Some women may experience nausea, fluid retention, breast enlargement and discomfort, particularly during the first few months of taking hormone replacement therapy (HRT). Usually these symptoms fade over time as the body adjusts to the new levels of hormones. If these symptoms persist then the dose, brand or the way it is administered may need to be changed. Specific preparations are less likely to cause these side effects and changing can usually overcome these problems.

Breast soreness and nausea are side effects of taking oestrogen while in some women progesterone may cause bloating, depression and mood swings - symptoms similar to those of premenstrual syndrome (PMS). Some HRT does not require additional progestins and can be very useful if these effects occur. Adding testosterone may be helpful if breast tenderness is a problem. Often a reduction in the dosage, or change of brand, overcomes this problem.

Breakthrough bleeding can sometimes become a problem. If this is an issue then you can talk to your health practitioner about ways to reduce or eliminate this.

Does HRT cause weight gain?

With ageing, the base metabolic rate tends to decline and weight increases if energy intake from food and beverages exceeds energy used in daily activities and exercise.  

A weight gain of around five kilograms is common over the years from 45-55. 

Gaining weight specifically from hormone replacement therapy, however, is uncommon. This may occur temporarily when starting HRT, but it is usually from fluid retention and is related to the body readjusting to changing hormone levels. 

Regular exercise is particularly beneficial, when combined with a well-balanced diet, not only in helping to control weight, but also in helping to reduce the risk of heart disease and osteoporosis, as well as a range of other beneficial effects.

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Content updated June 8, 2010