Her Hormone Health

When I first started experiencing what I now recognise as possible progesterone intolerance symptoms, I didn’t immediately connect them to my HRT. In fact, for a long time I assumed that feeling tired, bloated, sore and generally not quite myself was simply something I had to live with.

For a long time, I believed I simply hadn’t found the right HRT combination yet.

I’d experienced early menopause from my early 30s and struggled with some incredibly difficult symptoms, particularly anxiety and frequent hot flushes. I’ve previously shared more about my journey with early menopause and starting HRT, including what eventually led me to try hormone replacement therapy. When I eventually started HRT, it helped. Those symptoms became much more manageable and, after everything I’d read and heard about HRT, I hoped I would eventually find the combination that made me feel completely like myself again.

But progesterone was always the difficult part for me. I tried different preparations and ways of taking it, often experiencing side effects that meant we needed to try something else. Eventually, I had a Mirena coil fitted alongside my oestrogen, and for a while this seemed to be the option I tolerated best.

Then, very gradually, things started to change.

I was getting headaches almost every day. I felt exhausted, bloated and foggy-headed. My body often felt puffy, inflamed and strangely tender to touch. My mood was low and, eventually, I started experiencing migraines with aura – something I’d never previously suffered with.

The difficult part was that many of these symptoms could have had numerous causes, including menopause itself. I didn’t immediately look at my HRT and think, “This is the problem.” In fact, for quite a long time I assumed this was simply how I was going to feel.

It was only when the symptoms became increasingly difficult to live with that I started looking more closely at whether the progestogen component of my HRT could be contributing to how I felt.

This is my personal experience, not an argument against HRT. HRT gave me significant relief at a time when I desperately needed it, and many women find a treatment that works extremely well for them. But if you’re taking HRT and still don’t feel well, I think it’s equally important to know that persistent symptoms deserve to be discussed rather than simply accepted.

In this article, I’ll share the progesterone intolerance symptoms that made me start asking questions, what I learned about progestogen intolerance, and the process I went through with my GP before eventually deciding to try life without HRT.

What is progesterone intolerance?

You may see the term “progesterone intolerance” used online, but when we’re talking about HRT, “progestogen intolerance” is often more accurate. Progestogen is the broader term covering both progesterone and synthetic hormones that act in a similar way.

If you have a uterus and use systemic oestrogen as part of HRT, a progestogen is usually needed to protect the lining of the womb from the effects of oestrogen.

Some women, however, experience troublesome side effects from the progestogen component of their HRT. These can include headaches, mood changes, tiredness, dizziness, breast tenderness and bloating. Frustratingly, some of these can also be symptoms associated with menopause itself, which can make working out what’s happening surprisingly difficult.

Importantly, struggling with one type of progestogen doesn’t necessarily mean that every form of HRT will cause the same problems. Different preparations, doses and ways of taking them may be tolerated differently.

That was certainly important in my own experience. I didn’t try one form of HRT, experience some side effects and decide it wasn’t for me. Over several years, I worked through the different progesterone options offered to me, including different ways of taking it, before eventually having a Mirena coil fitted.

For quite some time, Mirena seemed to be the option I tolerated best. It was only much later, when a collection of symptoms gradually became harder to ignore, that I began questioning whether the progestogen component of my HRT might still be contributing.

If you’re experiencing side effects, don’t stop prescribed HRT suddenly based on a list of symptoms online. Speak to your GP or menopause specialist about what you’re experiencing and whether changing the dose, preparation or way you take your HRT could be an option.

I had already tried different forms of HRT

Before I began questioning whether HRT itself could be contributing to how I felt, I’d already spent several years trying to find a combination that suited me.

Oestrogen wasn’t generally the part I struggled with. The difficulty was finding a form of progesterone that I could tolerate. Over time, I tried different options, including tablets, patches and vaginal progesterone, but experienced significant side effects with the different preparations I was offered.

I didn’t want to give up on HRT. It had helped enormously with some of my most difficult menopause symptoms, particularly the anxiety and hot flushes, so each time something didn’t suit me, I hoped the next option would be the one that worked.

Eventually, I had a Mirena coil fitted, which releases the progestogen levonorgestrel directly into the uterus. After the initial settling-in period, this was the option I tolerated best and I remained on it for around two years, alongside oestrogen gel and, later, testosterone. I’ve previously shared my experience of having the Mirena coil fitted, including why I chose it and what the fitting itself was like.

That’s an important part of my story because experiencing side effects with one HRT preparation doesn’t mean another won’t suit you. There are different types, doses and ways of taking HRT that can be discussed with your GP or menopause specialist.

For me, stopping HRT wasn’t my first response to experiencing side effects. It was something I only began considering much later, after trying the alternatives available to me and then developing a gradual pattern of symptoms while using the combination that had previously seemed to work best.

The progesterone intolerance symptoms that made me question my HRT

For me, this wasn’t one dramatic reaction. The symptoms seemed to creep in gradually, which was probably one of the reasons it took me so long to question whether my HRT could be contributing.

The main things I was experiencing were:

• Daily headaches – eventually having a headache became my normal rather than an occasional problem.
• Extreme bloating – sometimes I’d wake up already very bloated, rather than being able to connect it to something I’d eaten. My stomach could change dramatically over a very short period of time.
• Puffiness and tenderness – I often felt generally swollen or inflamed, and my body could be so tender that even being gently touched or squeezed on my arm could hurt.
• Exhaustion – I felt physically drained and struggled to find the energy or motivation for things I normally wanted to do.
• Brain fog – thinking clearly and concentrating became much harder.
• Low mood and tearfulness – by the time I first went to my GP about everything, I felt completely worn down by how I was feeling.

Not every symptom on this list can automatically be attributed to progesterone or HRT. Headaches, tiredness, mood changes and bloating can have many possible causes, and several overlap with menopause symptoms themselves.

That overlap was a huge part of the problem for me. I was already dealing with early menopause, so for a long time I didn’t know whether this was simply another stage of that journey, something completely unrelated, or a reaction to my medication.

Later, I also began experiencing migraines with aura for the first time. I would suddenly see kaleidoscope-like lights and white spots affecting my vision, followed by a painful headache. I can’t say that HRT or the Mirena caused these migraines, but because they were new for me and appeared alongside the increasingly frequent headaches, they became another reason to go back to my GP and reassess what was happening.

When I first asked my GP for help

By around November 2025, I knew I wasn’t feeling right, but I didn’t know why. I was physically exhausted, having headaches every day, feeling puffy and tender all over, and becoming increasingly low and tearful.

Eventually, I went to my GP because I simply didn’t know what else to do. I remember becoming quite upset during the appointment because I felt so worn down by feeling unwell all the time.

At that stage, I hadn’t made any connection between my symptoms and HRT, and it wasn’t something that came up during the consultation. My GP arranged a comprehensive set of blood tests, which was reassuring, but when the results came back largely within range, there wasn’t really an explanation for why I felt so unwell.

I think this is where it can become difficult when you’re experiencing a collection of fairly non-specific symptoms. A normal blood test doesn’t mean the symptoms you’re experiencing aren’t real – it simply means the tests haven’t necessarily identified their cause.

Looking back, I wish I’d kept a clearer record of when my symptoms started, how they had changed and what medications I was taking. I’m not suggesting we should diagnose ourselves before seeing a doctor, but I do think going into an appointment with a symptom timeline, your current medications or HRT preparations, and a few specific questions can make it easier to have a more focused conversation.

At the time, though, I left knowing that my blood tests hadn’t revealed an obvious explanation and simply carried on. It wasn’t until things changed again that I started looking at my HRT more closely.

When I started questioning whether HRT could be contributing

After that first appointment, I carried on for a while because I didn’t really know what else to do. My blood tests hadn’t provided an obvious explanation, but I still didn’t feel well and the daily headaches continued.

Then I started experiencing migraines with aura. Because this was completely new for me, it prompted me to look again at everything that was happening rather than continuing to accept the symptoms as my new normal.

I began researching the possible side effects of the medication I was taking and looking more closely at the Mirena coil. Headaches were one of the symptoms that kept appearing, and that made me think back over my previous experiences with progesterone.

I’d already struggled with several different progesterone preparations before having the Mirena fitted. Suddenly, I had a question I hadn’t seriously considered before: could the progestogen component of my HRT be contributing to at least some of the symptoms I was experiencing?

I started reading more about progestogen intolerance and recognised several of the symptoms being discussed. That didn’t tell me definitively what was causing mine, but it gave me something much more specific to take back to my GP.

I think there’s an important distinction here between researching your symptoms and diagnosing yourself. Information online can help you recognise patterns and formulate questions, but symptoms such as headaches, migraines, fatigue, bloating and changes in mood can have many different causes.

For me, the research wasn’t the answer – it was what helped me have a more informed conversation with my doctor.

Going back to my GP with a clearer picture

When I went back to my GP a few months later, the appointment felt very different. I saw another doctor and this time I was able to explain not only how I was feeling, but the pattern I’d started to notice and why I wondered whether the progestogen in my HRT could be contributing.

I felt much more heard during this appointment. We talked through the headaches, the newer migraines and my history of struggling with different forms of progesterone. My GP understood why I was questioning whether continuing with my current HRT was still the right option for me.

But stopping HRT wasn’t a straightforward decision.

Because I experienced menopause unusually early, in my early 30s, there are additional long-term health considerations for me. Oestrogen has an important role in maintaining bone health, and early menopause is associated with an increased risk of problems such as osteoporosis and cardiovascular disease. My GP wanted me to understand those considerations before deciding to stop HRT.

We also discussed what other options might be available. By this point, I’d already tried the different progesterone preparations offered to me. One possibility raised was hysterectomy, which could potentially allow me to use oestrogen without needing progestogen to protect the lining of the womb, but that was obviously a much bigger decision and not something I wanted to rush into.

I left the appointment without making an immediate decision. I took some time to think about what we’d discussed, weighed the potential longer-term benefits of HRT against how I was feeling day to day, and then went back to my GP.

For me, quality of life had become a significant part of that decision. I wasn’t simply experiencing a minor inconvenience that I could easily work around – I had reached the point where feeling exhausted, sore and having headaches almost every day was affecting how I lived.

Eventually, I decided with my GP that I wanted to have the Mirena removed and try a period without HRT.

It wasn’t a decision I made lightly, and it isn’t one I’d suggest somebody else makes based on my experience. But after years of trying to find a combination that worked for me, I felt I needed to find out how I would feel without it.

What happened after I stopped HRT?

One of the biggest questions I had was whether anything would actually change. After feeling unwell for so long, I didn’t know how much of what I was experiencing was connected to HRT and how much might simply continue.

Some changes happened surprisingly quickly. My daily headaches almost completely stopped. The constant puffiness and tenderness gradually eased, the unexplained bloating reduced considerably, and I began to feel less physically exhausted and clearer-headed.

I’ve experienced a small number of migraines with aura since having the Mirena removed, so I can’t say that HRT was definitely responsible for those. What I can say is that they have been far less frequent than they were during that final period on HRT.

Other changes took much longer. It has been around six months since I stopped HRT, and it’s really only recently that I’ve started to feel properly like myself again. After such a long period of feeling heavy, sore, tired and mentally foggy, that has been quite a significant realisation.

But coming off HRT didn’t simply make every problem disappear. The menopause symptoms that HRT had previously helped control began to return, particularly hot flushes, anxiety and problems with sleep.

I knew that was a possibility before making my decision, and managing those symptoms has become another part of this journey. I’ve been exploring different ways to support myself without HRT, with some things helping me considerably and others being more of a work in progress.

I’ll cover that separately because I think it deserves its own article. This isn’t a story where I stopped HRT and everything instantly became perfect. It’s about recognising that, for me, the balance had changed – and finding a different way forward.

What to do if you think your HRT isn’t suiting you

If you’re reading this because you’re on HRT and still don’t feel well, my biggest takeaway from my own experience is not to assume that feeling rubbish is something you simply have to put up with.

At the same time, experiencing side effects with one type of HRT doesn’t necessarily mean HRT as a whole isn’t suitable for you. Different progestogens, doses and ways of taking them can affect people differently, and changing your HRT may be enough to find an option you tolerate much better.

A few things I wish I’d done earlier are:

• Keep a simple symptom diary – note what you’re experiencing, when it happens and whether anything has changed.
• Write down exactly what HRT you’re taking, including the dose and when each preparation was started or changed.
• Think about the timeline – did your symptoms begin or become worse after starting or changing something?
• Take your notes to your GP or menopause specialist and explain how the symptoms are affecting your everyday life.
• Ask whether your symptoms could be side effects and whether there are other HRT preparations, doses or routes you could consider.
• Don’t assume every symptom is caused by HRT. Persistent or new symptoms may need investigating for other possible causes too.

I also wouldn’t recommend suddenly stopping prescribed HRT because your symptoms sound similar to mine or to a list you’ve found online. This is particularly important if, like me, you’ve experienced early menopause, where HRT may have benefits beyond simply controlling symptoms.

For me, doing my own research helped enormously, but not because it allowed me to diagnose myself. It helped me organise what I was experiencing, recognise a possible pattern and go back to my GP with much clearer questions.

Sometimes that can be the difference between saying, “I just feel awful and I don’t know why,” and being able to have a much more focused conversation about what might need reviewing.

You don’t have to feel amazing on HRT for your experience to matter

One of the hardest parts of this journey was hearing so many stories from women who described HRT as life-changing and wondering why I didn’t feel the same.

HRT did help me. It gave me significant relief from severe anxiety and hot flushes at a time when those symptoms were becoming incredibly difficult to live with. That’s something I don’t want to lose from my story simply because I’ve ultimately chosen a different path.

But I also never had that moment of feeling completely like myself again that I’d hoped for. For a long time, I thought that meant I simply hadn’t found the right combination yet, so I kept trying.

Eventually, my experience became less about whether HRT was “good” or “bad” and more about whether the balance of benefits and side effects was still right for me.

If HRT makes you feel well, that’s wonderful. If you’re struggling with one preparation, there may be other options worth exploring. And if you’ve tried different approaches and still don’t feel right, I think you deserve to have that experience taken seriously too.

Six months after stopping HRT, I’m still learning what managing menopause without it looks like for me. But after a long period when I barely had the energy or mental clarity to write, I’ve recently started feeling much more like myself again – and that’s partly why I’m finally able to share this story.

My experience won’t be the same as every woman’s, and it isn’t intended to tell anyone whether they should or shouldn’t take HRT. I hope instead that it encourages you to pay attention to how you feel, ask questions when something doesn’t seem right and work with a healthcare professional to find the approach that is right for you.

What happened next?

Stopping HRT meant some of my menopause symptoms gradually returned, particularly hot flushes, anxiety and disrupted sleep. I knew this was a possibility, but knowing something might happen and actually living with it are two very different things.

Over the past six months, I’ve been exploring what I can realistically do to manage those symptoms and support my longer-term health without HRT. Some things have made a noticeable difference for me, while others are still very much a work in progress.

I’ll share that next – including what’s helped with my hot flushes and anxiety, the lifestyle changes I’ve been focusing on, and how I’m thinking differently about areas such as bone and cardiovascular health following early menopause.

I’ll add the link here once that article is published.

Sources & Further Reading

• NHS – Side effects of hormone replacement therapy (HRT) – information on possible oestrogen and progestogen side effects and what to do if they persist.
• NHS – Treatment for menopause and perimenopause – current guidance on HRT, including the different ways oestrogen and progestogen can be taken.
• NHS – Benefits and risks of HRT – including the role of HRT in bone health and its particular importance when periods stop before 45.
• NHS – Side effects and risks of the hormonal coil (IUS) – including information about using an IUS as the progestogen component of HRT.