You have the prescription. Now the questions start.
Dose, format, whether you need blood tests, what's happening with your weight. Five pages for women already on HRT.
Four questions that come up once you've started
Most women are prescribed hormone therapy and then left alone with it. No follow-up, no adjustment, nobody to ask.
The hormones get blamed first, and they're rarely the main driver. Weight gain and the shift of fat toward the middle happen in midlife whether or not you take HRT. What hormone therapy can cause early on is fluid retention and bloating, which usually settles within a few months and differs depending on which progestogen you're on. Telling those two things apart changes what you do about it.
The aim is the dose that controls your symptoms, not the smallest number on the chart. Plenty of women are started low, never reviewed, and left assuming partial relief is all HRT does. If symptoms are still there months later, the dose is a conversation worth having rather than a verdict you have to accept.
For standard menopausal hormone therapy, treatment is usually guided by how you feel rather than by a number, and routine level monitoring isn't the default. There are real exceptions — questions about whether a patch is absorbing, premature ovarian insufficiency, testosterone. Worth knowing which situation you're in before paying for a quarterly panel.
Dose, delivery route and the type of progestogen are three separate dials, and each changes how you feel. A difficult first six months often means the wrong combination rather than the wrong treatment. Most women who stop never got as far as trying a second one.
Five pages for the follow-up you didn't get
What your dose is actually doing
How standard doses compare, what "not enough" feels like as opposed to "wrong formulation," and how long to give a change before judging it.
Patch, gel, spray or pill
What genuinely differs between delivery routes, which differences matter for your own history, and what to ask about before switching.
The weight question, answered properly
What the research actually shows about hormone therapy and body composition, how to tell fluid retention from fat gain, and which clinics are selling you a test you don't need.
There's nothing on the other side of this to buy
Most HRT information online is attached to something for sale. That's how it gets funded, and it's why the advice so often ends up pointing at a product.
- We don't sell hormones, creams, pellets, or compounded prescriptions.
- We don't sell supplements, saliva tests, or hormone panels.
- We're not a clinic and we don't take referral fees from one.
- The pages are free and the app is free.
Worth going back and asking
Five pages, free. Enough to have a specific conversation about your dose instead of wondering whether this is as good as it gets.
Ask Elina answers follow-up questions about your own dose, formulation and history, free, on iOS and Android.
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