Side effects of HRT

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is medicine used to treat the symptoms of the menopause.

It is common to have side effects in the first few months of taking HRT. These usually settle on their own within 6 to 8 weeks.

Side effects include weight gain, irregular bleeding, feeling sick (nausea) and skin irritation. They can also include:

  • tender and enlarged breasts
  • leg cramps
  • bloating
  • headache
  • pre-menstrual symptoms
  • lower tummy (abdominal) pain
  • backache
  • a depressed mood
  • acne or greasy skin

If you still have side effects after 3 months of treatment, you might need to change the type (preparation) of HRT or amount (dose) that you take. Your doctor or nurse talks to you about this.

Weight gain

It's been proven that the menopause leads to weight gain. Any weight gain might not be a result of taking HRT. Your body’s fat distribution also changes during the menopause. You might have more fat around the waist and less fat around the hips and buttocks.

You may have water retention when taking HRT. This is when too much water builds up in your body. If this happens, it might be worth trying a different preparation of HRT.

Blood pressure

There is no evidence that blood pressure increases with taking HRT. You should have your blood pressure checked and treated in the usual way.

Irregular bleeding

Irregular bleeding in the first few months of taking HRT is quite common. This usually settles on its own.

We need to investigate any bleeding after the first 6 months with an ultrasound scan.

In some cases, you might have a hysteroscopy. This is a test that looks inside the womb, through the vagina, using a small telescope at the end of a narrow tube.

Feeling sick (nausea)

You might feel sick when having HRT. Taking the HRT tablet at night with food instead of in the morning can help with this.

Changing from tablets to another preparation of HRT (such as a gel or patch) might also help.

Resource number: 3530/VER3
Last reviewed: July 2019
Next review: July 2022

Contact us

For any questions about HRT, please contact the gynaecology nurse consultant.

Phone 020 7188 8032 Monday to Friday, 9am to 5pm.

Email: [email protected]

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