What should you expect in your first week on HRT?
Usually not much relief yet, and possibly a few mild side effects: an NHS trust page says HRT typically takes a few weeks to help and up to 3 months for the full effect, while early side effects often settle within weeks.
The Guy's and St Thomas' NHS Foundation Trust page puts early side effects like tender breasts, nausea and leg cramps at usually disappearing within 6 to 8 weeks, and the NHS (2023) suggests carrying on for at least 3 months if you can. Week one is for writing things down, not for deciding whether it works. This is general information, not medical advice. Talk to your clinician.
Your first 7 days, one card a day
Swipe through. Each card is one small thing to note, using what My Midlife Story actually does.
Day 1
Log the start.
Use "Something changed" to record the treatment your clinician prescribed and the date. Later notes never overwrite it.
Day 2
Note your baseline.
Hot flushes today? Night sweats last night? One tap each. This is what you will compare against in week six.
Day 3
Watch for the common ones.
Headache, breast tenderness, nausea, leg cramps: the NHS (2023) lists these. Note the time, not just the day.
Day 4
Write one question.
Anything you want to ask at your review. Save it as a question so it's waiting for the visit brief.
Day 5
Check your sleep.
Poor sleep is one tap. If you turned on Apple Health sleep context, it shows alongside your notes.
Day 6
Skip a day if you like.
Missing days stay unknown, not symptom-free. No streaks, nothing lost.
Day 7
Read the week back.
Filter to 7 days. It's early: Guy's and St Thomas' NHS Foundation Trust says benefits usually take a few weeks. You're building the record, not judging it.
HRT first-week questions
How long does HRT take to work?
The Guy's and St Thomas' NHS Foundation Trust HRT page says it usually takes a few weeks to feel the benefits, and the full effect can take up to 3 months. A first week with little change is common.
What side effects are common when starting HRT?
The NHS (2023) lists oestrogen side effects such as headaches, breast pain or tenderness, feeling sick, leg cramps and spotting, and progestogen side effects such as headaches, breast tenderness, mood changes and acne. It says they often go away after a few weeks.
Should I stop HRT if I get side effects in week one?
Don't change or stop a prescription on your own. The NHS (2023) suggests carrying on for at least 3 months if possible, and to speak to a GP if side effects are severe or last longer than 3 months. If something worries you, call your prescriber.
Is bleeding normal when starting HRT?
The NHS (2023) lists unexpected spotting or bleeding as a possible side effect, and says to speak to a GP if irregular bleeding goes on for more than 6 months, gets heavier, or starts after your periods had stopped for a while.
What should I write down in the first week?
The dose and form you were prescribed and the date you started, any side effects with the time they happened, and the symptoms you started HRT for (hot flushes, night sweats, sleep) so you can compare later. One line a day is enough.
Does My Midlife Story tell me if my HRT is working?
No. It does not diagnose, recommend treatment or doses, or say one thing caused another. It keeps your notes by date, marks treatment changes with "Something changed", and turns the notes you choose into a visit brief and PDF.
Is My Midlife Story free?
Logging, history, search, visit briefs, PDF export, reminders, encrypted backup and deletion are free, with no account. Optional Premium (monthly or annual) adds comparisons between periods you choose, grouped Replays and advanced visit briefs.
Paper diary vs notes app vs My Midlife Story
Honest read: a paper diary works fine for one week. The app earns its place at month three, when you need to find what changed.
What it looks like
Who this is not for
- Anyone with severe or worrying symptoms. Don't wait for a review: contact your prescriber or GP.
- People who want the app to judge their HRT. It won't, by design. We chose to keep every note in your own words and never draw medical conclusions from them.
- Android users. It's iPhone and iPad only.
Why bother tracking the symptoms you started for? The NHS (2026) says menopause symptoms usually last 7 to 9 years and can change over that time, so a dated record helps you and your clinician see the shape of it. Mayo Clinic (2026) notes that people with a uterus taking estrogen also need a progestogen, which is why your prescription may have two parts worth logging.
Start on your iPhone
Start on your iPhone tonight: log the day you began, and let week one be the first page of the record.
My Midlife Story: Menopause on the App Store · Updated November 2026
Related
- My Midlife Story: the menopause tracker that writes your visit briefLog hot flashes, night sweats, sleep and brain fog in one tap, then take a one-page visit brief to your doctor. Free and private on iPhone.
- Best free menopause tracker app: six compared before your year-end visitSix menopause tracker apps checked against their App Store listings in November 2026: what is free, doctor reports, accounts and tracking labels.
- Menopause terms explained for partnersA plain-English menopause glossary for husbands and partners: 12 words you'll hear, sourced from NIH, NHS and Mayo Clinic. Tick off each one.
- How long to track menopause symptoms before your doctor visitTrack for 2 to 4 weeks, plus a few months of cycle dates if you still have periods. Sort your symptoms and get a 4-week tracking plan.