.

How long after starting HRT do you feel a difference?

Everyone’s experience of taking HRT is different. Some may feel a difference within a few days, while for others it might take weeks or even months.

Side effects are common when starting HRT treatment. These tend to wear off as your body gets used to the hormones. Read the leaflet that comes with your medication for full details about possible side effects and contact your doctor if you are concerned.

In general, seek urgent help if you notice:

  • Shortness of breath or difficulty breathing
  • Chest pain
  • Swelling, redness or pain in one or both legs
  • Signs of high blood pressure, including headaches, blurred vision, seeing flashing lights and dizziness
  • New headaches
  • Any other serious or worrying symptoms 

How long does it take for HRT to work?

Everyone’s experience will be different. While you may start feeling a difference within a few days or weeks, it usually takes longer for HRT to achieve its full effects.

Three to six months is a reasonable trial period for systemic HRT, which includes pills, patches, sprays and gels. If you haven’t seen an improvement by this point, speak to your doctor. They may change your dose or carry out further tests to rule out other causes for your symptoms.

Vaginal HRT can take slightly longer to work. While you are likely to see an improvement in the first three months, it can take up to a year to experience the full effect. This is due to the structural changes that can happen in the vagina and genital area during menopause. The more severe your symptoms, the longer it can take to work.

How long do HRT patches take to work?

It takes a variable amount of time for HRT patches to work, just like other forms of HRT. Some will see the first signs of improvement within days or weeks, while others may need to wait a couple of months.

How long does it take for oestrogen gel to work?

Oestrogen gel, also known as Oestrogel or Estrogel, works in the same way as other types of HRT. You might notice a change within the first few days or weeks, although it’s common to need a few months to see the full effect of treatment.

Why does HRT not work immediately?

There are several reasons why your HRT may not work immediately. 

  1. It takes time for the hormones to build up to an effective level and to reverse the changes caused by months or even years of low oestrogen levels.
  1. Menopause symptoms are complex. While low oestrogen levels are largely responsible, the way you experience these symptoms will be affected by many different factors. These include stress, mental wellbeing and your general health. You may notice that your hot flushes improve more quickly than symptoms which have multiple contributing factors like mood swings, poor sleep and aches and pains.
  1. Your symptoms may improve slowly, in which case it becomes more difficult to see the change and may even seem like your HRT isn’t doing much. Symptom tracking can help you to monitor your progress and see how effective your HRT really is. You might be pleasantly surprised!

Read more about menopause symptom tracking

What should I do if my HRT isn’t working?

HRT often takes a while to work, so don’t be disheartened if you don’t notice an immediate effect. 

It’s normal practice to check in with your doctor after around three months on HRT for a medication review. They might suggest an increased dose or different type of HRT if your symptoms are still troubling you.

Your doctor may also want to revisit your diagnosis if HRT really doesn’t help. As many different medical conditions can cause symptoms which mimic menopause, they might want to run some tests to rule out any other underlying conditions. 

It’s also worth checking that you’re taking your HRT correctly. This is especially the case for transdermal HRT, such as patches, gels and sprays. These can sometimes be affected by your:

  • Skincare routine
  • Daily activities
  • Where on your body it’s applied

Check the instructions in your medication pack for further details.

Find out what to look out for if you think your HRT is not working for you.

Final word

After starting HRT, it can take a while to feel a difference. You can expect to see an improvement in your symptoms by the time you have been on treatment for three months.

If things still aren’t improving, ask your doctor for advice.

If you are receiving your HRT through Stella, your subscription includes a treatment review after three months to check how you are feeling and if your symptoms have improved. If you have any queries before your review, please contact us at

Find out more about menopause on our blog or in our symptoms library.

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