How long does it really take for hormone replacement therapy (HRT) to kick in?
I’ve seen patients go from burnout and brain fog to energized and thriving within a few short weeks. In this article, I’ll walk you through the exact changes to expect, when to expect them, and what to do if you’re not seeing results.
If you’re ready to take control of your health, this is the place to start. Book your appointment with Viking Medical Group—let’s get you feeling your best, inside and out.
Still wondering if HRT is for you? Check out my complete HRT video playlist to learn everything you need to know.
So, When Will You Feel a Difference After Starting HRT?
This is kind of a loaded question. It’s different for everyone, but on average:
- For men, I would say between 4 to 6 weeks. I tell men to start expecting some changes around 4 weeks with testosterone replacement therapy.
- For women receiving BHRT pellets (bioidentical testosterone pellets), I typically see results within 2 weeks, with a peak around 4 to 6 weeks.
Beyond those initial changes that you may feel, visual results like body composition can take 3 to 6 months. This will vary depending on your gym routine, diet, training level, and other personal factors.
All effects will vary by age, sex, health status, and fitness history. It’s very individualized. There’s not one script for everyone.
Signs That HRT Is Working For You
Typically, when patients come to us, they’re dealing with symptoms like:
- Fatigue
- Depression
- Insomnia
- Muscle atrophy or decreased strength
- Low libido
- Decreased sex drive
- Erectile dysfunction
Once patients start a customized HRT program, after labs and appropriate dosing, we usually start seeing changes within 2 to 4 weeks.
Here’s what I typically see:
- Sleep patterns improve first. Especially for women on pellet therapy, sleep often gets better within a week. This is anecdotal, based on what patients tell us in real time.
- Men typically see sleep improvements a little later, around 2 weeks, especially with testosterone injection therapy.
- Libido tends to improve around 4 to 6 weeks for both men and women.
- Muscle mass and body composition changes (lean mass vs. fat mass) happen more gradually, around 3 to 6 months.
- For women experiencing hot flashes, those symptoms often lessen dramatically within 2 weeks.
If you’re seeing improvements in sleep, mood, libido, or body composition, that’s a sign this is the right therapy for you, and that it’s working.
What Are the Signs That HRT May Not Be Working?
If someone has been on HRT for 4 to 6 weeks and they don’t see any improvement, for example:
- Libido is still low
- Erectile dysfunction hasn’t changed
- Motivation and mood haven’t improved
That’s a sign to dig deeper. I always say: listen to the patient. They’ll tell you exactly what’s going on.
If you’ve been on treatment for 3 months and you’ve experienced zero change, it’s time to get new labs and figure out if you’re dialed in correctly.
And like anything else, if side effects outweigh the benefits, then it’s obviously not the right treatment for you. It could also be the form of treatment. Maybe injections aren’t the best fit, and you’d do better with cream or pellet therapy.
Everyone is different. This isn’t a one-size-fits-all process. If one method isn’t working, we switch to something else and monitor closely with labs. We use data and your symptoms to maximize your results.
Common Side Effects to Expect in the Early Stages of HRT
The most common issue I see is with injection sites, especially for people new to self-injection.
- It’s typically a subcutaneous injection in the abdomen.
- Patients may experience bruising or small hematomas, especially at first.
This is the biggest early issue I see with men.
For women, I don’t usually hear many complaints in the early stages. Occasionally, they report:
- More acne
- Slight peach fuzz around the lip
Other than that, women typically only have a small wound from the pellet insertion, which heals in about 4 to 5 days. Overall, I haven’t heard many negative early effects from starting HRT or BHRT.
What Factors Can Affect How Well HRT Works for Me?
The biggest factor here is you:
- Your motivation
- Your compliance with the regimen
- Whether you’re actively involved in the treatment plan
Following your provider’s guidelines, getting labs done, and being part of the treatment vs. just receiving the treatment, I would say is the biggest component of whether or not you’ll succeed.
Stress also plays a major role. People in high-stress environments have high cortisol levels, which can affect results.
We’re focusing on rebalancing one part of the system: your hormones. If your labs look great but you still don’t feel better, something else is going on, and we’ll help you figure that out.
What Types of HRT Are Available?
There are two main categories:
- HRT (Hormone Replacement Therapy)
- BHRT (Bioidentical Hormone Replacement Therapy)
At Viking Medical Group, we offer both.
Bioidentical Hormone Replacement Therapy (BHRT)
- Typically used for women
- Most common method is pellet therapy
- Pellets are made from yam-derived hormones, modified to replicate your body’s natural testosterone
Traditional HRT for Men
- Usually administered through injectable testosterone, given subcutaneously
- Frequency is based on lab data and individual needs
- For those who can’t or don’t want to inject, we also offer testosterone cream
When You Should Adjust or Stop HRT
When to Adjust HRT
We base adjustments on lab work, which we check every 12 weeks. The goal is to dial in your levels until everything is balanced.
For men, we closely watch:
- Testosterone levels
- Estradiol levels
Estradiol can rise due to aromatization, where the body converts excess testosterone into estrogen. High estradiol can cause:
- Mood swings
- Irritability
- Feeling short-fused
We often tweak those levels during follow-up labs to keep everything where it should be.
When to Stop HRT
You should stop HRT if you feel no benefit at all, even when your labs show your levels are in the right range.
If everything looks good on paper but you feel no different, then it’s likely not the right treatment for you, and there’s no sense in continuing something that’s not helping.
When Should You Contact Your Doctor?
If you’re experiencing severe side effects, contact your provider immediately.
If you’re not seeing any changes at all, you should also reach out. I usually say:
- Men: If you haven’t felt any difference within 4 weeks, talk to your provider
- Women: Usually expect results in 2 to 4 weeks
If by 6 to 8 weeks you’re feeling no difference, reach out. At that point, your provider will probably order labs sooner than the typical 3-month schedule and make any necessary adjustments.
Again, if you experience any severe side effects, reach out to your provider immediately.
Feel Like Your Best Self with HRT from Viking Medical Group
Considering hormone replacement therapy? At Viking Medical Group, we’ve helped countless patients regain their energy, clarity, and confidence through customized HRT plans, and we’re ready to do the same for you.
Whether you’re just starting out or want to fine-tune your current therapy, we’ll assess your symptoms, review your labs, and tailor your treatment to help you feel your best.
Book your appointment today and start feeling the difference with HRT.