Is My HRT Working? How to Know If You’re Feeling As Good As You Could.

It’s a question I’ve asked myself—and one I hear often.

“How do I know if my HRT is working?”
“Is this as good as I can feel?”

Some days, I feel like I’ve got it right. Other days… I don’t.
That’s the truth of perimenopause and postmenopause—it’s rarely black and white.

And so, this blog isn’t here to offer certainty.
It’s here to help you ask better questions.
To listen in more closely.
To trust yourself more deeply.

Because if you’re even asking this question, I gently suggest… the answer is probably no.
No, you’re not feeling as good as you could.
Because somewhere in you, there’s a quiet knowing that there could be more ease, more energy, more you.

What HRT Can Do (When It’s the Right Fit)

Let’s start with the science.

HRT—hormone replacement therapy—can be transformative for many women.
When personalised and properly prescribed, it can help:

• Relieve hot flushes and night sweats

• Improve sleep

• Reduce joint pain and vaginal dryness

• Support brain function and memory

• Improve mood, focus, and energy

• Protect bone and heart health over time

And if it’s the right fit for you—it can feel like you’re getting yourself back.

But...

What HRT Won’t Do

Many women start HRT and then feel confused when they still don’t feel quite right.

And here’s the honest truth:
HRT can support your physiology—but it won’t fix your life.

It won’t:

• Heal chronic stress or emotional exhaustion

• Break people-pleasing habits or perfectionism

• Help you set boundaries or make space for joy

• Release old grief or guide you back to your body

• Change a life that feels misaligned

That’s where the deeper work begins.
That’s where therapeutic coaching, journaling, rest, and reflection come in.
That’s where you return to yourself.

So if you’ve started HRT and you’re still tired, still flat, still not quite you—you’re not doing anything wrong.
You’re simply human.
This is a layered transition.
And there is no quick fix, only a deeper unfolding.

How Do I Know If My HRT Is Working?

Here are some signs to consider:

• You’ve been taking it for at least three months, and most of your key symptoms (e.g. sleep, hot flushes, mood, brain fog) have not improved

• You feel better in some ways, but something still feels off—physically or emotionally

• You’re struggling with side effects (e.g. breast tenderness, low mood, breakthrough bleeding)

• You’ve changed HRT type or dose and feel worse, not better

• You feel like you’re coping, but you’re not thriving

And—here’s the key one:
You’re asking the question.

Because the act of wondering—“Is this as good as it gets?”—suggests your body is trying to speak to you.

But Are You Listening to Yourself?

When you ask,
“How do I know if my HRT is working—or if it could be better?”
you’re often not just questioning the treatment.

You’re questioning yourself.
Your ability to know.
To trust what you feel.
To believe the signals your body is already sending.

Because if you’re asking, the signs are likely there.
But instead of turning inward,
you might be looking outward—waiting for someone else to confirm what you already know deep down.

This isn’t a criticism. It’s conditioning.

We’ve been taught to hand our authority over.
To trust professionals over intuition.
To seek certainty in a system that often overlooks nuance.

And it’s completely understandable.
When everything is changing—from your body to your brain to how you feel in the world—
it’s hard to know what’s “just hormones,” what’s emotional, and what’s real.
(Hint: It’s all real.)

But the truth is—your body is speaking.
And maybe the deeper question is not “Is my HRT right?”
…but “Do I trust myself to know what’s right for me?”

A Note for Women Who Can’t or Don’t Want to Take HRT

Let me say this clearly:
Not everyone can or wants to take HRT.

And that’s okay.

You still deserve support.
You still deserve to feel good.
You are not excluded from wellbeing because of your circumstance—or your choice.

Everything I’m about to say applies just as much if you’re navigating this transition without hormones.

Because whether you’re on HRT or not, your body still speaks.
And your job is still to learn how to listen.

The Science of Hormones (And Why It’s Not the Whole Story)

Let’s talk about the biology for a moment—because understanding what’s happening in your body can be incredibly validating.

In perimenopause, progesterone is often the first hormone to decline.
Progesterone is a calming hormone—it helps with sleep, soothes the nervous system, and balances the effects of oestrogen. As it drops, you might notice:

• Trouble falling or staying asleep

• Heightened anxiety or irritability

• A sense of being “on edge” without knowing why

Then, oestrogen begins to fluctuate and eventually decline.
Oestrogen is a powerful anti-inflammatory. It keeps joints supple, the brain sharp, the skin elastic, and the pelvic tissues lubricated. Without it, you might feel:

• Aching joints or stiffness, especially in the morning

• Vaginal dryness or pain with intimacy

• Brain fog or forgetfulness

• A loss of joy in movement or motivation

Testosterone also plays a role in libido, energy, and muscle strength. As it declines, you might feel flat, foggy, or disconnected from your drive.

But here’s the nuance:

Hormones influence your physiology—but so does your life.

• Poor sleep isn’t just low progesterone—it can also be stress, mental load, or blue light late at night.

• Achy joints aren’t just falling oestrogen—they might be your body asking for more movement, more hydration, or less inflammation in your diet.

• Low libido isn’t just testosterone—it could be unspoken resentment, unmet needs, or disconnection from your own body.

So yes, the science matters.
But so does your story.
(If you read my last blog, you’ll know how much I believe in that.)

HRT may help replenish what’s declining.
But it won’t unpack your schedule.
It won’t process your stress.
It won’t stretch your spine or soften your breath.

That’s your work.
Your invitation.
Your unfolding.

Listening to What Your Body Is Really Saying

Listening is a skill we’ve forgotten—and one of the most healing things we can relearn.

And sometimes, it’s confronting.

Because when you finally stop and listen, you might hear just how tired you are.
Or how lonely. Or how unfulfilled.

But you also might hear a whisper of your old self… or your next self.
That’s where the magic begins.

Try this:

• Ask yourself: What do I feel right now? What do I need today?

• Track your symptoms—but also your energy, your mood, your capacity

• Notice patterns: when do things feel worse? What helps? What drains you?

• Begin to trust your signals—without needing someone else to confirm them

• Remember that your emotions are messengers, not flaws

You are not making this up.
You are not being dramatic.
You are not meant to suffer silently.

A Final Thought

So, how do you know if your HRT is working?

You ask.
You listen.
You stay curious.
You remember that coping is not the same as thriving.

You trust yourself enough to say:
“This still doesn’t feel right.”
You work with someone who sees the whole of you—not just your lab results.
You honour the fact that your body, mind, and soul are all part of the picture.

And maybe for the first time in a long time,
you start to believe you’re allowed to feel good.
Not perfect.
But good.
And that is enough.