When a person stops taking hormone replacement therapy (HRT), their body undergoes several changes as it adjusts to the withdrawal of supplemental sex hormones it has gotten used to receiving. The specific changes depend on the type of HRT the person was receiving.
Estrogen HRT
If a woman stops taking estrogen HRT, she may experience:
- Return of menopause symptoms: Hot flashes, night sweats, vaginal dryness, mood changes, trouble sleeping, etc. Symptoms are often more severe than prior to starting HRT.
- Bone loss: Estrogen helps maintain bone density. Lack of estrogen leads to accelerated bone loss and increased risk of osteoporosis and fractures. Regular bone density screening is recommended.
- Heart disease risk: Estrogen HRT helps protect cardiovascular health. Stopping it removes those heart protections. Cholesterol levels may rise as well.
- Genitourinary atrophy: Thinning of tissues in the vagina and urethra leading to painful intercourse, urinary issues, and infections. Localized estrogen treatment may be used to manage symptoms.
Testosterone HRT
If a person assigned female at birth stops supplemental
testosterone therapy, the following changes could occur:
- Loss of masculinizing effects: Facial/body hair loss, voice changes, muscle loss, redistribution of fat to hips/thighs, decreased libido, erectile dysfunction.
- Mood changes: Depression, mood swings, emotional lability due to withdrawal of testosterone’s mental health benefits.
- Hot flashes: Testosterone withdrawal can trigger hot flashes and night sweats.
- Fatigue/low energy: Testosterone increases energy levels, so stopping replacement therapy can substantially reduce energy and stamina.
If a person assigned male at birth stops
testosterone replacement therapy, they may experience:
- Reduced bone density: Testosterone helps maintain healthy bone density in those assigned male at birth. Lack of testosterone is a risk factor for osteoporosis.
- Loss of masculinizing effects: Muscle mass decrease, weight gain, breast tissue growth. Libido and sexual functioning decreases.
- Anemia: Testosterone promotes red blood cell production. Deficiency can lead to anemia.
- Fatigue: Low testosterone reduces energy levels and endurance.
Other Considerations
- Consult your healthcare provider before stopping HRT to understand risks and minimize side effects
- Do not quit “cold turkey” - tapering dosage slowly minimizes withdrawal effects
- Seek prompt medical attention for severe symptoms like depression, hot flashes interfering with daily life, rapid onset osteoporosis, etc.
- Those who underwent gender affirming procedures/surgeries require HRT to maintain results
- Consider managing menopause symptoms through lifestyle, alternative medicine before resorting to HRT again
In summary, when you stop HRT -
especially abruptly - your body can experience distressing
withdrawal effects. Work closely with experienced doctors to make safe adjustments allowing your body to adapt.