hormone therapy: what to know before you start

Hormone therapy can quickly change how you feel — energy, mood, sleep and sex drive all shift when hormones change. That power is why treatment helps many people, and why it needs care. This page gives straight advice on common hormone therapies, what to watch for, and how to stay safe when getting prescriptions or using compounded meds.

Types of hormone therapy you’ll meet

Menopause HRT: Estrogen, often paired with progesterone if you still have a uterus. It eases hot flashes, night sweats, and vaginal dryness. Low-dose options focus on symptoms with lower side effects.

Testosterone replacement: Used for men and some women who have low testosterone causing fatigue, low libido, or reduced muscle mass. Delivery comes as gels, injections, or pellets. Dose and monitoring matter more than the product name.

Thyroid hormone replacement: Levothyroxine (T4) is the usual starting point. Some people use combination T4/T3 or desiccated thyroid when symptoms persist despite normal labs. Always check TSH and free hormones before changing therapy.

Practical tips for safe use and monitoring

Get baseline labs. Before starting, ask for TSH/free T4 (thyroid), estradiol or FSH (menopause cases), total and free testosterone, lipid panel, liver tests and a basic CBC when relevant. Baseline numbers set the target for follow-up.

Plan follow-up testing. Early checks at 6–12 weeks can catch dose problems. After things stabilize, most people need checks every 6–12 months. If you’re on estrogen and have risk factors, your clinician may want more frequent checks.

Watch for specific side effects. Estrogen can raise clot risk, especially in smokers or people over 60. Testosterone may cause acne, mood shifts, or raise red blood cell counts. Thyroid overtreatment can increase heart rate and bone loss. Report new symptoms fast.

Be careful with interactions. Some meds change hormone levels — enzyme inducers, steroid drugs, and certain antidepressants can matter. Share a full med list with your prescriber and pharmacist.

Choosing a pharmacy and compounding options. If you need a compounded formula (custom dose or form), pick a pharmacy that follows USP standards and has clear quality controls. Ask about batch testing, expiration dating, and whether they supply certificates of analysis. Don’t buy hormones from sites that won’t verify prescriptions or won’t provide contact info.

Find the right prescriber. Look for clinicians who measure symptoms and labs, not just hand out scripts. Endocrinologists, gynecologists, or experienced primary care doctors are good starting points. If you use a telemedicine service, confirm their lab and follow-up plan.

Simple checklist before you start: 1) Get baseline labs. 2) Talk risks and goals with a clinician. 3) Choose a certified pharmacy. 4) Schedule follow-ups. These steps cut risk and help you see results faster.

Hormone therapy works for many, but it’s personal. With the right tests, clear goals, and a trusted provider or compounding pharmacy, you can get benefits while keeping risks low. Ask questions, keep records of labs and doses, and don’t accept vague plans — your hormones deserve a clear roadmap.