Question: I had Cushing's a number of years ago and completely recovered. Due to menopause, I started hormone replacement therapy (HRT) and I feel like some of my Cushing's symptoms have returned. Can side effects from HRT mimic Cushing's symptoms?

Answer: In menopausal patients, HRT, when given for a short-time typically leads to significant improvement of menopausal symptoms such as hot flashes, poor sleep, vaginal dryness and many other symptoms related to estrogen deficiency. At commonly given low doses they do not cause weight gain or flushing ( HRT usually make this symptom better). If a patient is getting symptoms of Cushing's back, it is important to re-visit the dose of estrogen given (typically a low dose estrogen patch is used along with an oral progesterone agent if the woman has a uterus). Most importantly, it is absolutely critical to determine whether the return of Cushing's symptoms may be due to recurrent Cushing's.