Before you start: the questions worth asking
Eight questions, written down before you go, because appointments are short and questions evaporate in the room.
- What would you expect this to help with, and what would you not?
- How long before I should expect a change, and in which symptoms first?
- What are the common side effects, and which of them would mean contacting someone rather than waiting?
- How exactly do I take it, and what do I do if I miss one?
- What are the risks and benefits given my history specifically?
- What happens at the review, and when is it?
- What would make you change the plan?
- What should I do if it has not improved by then?
Question one prevents a specific disappointment, which is judging a treatment against a symptom it was never likely to address.
Question two turns an indefinite wait into a defined trial. Without a timescale, "give it time" has no end.
Question eight is the most valuable question in any appointment and it is almost never asked. It converts a prescription into a plan with a next step.
Then set up the record before the first dose, because the comparison you will want at the review needs a before.
The five-minute setup, before you start
Write down the start date. Exactly. It is the axis everything else is read against, and it is a one-line note people are certain they will remember and do not.
Write down the preparation, dose and route. In full, from the packet.
Keep recording the same symptoms, in the same format. The value at the review comes from before and after being comparable, and changing how you record at the moment you start makes them not.
Note where you are starting from. A short summary of the last six weeks: how often, how bad, what it stopped you doing. That paragraph is your baseline, and it is the thing recall will overwrite.
How to log HRT changes. · Between appointments.
What to record once you start
| Field | Why |
|---|---|
| Start date, and every change with its date | The timeline is what gets interpreted |
| Preparation, dose, route | A change in any of the three changes what is expected |
| The same symptoms, separately | They respond on different timescales |
| Side effects, with dates | Timing relative to a change is the whole signal |
| Adherence, honestly | Missed days change the interpretation completely |
| Anything else that changed | New medication, illness, a bad run of sleep |
The adherence row is uncomfortable and it is the one that matters most. Patches that came off, a late repeat, gel applied at wildly different times, days simply forgotten. None of it makes you a bad patient and all of it changes what a clinician concludes. When HRT does not seem to be working.
On risks
Ask about your own history and circumstances, not in general.
Risk discussion in this area is individual: it depends on your medical history, your family history, your age, how long since your last period, and what else you take. A conversation about your situation is far more useful than any general summary, including this page, and it is the reason a general summary is not offered here.
And read the guidance rather than the coverage of it. NICE NG23 and your own health service's pages are public, written to be read, and considerably more careful than most reporting about them. How to read a menopause study. · What NICE NG23 actually says.
What good looks like leaving the appointment
You know what you are taking, how, and what to do if you miss it.
You know what it is expected to help with, and what it is not.
You have a date for the review and an expected timescale.
You know which side effects mean contacting someone rather than waiting.
And you know what happens if it has not helped.
If any of those five is missing, ask before you leave. Each is one sentence to answer and expensive to work out alone afterwards. What happens at a menopause appointment. · The HRT review appointment.
What this page is not
It is not medical advice and it does not describe what HRT does. It is a list of questions and a description of what to record.
HormoneLog records and does not assess. It holds what you took, when, and what you noticed, with dates. There is no score in it, no threshold, and nothing that suggests a direction, because those are prescribing decisions made by someone who can examine you.
Why tracking perimenopause symptoms is worth it. · HRT formulations explained. · What to take to your first appointment.
More in this section
About HormoneLog
HormoneLog is an iOS app from Baker Ventures LLC for tracking perimenopause and menopause symptoms and keeping an HRT record: what you took, at what dose, from when, and what changed afterwards. It is built for the appointment, where "it has been bad lately" is worth far less than a dated record of frequency and severity. The app is in development.
HormoneLog is a record-keeping tool. It does not diagnose, does not score you, and makes no claim about symptom relief. The guides on this site link to NICE, the NHS, the Menopause Society and peer-reviewed sources, and say plainly where the evidence is thin. Everything here is free and needs no account.
Questions and answers
What should you ask before starting HRT?
What it is expected to help with and what it is not, how long before you should expect a change, what the common side effects are and which would mean contacting someone, how it is taken, what happens at the review, and what would be tried next if it does not help.
How long before HRT works?
That depends on the symptom, the preparation and the dose, and it is a question for your prescriber rather than an article. Asking for an expected timescale at the appointment is what turns an indefinite wait into a defined trial with a review date.
What should I record once I start?
The exact start date, the preparation, dose and route, then the same symptoms you were recording before, in the same format, plus any side effects with dates and honest adherence.
What are the questions people forget to ask?
Which of my symptoms would you not expect this to help, what would make you change the plan, and what should I do if it has not improved by the review. All three convert a prescription into a plan with a next step.
Should I ask about risks?
Yes, and specifically about your own history and circumstances rather than in general. Risk discussion is individual, and a conversation about your situation is far more useful than any general summary including this page.
Is this page medical advice?
No. It is a list of questions and a description of what to record, so that the appointment and the review are productive. The prescribing decisions belong entirely to you and your clinician.
HormoneLog. “Before you start: the questions worth asking.” Baker Ventures LLC, September 7, 2026. https://hormonelog.bakerventuresstudio.com/guides/what-to-ask-before-starting-hrt/