I started HRT about a week ago and still

Two things matter most tonight: stop changing the dose yourself, and book a review with the doctor who prescribed it — this week, not in a month.

Low mood and feeling unsettled are listed side effects of both the oestrogen and the progestogen part of HRT, and they usually settle over the first few weeks — but they are also the reason to go back and be reviewed, not to keep experimenting. I am not diagnosing anything, and I will not tell you to change a dose: that is your prescriber's call.

First, the honest answer to your question. On the NHS patient page for HRT (checked 9 October 2026): "mood changes, including low mood or depression" appear under both oestrogen and progestogen side effects, and "they will often go away after a few weeks." The same page says side effects usually improve over time and it's worth carrying on at least 3 months if you can, but to "speak to a GP if: you have severe side effects or they continue for longer than 3 months." What I don't have: a reliable figure for *how many weeks mood specifically* should take to lift on HRT — that varies by person and by product, and it is not something I can give you confidently, so treat any number you read elsewhere as a story, not a deadline. So: one week in is early, and two weeks of feeling low is exactly the point to raise it with the prescriber — not to push on quietly.

1) What you have already tried, and the better alternative

Changing the dose yourself. This is the one thing to stop today. It is a legitimate move to make, but only with the prescriber — the NHS page itself notes a GP may suggest changing dose, type, or how it's taken (for example tablets to patches), which is exactly the conversation to have instead of a home trial. From tonight: take it only as it is written on your own box or prescription, write down every date you changed something, and bring that list to the review. Do not decide a new dose tonight. Stopping is also not yours to do alone.

The mood tracker. Keep it — it is the most useful thing you will bring. But add two columns: *what the dose was that day* and *any dose change date*. That turns a mood diary into evidence about timing, which is what the prescriber actually needs.

Better alternatives, all kitchen/home levers:

• One fixed anchor a day — same wake time, a meal at roughly the same hours, and the HRT at the same time with something you already drink. With a school week this is the only kind of consistency that survives, and irregular hours make mood look worse than it is.
• Food already at home that helps steadiness: regular protein and slow carbs at breakfast (eggs, oats, milk/yoghurt, beans on toast), and a proper lunch before the school run rather than nothing until 4pm. Steady blood sugar is a mood lever; it is not a treatment for depression.
• Alcohol down, not up. Low mood and HRT plus a nightcap is a bad combination, and alcohol worsens both sleep and low mood. Pick the two evenings this week you skip.
• Ten minutes of daylight and a short walk after the school drop-off if it can be arranged — one fixed slot on the calendar, ideally with the sibling or a neighbour, not a solo act of discipline.
• Say it out loud once a day. Ten minutes with the person nearby who doesn't need solving: "I'm flat this week and it's not the kids." Low mood that stays private stays unreviewed.
• Write one question now, so Friday doesn't evaporate: "Is what I'm feeling a known HRT side effect, does it need a different type or route, and is there a time limit before we change something?"

The one thing I need from you: have you had any thoughts of harming yourself, or that life isn't worth living? That single answer changes everything below.

2) Constraints and the avoid list

• No more dose changes in either direction — not up, not down, not skipping to test what happens, not "just for tonight." Take it as prescribed and let the prescriber read the timeline.
• No new supplement, herbal product, "balance" remedy or powder to fix the mood. Anything bought without a prescription goes in the same bag as the HRT box for the visit — interactions with a prescription medicine cannot be sorted out at home.
• No prescription HRT from an online seller, and nothing borrowed from a neighbour or a friend, to compare or to top up.
• Don't use the mood tracker as a severity score. A low entry is not a test result. Severity is a conversation with a person.
• Don't add anything for sleep, "calming," or energy on top of it. It makes the next review unreadable.
• Don't wait for the 3-month mark to report severe or worsening symptoms. The 3 months on the NHS page is about mild side effects settling, not about how long severe ones are tolerated.
• Don't dose anyone else — not the child, not the elder, not the sibling. Their medicines are their own business.

3) Red flags — when to stop DIY and get help now

Call your local emergency number now, or go to the emergency department (and don't drive yourself if it's chest pain):

• any thought of ending your life, a plan, or you have already done something to hurt yourself — stay with someone, don't stay alone, and put distance between yourself and anything you could use to harm yourself. This overrides everything else on this page.
• chest pain or pressure, or chest pain with breathlessness
• one-sided weakness, numbness, or speech going wrong
• a sudden, worst-ever headache that peaks within seconds
• a swollen, painful calf, or chest pain with sudden breathlessness — NHS notes HRT carries a small increase in the risk of blood clots
• heavy or unexpected vaginal bleeding, or bleeding that soaks through
• you cannot be woken, you are newly confused, or you have a fit
• you stop eating and drinking

Book the review this week (not an emergency) — and go sooner, the same day, if function has dropped: you cannot get through the school run, you cannot work, you are not sleeping, or the low mood is most of the day, most days. Two weeks of low mood that isn't lifting is the point at which it stops being "settling in."

Decision tree, screenshot-friendly:

```
Am I having any thought of harming myself, or a plan?
├─ YES → call local emergency number now. Stay with someone. Go now.
└─ NO
├─ Chest pain · one-sided weakness · speech change · worst-ever headache
│ · swollen painful calf · sudden breathlessness · heavy bleeding
│ · cannot be woken · new confusion → Emergency department now.
├─ Low mood most of the day, most days, or function has dropped
│ → Same-day or this-week appointment with the prescriber. Say: "week two on HRT,
│ low and unsettled, and I changed the dose myself."
├─ Mild and settling, no red flags
│ → Back to the prescribed dose only, keep the tracker, book the review
│ for the 3-month point — and report sooner if it worsens.
└─ Still not improving past 3 months
→ Back to the prescriber for a dose/type/route review.
```

What success looks like in 24 hours

Not "feeling better" — that isn't on offer and I'd be overpromising. Success tonight is: the dose is unchanged and was taken as prescribed; the next dose is too; the dose-change dates are written down; the appointment is in the diary; and one person knows you are flat. If the mood is still low tomorrow, that is expected in week two and it is not a reason to adjust anything — it *is* a reason to keep the appointment.

Bring to the visit: every box and packet including supplements, the dose-change dates, the mood tracker with the dose column, whether you've had thoughts of dying, what you want asked, and who is at home. I am not a clinician and this is not a diagnosis, not a treatment plan, and not a dose: I can't calculate or adjust a dose, and I can't stand in for your prescriber — but I can tell you that one week in is early, that low mood is a known effect on both halves of HRT, and that stopping the self-adjusting today is the part that actually improves your next appointment.