The time it takes for hormones to balance after stopping hormone replacement therapy (HRT) can vary quite a bit between individuals. However, most experts agree it can take anywhere from 3 months to a year or sometimes longer for hormones to rebalance.
There are a few key factors that influence how long it takes:
How long were you on HRT
- If you were on HRT for many years, it often takes longer for the body to start naturally producing hormones again. Most data show at least 6-12 months for hormones to regulate after long-term HRT.
What types of hormones you were taking
- The most common hormones in feminizing HRT are estrogen and anti-androgens like spironolactone or GnRH agonists. For masculinizing HRT, testosterone is the main hormone. Coming off testosterone alone may be faster to recover from than if you stop dual estrogen plus anti-androgen therapy.
Your age and existing hormone levels
- Those who start HRT at younger ages and still have intact gonads (ovaries or testes) seem to rebalance faster, as the organs can resume production. Older individuals or those who had gonads surgically removed may take much longer.
Use of other related medications
- Sometimes HRT is used alongside other drugs that alter hormone levels like birth control, GnRH agonists, metformin, corticosteroids, etc. Coming off these together with HRT can complicate and lengthen the transition.
Individual variation
- Our bodies are complex! So while general estimates help set expectations, there is high individual variability in rebalancing timeframes after stopping HRT or any hormone medication.
What to Expect
As your natural hormone production kicks back in after quitting HRT, you may notice some of the following:
- Hot flashes, night sweats, trouble sleeping
- Fatigue, low mood or irritability
- Headaches or muscle/joint aches
- Lower libido, erectile dysfunction, vaginal pain
- Redistribution of weight, water retention
- Loss of breast size (for trans women stopping estrogens)
- Possible growth of body/facial hair and voice changes (for trans women stopping anti-androgens)
The severity of these changes depends heavily on how long you've been on treatment, underlying health issues, genetics and environmental factors.
Most tend to last a few weeks to several months before leveling out.
Managing Rebalancing Side Effects
There are things you can try to ease the transition:
- Continue seeing your hormone therapy providers during rebalancing
- Stay hydrated and eat a balanced, nutrient-rich diet
- Reduce intake of alcohol, caffeine and inflammatory foods
- Exercise regularly - ideally cardio, strength training and stretching/yoga
- Get enough sleep and take breaks when needed
- Reduce stress through meditation, journaling or being in nature
- Ask your doctor about temporary medications for hot flashes, sleeping trouble, pain or low mood
Also, know that some revert back to taking
lower-dose "bridging" hormones (like birth control pills) in between stopping HRT and the natural system kicking back in fully. This may help blunt the intensity of reverting effects. Consult your provider to see if this option is OK for your situation.
HRT Specialists to Guide You Through Rebalancing
If you have decided to halt hormone replacement therapy, having an experienced
gender-affirming hormone doctor on your side can make all the difference.
Vitality Balance Clinic offers top gender transition specialists across the United States to support balanced wellness during and after HRT.
Our board-certified endocrinologists, OBGyns and other providers specialize in evidence-based transgender care, hormonal balancing therapies and helping you feel your best in your body.
We take an integrative approach and
get to know you as an individual, understanding your unique needs, goals and health background. This allows us to come up with a personalized care plan to safely halt HRT doses when the time comes and manage any symptoms that may crop up along the way.
Guiding people toward hormonal balance and harmony is our passion!
Reach out to Vitality Balance Clinic today to start your journey of understanding, empowerment and self-care surrounding gender-affirming hormones. Our mission is for you to feel wholly supported, informed and confident every step along your path, wherever it may lead. We're eager to work together toward your vibrant, optimal wellness.
