Starting Bioidentical Hormone Replacement Therapy (BHRT) is an exciting step toward feeling your best—but it’s also normal to have questions as your body adjusts. At Flow Wellness, we want you to feel informed, confident, and supported throughout your treatment.

Below, we’ve answered some of the most common questions we receive from patients in the first few weeks or months of BHRT. If anything feels off, or if you just want to check in, don’t hesitate to reach out—we’re here to help.

1. Why am I having vaginal bleeding or spotting after starting BHRT?

Light bleeding or spotting can be common, especially in the first few months of treatment. Hormones like estrogen or progesterone can stimulate the uterine lining, leading to mild bleeding as your body adjusts.

Contact us if the bleeding is heavy, prolonged, or occurs after you’ve been on BHRT for several months. We’ll evaluate further to make sure everything’s on track.

2. Why do I feel bloated or have breast tenderness?

These are common side effects during the adjustment phase. Estrogen can lead to temporary water retention and breast sensitivity.

Symptoms usually improve within a month or two. If they persist, we may adjust your dosage to improve comfort.

3. Is it normal to feel moody or emotional?

Yes, it’s not uncommon to feel more emotionally sensitive in the early weeks. Estrogen, progesterone, and testosterone influence brain chemistry and mood, and your body needs time to rebalance.

If mood swings are intense or don’t improve, let us know. Many patients benefit from journaling, mindfulness, exercise, or therapy during this transition.

4. Why am I having headaches since starting BHRT?

Estrogen can affect blood vessels and, in some cases, trigger headaches—especially in people with a history of migraines. This usually improves over time.

Stay hydrated, sleep well, and manage stress. If headaches persist or worsen, notify your provider. If severe, seek urgent care.

5. Can BHRT cause weight gain?

Significant weight gain is uncommon, but you may notice mild changes in weight or bloating. Hormones can influence appetite, water retention, and fat distribution.

Eating nutrient-rich foods, staying active, and prioritizing sleep can help. Let us know if you’re concerned—we’re happy to review your plan.

6. Why do I feel tired or have low energy?

Fatigue can occur while your body adapts to new hormone levels. Disrupted sleep, night sweats, or energy shifts can contribute to tiredness.

We can adjust your BHRT dosage, review your labs, or evaluate other causes like iron levels. Most patients notice improvements within a few weeks.

7. Is it normal to have changes in my skin or hair?

Yes! Hormones affect skin elasticity, oil production, and hair growth. Estrogen may improve skin hydration, while testosterone or DHEA may impact hair texture or thickness.

If you experience acne, hair thinning, or unwanted changes, tell your provider. We may recommend supplements, topical support, or adjustments to your treatment.

8. Why are hot flashes or night sweats coming back?

Hormone levels may still be stabilizing, or your current dose might need adjusting. Triggers like caffeine, alcohol, or stress can also play a role.

We can track your symptoms and perform lab testing if needed to optimize your dosing.

9. Can BHRT affect my sex drive?

Yes—often for the better! Estrogen and testosterone can help restore libido, reduce vaginal dryness, and improve sexual comfort and satisfaction.

If you’re still noticing low desire or discomfort, we can adjust your treatment or recommend supportive therapies.

10. When should I contact my doctor about BHRT concerns?

These are concerns that aren’t emergencies but should be checked out soon. You can message us through the patient portal or call to make an appointment:

• Light vaginal bleeding or spotting that feels unusual for you.
• Mood changes that feel overwhelming, like feeling very sad or anxious for a long time.
• Symptoms that don’t improve, like hot flashes, tiredness, or other issues that stick around after a few months on BHRT.
• Mild headaches that don’t go away or happen often.

We’ll talk with you, maybe adjust your BHRT plan, or do tests to make sure everything’s on track.

Seek urgent or emergency care:

These are rare but serious signs that need quick attention. Call your doctor right away, go to urgent care, or visit the emergency room if you have:

• Heavy vaginal bleeding that soaks through a pad every hour or includes large clots.
• Chest pain, shortness of breath, or leg swelling (these could signal a blood clot or heart issue).
• Severe headaches or vision changes, like sudden blurry vision or seeing double.
• Sudden, severe mood changes that make you feel unsafe or out of control.

Don’t wait—these need to be checked immediately to keep you safe.

BHRT Is a Journey—And We’re Here Every Step of the Way

Adjusting to hormone therapy is a process, and it’s completely normal to have questions along the way. At Flow Wellness, we’re here to support your success with ongoing check-ins, symptom tracking, and personalized adjustments to help you feel your best.

Interested in starting BHRT therapy? Book a consultation today!