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It is important to understand that no two women experience Surgical Menopause exactly the same way, some women have menopausal symptoms that go nearly unnoticed while other women experience debilitating symptoms. On that same note as pertains to HRT, there is not a one size fits all HRT or dose. Finding the correct delivery system and dosage of HRT does not typically happen overnight. Though some women are fortunate enough to stumble upon a dose and HRT that works well for them off the bat, most women have to go through a process of trial and error to find what HRT suits them best.The important thing is not to get discouraged, as many women find their ideal HRT and dose within a few months, while others will have a longer journey.


Here are a few rules of thumb to follow to help you troubleshoot getting your HRT right.


Start Low and Work Upwards:


When starting on HRT it is always best to start on a lower to middle dose, the reason being it is easier to titrate your dose upwards rather than to clear excess hormones from the body. Because excess estrogen does carry health risks, the goal is to be on the lowest dose that you feel good on.


Adjustment Time:


HRT takes time to build up in the body, and because of this you cannot tell right away if your dose needs to be tweaked. It takes approximately 6-8 weeks for the body to fully adjust to an HRT and to stabilize.


The way you feel the first couple of days after beginning to take HRT is not indicative of how you will feel in a couple of weeks or even a couple of months, because the body needs time to adapt.


By the end of ten days to two weeks you will have a clearer idea of whether or not your HRT is close to correct. Pay attention to whether, as time passes, you are feeling better or worse on your HRT. If you are heading in the right direction, you should begin to notice that you are feeling better and more stable. If you are heading in the wrong direction, whether that means your hormones have gone too high or dropped down too low, you will notice that you feel worse.


The most important thing to getting your HRT right is allowing it the time it needs to acclimate to your body, and not changing it too quickly. When you change your HRT too often and too quickly , your body will become more and more discombobulated and out of balance as it has to begin the adjustment process all over again.


Have Your Hormone Levels Checked:


Getting your HRT right should be a collaborative process between you and your doctor. Your doctor may not always ask you to have your hormone levels tested, but if you are having difficulty with HRT, you should be getting your levels checked more often to see where things stand. Sometimes you have to be your own best advocate if your doctor is not as proactive and ask to have your levels checked with more frequency. While hormones can be tested via both saliva and blood, it has been found that blood tests yield more accurate results.


Finding Your “Sweet Spot”:


We like to refer to the HRT and dose that feels best to you as your “Sweet Spot”. A “Sweet Spot” is when your HRT dose is high enough to keep the bulk of your menopausal symptoms at bay and you feel as close as is possible to your pre-operative self. Please note: You will not feel exactly as you did before surgery, but you can still feel excellent.


Women in natural menopause’s estrogen levels fall to approximately 10-20 pg/ml (picograms per milliliter), and estrogen must be around 40-50 pg/ml to maintain healthy bones and prevent Osteoporosis. By contrast, women in Surgical Menopause can have their estrogen and progesterone levels fall to almost nothing, as their body no longer has ovaries producing these key hormones. With the assistance of HRT women can regain healthy estrogen levels.


Finding your “Sweet Spot” with HRT hormone levels is different for everyone. While you want your HRT to do its job of protecting your health and your bodies and keep it within a high enough range, some women feel good at a lower level while others require a higher level of estrogen to feel good. It is all about individuality, and what feels good to you.

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