r/LadiesHRTwithGLP1

I’m 46, 5’6”, around 160 lbs, and honestly feeling really lost with perimenopause, HRT, weight gain, sleep, and now considering GLP-1s. I’m hoping to hear from women who’ve gone through something similar.

I’ve been on HRT for about 2 years:
\- Estradiol patch 0.1 twice weekly
\- Progesterone 100 mg nightly

The HRT HAS helped some things, especially the rage/mood swings before my period, brain fog, and that “completely losing it” feeling the week before my cycle. But lately I still feel emotionally sensitive, sad, exhausted, and honestly just not like myself anymore.

Over the last 2 years I’ve gained about 15 lbs, mostly in my belly and breasts. My breasts constantly feel swollen/full/heavy, I feel puffy and inflamed all the time, my hair is thinning, and nothing fits the same anymore. It’s affecting my confidence because I don’t even feel like getting dressed or going anywhere half the time.

I work out 4-5x a week (mostly strength training), try to walk/get steps in, and I’m mindful about protein and food overall. I also try to take fiber because I’ve always had digestion/bathroom issues. But despite all of that, I still feel exhausted, hungry all the time, and like my body just keeps fighting me.

Sleep is also terrible. I wake up constantly and probably average around 5 broken hours a night.

I also have adenomyosis/heavy clotting, so I’m wondering if estrogen is making some of that worse too.

Last year I tried compounded semaglutide at a VERY small dose for about a month (even lower than the starter dose) and I was still so nauseous the entire time. It honestly felt like morning sickness and made it harder to even work out because I constantly felt sick. I’m wondering if tirzepatide is any better for people who were really sensitive to semaglutide nausea?

I guess my questions are:
\- Has anyone gained weight or felt constantly puffy/full on HRT?
\- Did lowering your estrogen dose help?
\- Did stopping HRT help or make things worse?
\- Has progesterone made anyone feel constantly hungry?
\- Did anyone eventually tolerate GLP-1s after bad nausea in the beginning?
\- Has tirzepatide worked better for anyone than semaglutide?

There’s SO much information online right now and every ad is another powder, gummy, hormone supplement, fiber drink, peptide, etc. I honestly don’t know what’s normal anymore or what direction to go in.

Would really appreciate hearing from women who’ve actually experienced this.

My doctor has me switching from oral estrogen to the patch. The first thing I see when my prescription is sent to the pharmacy is there is a shortage and they don't know when the patch will be in stock. So I had my doctor sent in another prescription for oral estrogen.

The patch came and I picked it up and opened the box. There are 4 patches in there. Months are longer than 4 weeks. Is this going to be my life from now on, where you never have enough and are always skipping weeks?

I decided to not use the patch until I'm out of oral estrogen so I can build a stockpile of patches.

It was bad enough on oral keeping enough on hand so I could take vacations and not be a slave to the day of the month I can pick up a prescription. I would skip days so I could build a little stockpile and do automatic refills so I could get more than 12 bottles in a year and then I could be free to take vacations in the wilderness a month or more long (I am retired).

What strategies do you have to keep enough patches on hand so you can just live your life without being chained to the pharmacy?

Ack!! I've been on HRT (.05 estradiol) + 100 mg Progesterone for about 6-8 months. Used to work well on my symptoms but lately, my sleep has been poor again. Doc upped my estradiol (patch) to .075. BOOM! Instantly...I mean the DAY I tried the new patch...weight loss stopped. I'm on week 6 of 2.5 mg Tirzepatide. Have been losing weight at a really fast clip, 2-3 lbs/week. And then...nothing. Zero loss, two weeks in a row. Plus, my peri symptoms have returned: nausea, super itchy skin, headaches. Anyone else experienced this? How long did it last?

I’m meeting with my doctor tomorrow and wanted to get some feedback here before I go.  I’ve been on HRT (.05% estradiol with 100 mg progesterone) for about 8 months.  No problems.  I started Tirzepatide at the end of March.  My weight loss had been GREAT...about 12 lbs in 5 weeks.  I started having trouble sleeping, contacted doctor, and she upped my estrogen to .075%.  IMMEDIATELY – the very day of new patch – weight loss stopped.  Nausea, headaches, felt terrible, slow weight gain despite a tight grip on calories, for two weeks.  I decided to cut down my new patch to the old .05% dose and immediately, nausea stopped and all other symptoms went away...and my weight started creeping down again (also increased Tirz dose from 2.5 to 3.5 mg).

 I’ve done some research and looks like doctor should’ve upped my progesterone, not estrogen, for sleep issues.  But it also looks like increased progesterone can cause bloating and insulin resistance (i.e. weight gain).  The other option is to keep things the same but get a patch that has .05% estradiol and 100 mg PROGESTIN, not progesterone.  But I read that progestin can ALSO cause water retention and insulin resistance/weight gain.

 I want to protect my uterus, of course, but I also want to lose weight!  I have almost 50 lbs to lose.  Can anyone tell me their experience with increased progesterone vs progestin in patch form?  If you experienced the water retention/insulin resistance, how long did it last?

Thanks!

Here is my Dexa from yesterday compared to last June at my initial goal, as well as Jan 2025 when I had already lost 40lbs! Just look at my elbow placement....I wish I had done a DEXA at the start.

I'm 5'4", SW 205, CW 125. Body fat is 28% currently. My current goal to be about 130lbs and 25% body fat. This goal is based on nothing...just sounds nice, so if anyone has advise let me know.

My original goal was 135, which I hit last June. I kept losing about 2 pounds per month for the first few months of maintenance, despite increasing cals and lowering dose. Kept increasing cals and lowered dose again to 7.5mg in November. Now that loss has slowed to less than 0.2 pound per month if I keep my cals around 1850-1900 per day, or even a little more.

I'm keeping a close eye on the Foundayo pill roll out and may switch to that in late summer if my pcp agrees.

I get quarterly DEXA scans and lean mass is holding steady, while fat is sloowwwlllyyy dropping. I strength train 3-4x per week for about 40 minutes and walk 3-5 miles per day. I turn 59 next month, and started menopausal hormone therapy in Jan, so I'm hoping that the MHT will help the muscles grow a bit faster. My OB has recommended adding testosterone gel to my MHT, and I'm getting the blood work next week to see if it's safe for me. While it is for libido, it may help the muscles as well. My libido has been gone for so long that I'm honestly more excited about muscle gains than sexy time, lol.

After almost a year of maintenance and body recomp, I have more definition in my arms, which have always been skinny, and my bra strap area is leaner, much less pooch over the strap. Shoulders are looking nice, just in time for summer. My boobs are mostly gone (a moment of silence for our fallen sisters, please), but the booty is still there, both with muscle and fat. Inner thighs and lower belly still holding onto the typical female softness, which is fine with me. Quads and hams have a modest amount of definition. All in all, I am tickled pink.

https://preview.redd.it/ll2rynsat40h1.jpg?width=826&format=pjpg&auto=webp&s=46981ecdf4e95898062a94296b14e6a1a81c3482

56F menopausal, estradiol patch .075, progesterone 200mg, Tirz 2.5 maintenance, Testosterone gel fda .5ml,
SW 156 CW 125
Totally a share here... I've been able to determine that in order for me to properly absorb the needed 200mg of progesterone, I have to take 2 100mg pills instead of 1 200mg pill. This way I am not spotting or bloated or experiencing that slight bleeding feeling. My gyno NP accepts my experience and wrote my script for the 100's. It was great to be listened to! My guess is that the pharmocodynamics between the 200mg pill vs 100mg alters with Zepbound on board??

Hi ladies -

are any of you using the glapp app to track your glp1 medication? Highly recommend.

I love the graph showing the estimate of how much is in your system based on timing and medication metabolism, and would love to have something like that for estradiol patches so that I could better understand and fine tune timing, placement, etc for minimizing symptoms. Does such an app exist? please share!

TIA.

Edit - please know that I feel quite ashamed for even starting a GLP with so little to lose. I should have left well enough alone. I started tirz November of last year, a microdose - 0.75 about every 4 days. I had been on HRT for a few years and was stable, feeling good, but wanting my meno middle to be smaller. After starting tirz I felt a bit flat, so my gynecologist increased my patch and progesterone and I felt good for months - goal weight achieved, working out, generally happy. Then I got sick, was feeling a little off emotionally and thought "meh, maybe I could stand to even gain a couple pounds, so I'll back off on the tirz" and just stopped. Around day 10 I had a panic attack. I administered a shot the next day and shortly felt better. This has happened a couple of times since then while trying to reduce my dose. I have read another places about GLPs causing anxiety while coming off of them. I'm wondering if in this case it has anything to do with less GOP but maybe too much estrogen now? Or maybe not enough, considering I'm getting some weird spotting since this whole anxiety thing reared its head, along with very dry eyes. At this point it's really hard for me to tell if maybe I need more estrogen, or less!

I am 53 y/o post meno and have been on an HRT journey for 2.5 years. I started with Biest creams and got rid of 3-4 hot flashes an hour and had no weight gain, but I was still low energy and grumpy. I then switched to the Estrogen .0375 patch for a year, along with a recent increase in Progesterone from 50 mg cream to a 100mg troche and my energy levels got so much better! But...the weight stall and the sleep issues.

I am super frustrated with my inability to stay asleep, that seems to have gotten worse since I started Tirz in January- I started at .25 microdose, and worked my way up to 2.5mg. I am also surprised and disappointed by the same 3-5 lbs lost and gained over the last 4.5 months! There is no real progress, and I have put in the work: I've gone from being dehydrated and a carb addict to 80 oz water and 80-100 g protein each day + walks and pilates reformer. Oh- and cutting my alcohol from 20 drinks a week to maybe 5 on weekends. You would think that alone + Tirzepatide would do some magic.

Is there anyone here who is on HRT and Tirz who has not seen the scale move much at all, and who still feels like crap/ can't sleep well? The scale just goes up and down and I am maybe at a steady 4 pounds lost since Jan 2026 (but it does creep up some weeks)

I have not slept well in over 15 years, but the 1am wakings started shortly after starting Tirz. My increase in progesterone helped for 2 weeks, then it was right back to waking 4 hours after falling asleep - no matter what time I go to bed, wine or no wine- even if I go to bed at midnight, like last night, I am up at 4am! 😞 Before I started Tirz, I wasn't waking up 4 hrs later- maybe 5 hours (still bad)- am I imagining things or can this drug affect sleep?

General feedback from my functional doctor is to up my Estrogen and try the RX 100mg Progesterone pill, but when I increased to the .05 patch last year for 5 months, I gained 7 lbs overnight and became so bloated, hindering me from being successful in my pilates reformer practice and being happy. Also, that dreaded RX Progestin pill makes me feel like a zombie the next day.

Thanks if you made it this far.

I've been post since August of last year. October through the end of the year I had the best sleep of my life. I was feeling great!! My HRT had been treating me well for a long time. Then at the beginning of the year, I started noticing some things coming back, hot flashes, insomnia, heightened anxiety. I thought it was post holiday. But it never settled. It was also around the same time I went on .06 micro dose every 10 days of tirzepatide for arthritis inflammation that couldn't be treated with steroids.

Went to my gyno for help and started weekly labs just to see if that showed anything, (for what that's worth, ik ik). Had to keep a symptoms log and all pointed toward estrogen deficit. We were all prepared to increase my Estrogel. But my numbers kept coming back higher and higher to the point where my doc was going to need to up my progesterone to 400mg if it didn't stop just for protection.

So a lower dose of estrogel for a couple of week. Ruled out ovarian issues, etc that would cause such a vast increase. Numbers bottomed out. Did find that I had way too much Vitamin D in my system. Switched to the patch. Now I'm on .05 E patch, 200mg P and a compounded T (same tirzepatide dosing).

The past two nights have been awful. Hot sweats that made me remember I had forgotten what hot sweats really were! Up for hours with a hot body and a surrounding chill from the wet neck, chest, and clothes.

Am I wrong that this should be easier in post? The majority of my hormones should be coming from HRT, correct? So, it would just make sense that things would level. How long would you wait before you started experimenting with your patch levels? I feel like I get into a good groove and then my hormones throw a wrench in the plans. And I thought those days were behind me. Sigh.

EDIT: My doc does not diagnose on numbers, however she does do bloodwork every six weeks just for reference. Since I started HRT my E numbers have stayed in the 50's (3 years) until recently when it went into the 400's. So, something wonky happened. But doc is treating me based on symptoms...just not as quickly as I would like. LOL

54, perimenopause hit me like a truck 2 years ago, on HRT 18 months. Ready to add compound sema. My husband retired early so I'm the income now. Trying to keep this affordable. And made the comparison. Our final choice was joinezra as they have a pharmacy menu visible . Align B12 starter 3 month $315 and Same pricing. But Eden was $150 starter 1 month sema. Pharmacy not named clearly. Didn't feel right for stacking with HRT where I want to know exactly what's in the vial. Join Pomegranate has a pharmacy menu visibletoo. Align B12 sema starter 3 month around $315. And that was the whole journey

Is HRT-specific intake actually meaningful or am I reading too much into it. And unrelated, my husband bought another tomato plant for our patio and I think we have 11 now. it’s becoming a jungle out there.

What combination of things is working well for you right now?

Got deleted from the menopause sub, hoping y'all can relate.

My patch days are Friday and Tuesday, I use testosterone cream daily. I am also on a GLP-1. This is all relevant, I promise.

Last weekend we had a big event at church and the days leading up to it my brain was already fried and I just...forgot my testosterone until Monday. I had been super irritable all weekend and just chalked it up to the missed T.

But I continued to feel off...irritable, and easily saddened. Tuesday was crazy at work and I didn't have time to shower between meetings (WFH) So I just put on the new patch quickly before my next call. I was hoping that might help a little but I got worse.

My husband's birthday was Wednesday and he's one of those never wants anything, stupid hard to buy for types. Won't ever buy himself anything. He gifted me an amazing, over the top experience for my birthday so I wasn't going to let his pass. I got him a midsize Blackstone. He tried to be appreciative but I could tell he didn't like it.

I was super moody the rest of the evening and it continued to spiral. Like I didn't even want to talk to anyone.

Remember the GLP-1 part? It sucks. The only good thing about it is the weight loss, but I got put on it because I developed a cardio metabolic disorder and now am at super high risk for stroke/heart attack. Also discovered I'm Insulin Resistant and probably have been for a long time. No amount of Statins, diet, or exercise will help, and I will be on this stuff for the rest of my life. I am on one of the smallest doses and I am rarely hungry. I'm also AuDHD and food is one of my triggers. I actually am seeing an RD to help me find things and ways to eat so that I don't lose muscle. I figured maybe my blood sugar was getting consistently low and started looking into OTC continuous glucose monitoring devices. I was also not losing any weight and actually gained on a couple days.

It really sucked because the previous couple of weeks I felt better than I had in AGES. Probably because I had figured out I wasn't drinking enough water and had more than doubled my intake and was finally hydrated for the first time in my life.

Last night I started feeling better, and I was pouring over my food diaries to figure out wtf I had done differently. Nothing stood out. I figured I'd just talk to my provider at my appointment next week.

This morning (Friday) I happened to scratch both sides of my stomach at the same time - one of those waistband itches? And discovered that I had TWO estrogen patches on. I never took off the Friday patch on Tuesday. I know that I wasn't getting a double dose or anything, and that whatever I did get was very small, but combined with the lack of testosterone for three days, it was enough.

Pretty soon I started to feel more like I had in the previous couple weeks. I'm sure some of it was psychosomatic but the fact that I started feeling better last night leads me to believe that the patch had finally exhausted it's supply.

So that's how I determined that my current dose of estrogen is perfect. As long as I'm not a dumbass and forget to take the old patch off.

I'm trying to figure out if this is from the GLP1 or something else. I have had a sleep study done, I have had all my bloodwork done. I sleep fine and track my sleep and my sleep architecture is okay. It's for sure not because I'm consuming less calories because I stopped for a while and then just started back up last week and it hasn't really impacted my hunger yet. I am trying to self diagnose using AI and it tells me that my cortisol is out of wack with being low in the morning and then higher at night because I have a bit more energy at night.

My doctor just prescribed me an estradiol patch. I get in my hot tub every night and also swim at the gym. I'm looking for a waterproof covering that might work similar to a tegaderm. Any ideas? Thanks!

Edit in response to all the answers: Thanks for the insight. I will use the patch with a tegaderm for now since I already have the supply, but plan to talk to my doctor at the follow up to switch to a more friendly version that allows for hot wet environments. My family has annual passes to our local hot springs resort and we swim almost daily in addition to doing hot tub, sauna, and steam room. I don't think my doctor realized how much water activities I do during the week.

I’ve been using Oestra since Oct but they only have a compounded cream (vaginal), that only comes combined and only in two different doses-combo of estradial and progesterone.

My estradial went up to 1040 and the first doctor I spoke with at Oestra told me it was “fine” even though I was feeling incredibly agitated and my thyroid Free T3 is right on the cusp of the too low range. I spoke with someone else there and they advised I could cut the dose in half. But I don’t like that I can’t get my estradial and progesterone separate.

However, I’ve looked at many other providers (and I pay out of pocket and get no reimbursement), but can only find ones that have the progesterone in another form (pill, etc). Concerned that those other forms aren’t as good so just wondering if others have had good results with any other forms like pill form, etc. and you also like the company you’re using? I’d also like to find one that addresses the thyroid issue, potentially.

F:37 SW:184 CW:176

Currently been on tirzepatide started titrated up and am at 4mg right now. I had to slowly titrate up because I barely had an appetite even on a low doze, it was a struggle to get myself at 1000+ calories a day. I’ve gotten better about finding foods I can eat and that have enough nutrients. I get 90-120 grams per day and shoot for 25-35 grams of fiber a day (this one is the hardest for me with the lower appetite) and drink enough water and throw some electrolytes in there when I need them. I climb/lift/hike/walk 3-5 days a week and I count my calories to just see what I eat each day. I’m sure I’m counting them accurately, I use a food scale and mostly eat at home. I know I’m not overestimating how much I’m eating. I also eat pretty well. Mostly Mediterranean diet with lots of veggies and fruits (am Sicilian)

I’ve been on tirzepatide since January 2026 and have only lost 5-8lbs (it goes up and back down but at my lowest right now it’s -8 lbs) and have just stalled there for 3 months, even after going up in a dose. If I go up anymore I doubt I’ll be able to eat enough, but I will as soon as I can handle it. Thing is, I also have endometriosis and have suspected I have some hormone imbalances for like 10 years now. (Took forever and an 8cm endometria to find out I had endo)

I JUST started bio identical progesterone. Birth Control (nuva ring worked best) kinda helped with endo pain cause I could skip periods, but made all my other hormonal symptoms a little worse.

I’ve done hormone testing at different phases of my cycle several times and the one common thread was that while my estrogen and progesterone (and other hormones) were in normal range, I had far more estrogen compared to progesterone.

Started cyclical bioidentical progesterone a few days ago. And have been taking a liver support supplement that has milk thistle and artichoke in it, NAC. And I just added in DIM yesterday as well as activated charcoal that I take spaced out from other vitamins/meds and meals.

The progesterone so far has no side effects and I’ve been getting the best sleep of my life. So I’ve had more energy and less brain fog. Also immediately lost the 3 lbs of bloating I’ve been carrying around since my last period.

—
I know it’s early, but for anyone who needed both hrt and glp-1, when did you see results? Need some hope. Seems like I may be turning a corner, but it’s been a LONG road.

I’ve been carrying around this weight and these symptoms that make me not feel like me ever since I went on the mirena 10 years ago and gained 60 lbs in 3 months. (Side note thyroid has been fine every single time I’ve checked it and have no food allergies or sensitivities). TIA for comments, support, or even just making through this long rant. ❤️

I am 51 and started both wegovy and BCP about a year and a half ago. I lost about 40 pounds (200–>160 and 5’4”) from September 24 to September 25 and BCP was not helping perimenopause symptoms so started estrogen and progesterone. After the weight loss I couldn’t handle the bloating from progesterone and stopped. In the past month I’ve had out-of-control bloating and figured I would revisit HRT if I’m going to be bloated anyways. I’m also considering trying the new high dose of wegovy since I’ve been gaining and losing the same 3 pounds for six months. I know I can’t change both at the same time and i’m not sure which to start first. The main reasons for HRT are worsening of sleep (harder to fall asleep now) and possibility that decreased estrogen is making my back and neck issues worse. I’ve been told the progesterone side effects will decrease after a few weeks, but I am nervous about additional weight gain since I’m already on a GLP-1 and have more to lose. Wondering if anyone has any input. Thank you in advance!