Thyroid & Hormone Health

Hormone replacement therapy

Hormone replacement therapy helps manage symptoms from hormone deficiencies such as menopause or low testosterone. Our team offers individualized options to improve comfort and quality of life.

Hormone replacement therapy (HRT) supplements or replaces hormones your body may no longer produce in adequate amounts. It is commonly used to ease menopause symptoms in people who produce female hormones and to manage hormone deficiencies such as low testosterone or hypogonadism in men and women.

At TidalHealth, HRT may include estrogen alone, estrogen combined with progestogen for those with a uterus or testosterone for people with low androgen levels. Treatment options include oral pills, patches, gels, creams, injections or implants, chosen with your care team based on your needs and preferences.

Why consider hormone replacement therapy?
HRT can help reduce symptoms such as hot flashes, night sweats, vaginal dryness, mood changes, low libido and fatigue. For some people, it may also help protect bone density and reduce fracture risk if osteoporosis is a concern.

Getting started
Before treatment begins, your clinician will review your medical history, symptoms and personal or family risk factors, such as heart disease, clotting conditions or cancer. This evaluation may include basic testing, such as hormone levels, cholesterol, blood sugar and, in some cases, bone density. Your treatment plan is tailored to your age, health, symptoms and goals.

What to expect with HRT
Treatment usually starts at the lowest effective dose and is adjusted as needed. Many people notice improvement in hot flashes and night sweats within days or weeks. Changes in mood, sleep and sexual function may take several weeks to months. Regular follow-up visits help track progress and address side effects or concerns.

Possible side effects and risks
Some people experience breast tenderness, spotting or irregular bleeding with certain preparations or fluid retention. Risks vary based on the type of hormones used, length of treatment and your health profile. These may include blood clots, stroke and, in some cases, increased breast cancer risk. Your TidalHealth clinician will review these risks and discuss alternatives, including non-hormonal options, when appropriate.

Follow-up and ongoing care
There is no recovery period after starting HRT, but your body may take time to adjust. Ongoing follow-up visits help review symptoms, monitor blood pressure and reassess treatment goals. Decisions about how long to continue therapy are individualized, with an emphasis on using the lowest effective dose for the shortest time needed. If you choose to stop HRT, your care team will guide you through a safe transition.

What is hormone replacement therapy (HRT)?
HRT replaces low or missing hormones to help relieve symptoms caused by menopause or other hormone deficiencies, such as hot flashes, night sweats, vaginal dryness, mood changes and low libido.

Who is a candidate for HRT?
You may be a candidate if you have significant symptoms of hormone deficiency and do not have certain conditions, such as recent cancers, active blood clots or uncontrolled cardiovascular disease. Your TidalHealth team will review your history and testing to determine if HRT is appropriate.

How soon will I feel better after starting HRT?
Some symptoms, like hot flashes, may improve within days or weeks. Others, including mood, sleep or sexual function changes, may take several weeks or months.

What are the main risks of HRT?
Risks depend on hormone type, dose, method of delivery and your health history. Possible risks include blood clots, stroke and increased breast cancer risk with some long-term estrogen and progestogen therapies. Your clinician will review ways to reduce these risks.

Can HRT cause weight gain?
HRT is not a primary cause of long-term weight gain. Some people notice temporary fluid retention or appetite changes, while aging and lifestyle factors play a larger role.

Is HRT safe if I have had a hysterectomy?
If you no longer have a uterus, estrogen alone is often used. If you still have a uterus, progesterone or a similar hormone is typically added to protect the uterine lining. Your TidalHealth provider will guide your treatment.

Can men receive HRT?
For men, HRT usually refers to testosterone therapy for clinically low testosterone. Evaluation and monitoring differ from HRT for women, and our specialists will guide your care.

How is HRT administered?
HRT can be taken as oral tablets, skin patches or gels, creams, injections or implants. The best option depends on your symptoms, health risks and preferences.

How long should I stay on HRT?
Treatment length is individualized. Many people use the lowest dose for the shortest time needed, while others continue longer with regular monitoring to reassess benefits and risks.

Will HRT affect fertility?
HRT for menopausal symptoms does not restore fertility. If fertility is a concern, talk with your TidalHealth provider before starting treatment.

How often will I be monitored?
You can expect a follow-up visit a few weeks after starting or changing your dose, then regular check-ins every few months to a year. Monitoring may include symptom review, blood pressure checks and occasional lab testing or imaging as needed.