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7-Day HRT Response LogFree printable tracker — one symptom, seven days, ready for your next appointment

HI
The HRT Index Editorial TeamIndependent women's health research
Published: Last reviewed:
Editorial research — not medically reviewed by a clinician. Why this label

Bring numbers to your prescriber, not impressions. This one-page log tracks your primary symptom, side effects, missed doses, and any bleeding — daily for seven days — so you can show a real trend instead of trying to remember whether you felt "a bit better."

Your log details

Name
Start date of this log
HRT product & dose
Route (patch / gel / pill / vaginal / other)
Date started or last changed
Primary symptom to track
Goal (e.g. fewer hot flashes per day)
Prescriber / appointment date

Daily log

Score your primary symptom each day (0 = none, 10 = worst imaginable). Add a side-effect note if something is bothering you. Mark any missed or late dose. Circle Y or leave blank for bleeding. Questions go at the bottom.

7-day HRT response log — daily symptom scores, side effects, and missed doses
MeasureDay 1Day 2Day 3Day 4Day 5Day 6Day 7
Primary symptom
(0–10)		       
Secondary symptom
(0–10, optional)		       
Night-sweat
wake-ups (count)		       
Nights of
unbroken sleep		       
Side effects
(brief note)		 
 
 		 
 
 		 
 
 		 
 
 		 
 
 		 
 
 		 
 
 
Missed or late dose?
(Y / N)		       
Any bleeding?
(Y / N / type)		       
Overall day
(0–10)		       

Questions for your prescriber

Write questions here as they come up so you don't forget them at your appointment.

1.
2.
3.
4.
5.

Never wait for a log if you have a red-flag symptom

Sudden chest pain, trouble breathing, one-sided leg swelling, face droop, slurred speech, very heavy bleeding with dizziness or faintness, or thoughts of self-harm — get urgent or emergency care now. In the U.S., call or text 988 for a mental health crisis, anytime.

This log is an educational tool only. It is not a medical record and does not replace advice from a clinician who knows your history. See our medical review policy.

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