How to keep a record of HRT dose changes
Record four things every time something changes: the date, what it changed to, what it changed from, and why.
The date is the one that carries everything else. "I've felt better lately" and "the dose changed six weeks ago" mean something together and very little apart.
Why this is worth a page of its own
Search for how to track HRT dose changes and you mostly get generic dosage charts, or trackers built for men on testosterone injections. Women adjusting patches, gels and tablets over months — often through several changes before something settles — have essentially nothing written for them. It is a real gap, and it's odd, because titration is exactly the period where a record earns its keep.
What a change entry needs
| Field | Why it matters |
|---|---|
| Date | Anchors everything after it. Without this the record can't be read. |
| What it is now | Product, dose, form (patch, gel, tablet, spray), and how often. |
| What it was before | The comparison is the information. A dose alone tells you nothing about direction. |
| Why it changed | In your own words. "Still waking at 3am" reads very differently from "skin reaction to the patch." |
What to keep tracking between changes
- The same symptoms, described the same way. Consistency is what makes before-and-after comparable. Changing your own wording midway makes a pattern invisible.
- Anything new since the change, dated.
- Bleeding, if relevant. Dates and pattern. NICE NG23 addresses unscheduled bleeding specifically in the context of the 3-month review, so it is likely to come up.
- Doses missed, patches that came off, days skipped. Not a confession — information that changes how everything else is read. A quiet fortnight of missed doses explains a lot, and only if it's recorded.
Two practical notes
Log the change on the day it happens. Reconstructing dates later is where records lose their value, and dose-change dates are unusually hard to remember accurately after a few months.
Don't try to draw conclusions in the log. Writing "the higher dose isn't working" turns an observation into an interpretation, and it will colour how you read everything after. Record what you took and what you noticed. Interpretation is your clinician's job, at the review.
Where this gets used
NICE NG23 recommends reviewing HRT "at 3 months to assess efficacy and tolerability; annually thereafter." That review asks two questions — is it working, and how are you tolerating it — and both are answered from the period since the last one. See what to bring to a 3-month review.
HormoneLog. "How to keep a record of HRT dose changes." Baker Ventures LLC, September 4, 2026. https://hormonelog.bakerventuresstudio.com/guides/how-to-log-hrt-changes