Many women believe hormone replacement therapy (HRT) is a magic bullet, treating menopause and leaving them symptom-free. However, all HRT does is replenish female sex hormones, oestrogen and progesterone, which naturally decline in menopause. In this, HRT tricks the body into thinking menopause isn’t happening.
Although HRT is an excellent way of dealing with menopausal symptoms and giving women agency over their bodies, it’s only ever a temporary solution. Problems can arise when coming off HRT, especially if you don’t follow the correct guidance. You may find your menopausal symptoms rebound or, worse, become more pronounced.
How long can you take HRT?
HRT isn’t designed to be a permanent solution. Despite there not being an upper limit on use, research suggests there may be associated risks with taking HRT for extended periods (1).
It’s best to take HRT for as long as the benefits outweigh the risks. If you’re concerned about side effects, it’s always best to consult your GP.
What are the side effects of stopping HRT suddenly?
If you stop HRT abruptly, your hormone levels will drop from high to low within a short amount of time. As a result, your body may go into ‘overnight menopause’, and bothersome symptoms like hot flushes, sleep disturbances, and mood changes may quickly reappear, disrupting your daily life.
Therefore, if you’re considering coming off HRT, always consult your healthcare provider. By gradually reducing HRT under the guidance of your GP, you will give your body more time to adjust and minimise the intensity of rebound symptoms. It’s a much kinder approach.
Do you need to wean off HRT?
While you can immediately stop milder forms of HRT, like topical creams for vaginal dryness, most HRT medication requires users gradually stop taking it over a two-to-four-month period.
Gradually decreasing your HRT dose reduces the risk of your symptoms returning in the short term. Your GP may advise lowering your HRT dose, cutting HRT pills in half, or using a patch with reducing doses.
Are there withdrawal symptoms from stopping HRT?
Ultimately, no matter how well you manage the HRT cessation, there are likely to be some side effects, but these should subside within a few months (4).
In one study, researchers found that amongst women who stopped HRT, menopausal symptoms were present in 4 per cent of participants, with 25 per cent experiencing vasomotor symptoms, 25 per cent having urogenital complaints, and 5 per cent suffering from mood-related issues (5).
If you’ve been taking HRT for a long time, are on a higher dose of HRT, or faced debilitating menopausal symptoms in the past, you may be more likely to experience withdrawal symptoms.
Will I lose weight if I stop HRT?
There’s very little research to suggest coming off HRT will make people lose weight. In fact, a recent systematic review found taking HRT was unlikely to cause weight changes during or after menopause (6).
Weight changes can happen due to age, lifestyle, diet, and menopause itself, but this is independent of taking and then stopping HRT.
Why am I bleeding after stopping HRT?
It’s common to have some vaginal bleeding after stopping HRT as your body adjusts to new hormone levels. You shouldn’t bleed more than four weeks after stopping HRT. If you do, this is postmenopausal bleeding (PMB) and worth getting checked out. For most women, there’s usually nothing to worry about. But it’s always best to get a second opinion.
How long does HRT stay in your system after stopping?
The time it takes for HRT to leave your system depends on the type of medication, its duration of use, and other personal factors.
Generally speaking, oral medications are metabolised and eliminated more quickly than medications given through injections or patches from the body.
In any case, it can take a few days to a number of weeks for the hormones to leave the body after HRT cessation. However, more research is needed in this area of women’s health.
Find out more
While HRT can be helpful for severe menopausal symptoms, it's not a permanent solution. When you decide to come off HRT, it’s wise to do so gradually and under the guidance of your GP. Always consult a healthcare professional if you have exceptionally challenging symptoms that last several months after coming off HRT.
In the meantime, take care to look after your body and mind. Eating a well-balanced diet, exercising regularly, and minimising stress will help you cope better during this transitional period.
You may also want to consider taking soya isoflavones, phytoestrogens that mimic oestrogen in the body, which may support your health and wellbeing during menopause.
For more information on menopause health, please browse the rest of our Menopause hub.
References:
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nhs.uk. 2020. Hormone Replacement Therapy (HRT). Available online: https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/#:~:text=Stopping%20HRT,usually%20after%20a%20few%20years.
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nhs.uk. 2020. Hormone Replacement Therapy (HRT). Available online: https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/#:~:text=Stopping%20HRT,usually%20after%20a%20few%20years.
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Ness. J, Aronow. WS, Beck. G. Menopausal symptoms after cessation of hormone replacement therapy. Maturitas. 2006;53(3):356-361.
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Murbach IG, Martins VFM, Cristófalo MM, Fukunaga ÉT, Aldrighi JM, Abreu LC, Association Between Hormone Therapy and Weight Gain in the Menopause Transition and After Menopause: A Systematic Review and Meta-Analysis. Journal of Human Growth and Development (Impresso). 2023; [online] 286–298.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
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Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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