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  • Writer's pictureMonica Bell

How Long Does It Take Hormone Replacement to Work?

At Optimal Hormone Health, we often get the question, “How long will it take for hormone replacement to work?” The short answer is, “It depends.” Since there is little research on bio-identical hormone replacement, we will discuss the factors affecting hormone efficacy and time frame from the perspective of our clinical experience. However, be assured that we expect variability, and hormone replacement requires patience and flexibility. Let's review how hormone replacement affects men and women and general expectations for symptom improvement.



When women go through menopause, estrogen, testosterone, and progesterone all decline; how much they decline is individual. Based on labs, we can initiate hormone replacement and then adjust according to how you react over time. Hormones affect almost every aspect of physical and emotional health.


Libido is tricky for women, irrespective of hormone fluctuations. Libido, desire, availability of sex with a partner, stress, ability to orgasm, and hormone levels are just a few factors. However, for most patients, libido improves in the first 6 weeks and generally increases over time.

Resolution of Hot Flashes

Hot flashes can be disruptive and embarrassing. They can also interfere with sleep, adding to menopausal discomfort. For most women, improvement in hot flashes occurs after about 6 weeks. The addition of progesterone can also help with consistent sleep quality.

Vaginal Dryness

Vaginal dryness and atrophy can contribute to painful sex to the point where you may avoid sex altogether. Most patients with mild vaginal dryness can expect relief within 6 weeks. Moderate vaginal dryness may require 6 weeks to 3 months, and severe vaginal dryness and atrophy could take a year or more.

Improved Mood

Mood can be associated with poor sleep, decreased serotonin, and brain fog. Estrogen increases serotonin, and progesterone helps you sleep. Mood can improve within 6 weeks, and brain fog in about 3 months.

Increased Bone Density

Loss of estrogen and testosterone contribute to bone loss. Bone density improvement can take up to a year but continues to improve over time for most patients, especially with the addition of consistent weight-bearing exercise.

Increased Muscle Mass

Women have less muscle mass than men, and as they age, maintaining or increasing muscle mass can be challenging. Estrogen and testosterone contribute to muscle mass improvement within about a year. Working out with weights will accelerate muscle mass development.



For men, declining testosterone levels can wreak havoc on motivation, energy, sex drive, and endurance.

Improved Libido and Erectile Dysfunction (ED)

Some men may experience significant improvement in ED and libido within a few weeks of starting testosterone replacement, while others may require several months to notice changes. Most men will notice an increase in morning erections in the first 6 weeks. It's essential to have realistic expectations and be patient with the process.

Increased Muscle Strength and Exercise Capacity

Men may notice increased muscle strength after about 10-15 months, but with weight lifting, they may see an increase in strength in just 8 weeks. With improved energy, men are more motivated to exercise and lift weights, which can accelerate muscle strength and mass.

Decreased Fat Mass and Waist Circumference

Losing fat is a consequence of improved energy, exercise, and attention to diet. Decreasing visceral fat is essential for heart health and vitality.  Men can see results in about 25-29 months. Hang in there! It will happen.

Increased Bone Density

Men have bone density issues just like women do. The incidence of osteoporosis in males is growing due to the aging population and a more sedentary lifestyle.  Men experience higher mortality and morbidity following fractures. It can take up to 41 months to see improvement in bone density.


Testosterone increases the release of dopamine, a neurotransmitter in your brain responsible for your feelings of pleasure. There may also be a connection between testosterone levels and the function of serotonin. Men can experience an improvement in mood within the first 3 months. Yay! 


Variables Affecting Hormone Efficacy and Length of Time

Several factors can impede or slow the improvement of hormone replacement. If you want to optimize its positive and life-changing effects, consider these factors. 


Compliance with hormone replacement is critical to efficacy. If you skip doses, take time off, and return, your response won’t be as robust. If you are experiencing unpleasant side effects, talk to us so we can evaluate and adjust your dosing or method of delivery.

General Health

Chronic medical conditions or health problems, such as high blood pressure, diabetes, and high cholesterol, can impact hormone efficacy. However, many health conditions are modifiable through diet and exercise. 


Let’s face it: if you are sedentary and have a lousy diet, hormone replacement can help motivate you to change, but without the commitment to improve your health, you won’t have as many benefits. Give yourself time, but start exercising and switching to a plant-based diet free of processed foods. Optimize the synergistic relationship between a healthy lifestyle and hormone replacement.

Pre-treatment Hormone Levels

We mentioned this earlier, but your hormone levels are unique to you. That is why hormone replacement requires a skilled, creative, and flexible approach. For example, a woman going through perimenopause will have different estrogen levels than someone in full menopause. And some women need higher doses of testosterone to benefit than other women. The other complicating factor is the lack of research on appropriate and therapeutic hormone levels for women. 


You Deserve to Feel Better

In a society that values immediate gratification, hormone replacement teaches you patience and the benefit of taking charge of your health. You deserve to feel better; hormone replacement can be the first step to improved health and well-being. 

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