Everyone’s body and needs are different, but most people typically see results from hormone replacement therapy (HRT) within 1–2 months. Talk with your doctor before making any adjustments to your dosage or schedule.

Healthcare professionals use HRT to medically treat people who have hormone-related conditions or symptoms.

They most commonly use it for people transitioning genders, going through menopause, or older cisgender men affirming their gender.

Keep reading to learn the common signs that your HRT may not be working and what to expect from your treatment timeline.

For signs your HRT isn’t treating your menopause, you should look out for persistent symptoms such as:

  • night sweats/hot flashes
  • sudden changes in mood
  • depression
  • sleep disturbances
  • vaginal pain
  • decreased libido
  • changes in appetite and weight
  • hair thinning
  • headaches

You should see a reduction in symptoms within 3 months.

For cisgender men on testosterone-related HRT, signs that the HRT is ineffective include:

  • gynecomastia
  • bloating
  • reduced muscle tone
  • diminishing sex drive

You should see the first positive results of the treatment within 3–4 weeks, but getting the maximum benefit will take longer.

Results for transgender, nonbinary, and gender nonconforming people taking HRT may happen slower. But you should start to see a development of your desired secondary sex characteristics within the first 3–6 months of consistent HRT treatments.

It may take up to 5 years for some effects to fully develop.

Learn more about what to expect during your transition.

Bottom line

If you have persistent symptoms or aren’t seeing the beginnings of the results that you expect in a month or two of consistent treatments — you may want to consult your doctor or healthcare team.

They may update your HRT schedule, adjust your dosage, or find a different treatment plan for you. Alternative forms of HRT, such as injections, inserts, gels, patches, and pills, may also be available.

Was this helpful?

Typically no, HRT use usually isn’t a sudden experience. But it’s possible that the dosage isn’t correct or the form of HRT isn’t suitable for your body. This may cause an adverse reaction or a very slow one.

If you notice a sudden change in any of your symptoms, it’s best to contact your doctor or healthcare team. Don’t discontinue the HTR unless you’re having an allergic reaction or your doctor advised you to do so.

Learn more about HRT safety.

Getting blood tests and contacting your doctor or medical care team is the best way to tell whether your dose is too low.

While on HRT, your doctor will recommend regular checkups and bloodwork — and it’s important to follow through with this schedule. Otherwise, this could lead to side effects.

For example, in males, there is a condition called aromatization that can cause high levels of testosterone to revert back into estrogen. This may lead to the opposite effect that you’re trying to achieve with HRT.

In females, excessively high levels of estrogen can lead to symptoms that are similar to premenstrual syndrome (PMS).

If your dose is too low, you may not notice any evident changes in your body or symptoms at all.

Yes, to manage symptoms of menopause or other health conditions, you might have to experience symptoms, but after 3 months, they should be lessened greatly. If not, you may need to change the method of your HRT (from pills to gel, for example) or otherwise adjust your dose.

Males using testosterone-based HRT should see a reduction in their symptoms during the treatment.

But healthcare professionals don’t typically recommend long-term use of testosterone for males due to the likelihood of harmful side effects. Your doctor or healthcare team will discuss other long-term ways of managing the symptoms of aging or low testosterone.

For gender-diverse people treating gender dysphoria with HRT, you may find that even while you enjoy the way your body is changing — some dysphoria still hangs around.

Surgery can be an option, but therapy is also one way to learn to cope with dysphoria and find gender euphoria in your life.

Keeping track of your symptoms with a journal is a great way to figure out whether your HRT is working or not. The exact time frame will depend on your sex, age, and goals, but more people should see results from HRT within 1–2 months.

If your dosage is too low, too high, or you might need an alternative to HRT — your health team will be able to help you with those decisions.

Make sure to keep up with your doctor’s recommended schedule for bloodwork and checkups.