Last updated: 11 November 2026
There is no known direct interaction between CBD and HRT, but no study has tested them together. Both are broken down by liver enzymes, so an effect is possible in theory, more with oestrogen tablets than with patches, gel or spray. Ask your pharmacist or GP before adding CBD, and never stop or change your HRT yourself.
Below: how CBD and HRT are processed, what is known for each type of HRT (tablets, patches, gel, spray, vaginal oestrogen, the Mirena coil and Utrogestan), whether CBD is a menopause treatment, what to ask your pharmacist and when to get help. This is general information, not medical advice.
Can you take CBD and HRT together?
Many women do take CBD alongside HRT, but there is no research on the combination. We found no study, case report or product warning describing an interaction between CBD and oestradiol, progesterone or the progestogens used in HRT. That is an absence of evidence, not proof of safety, so the decision belongs with your prescriber or pharmacist.
The Food Standards Agency (FSA) advises that, as a precaution, CBD is not recommended for people taking any medication unless under medical direction. HRT counts as a medication, so the honest answer is: speak to your pharmacist or GP first, tell them the CBD product and amount, and follow their advice.
It may help to know that the NHS page on oestrogen names epilepsy medicines such as phenytoin and carbamazepine, the antibiotic rifampicin, some HIV medicines and St John’s wort as things that may not mix well with HRT. CBD is not mentioned there. Our guide to St John’s wort explains why that herb is one to watch.
How CBD and HRT are broken down
Most interactions happen in the liver, where enzymes called cytochrome P450 (CYP) enzymes break medicines down. If one substance slows or speeds up an enzyme that another relies on, levels of the second can rise or fall.
- Oestrogen (oestradiol) is broken down mainly by CYP3A4 and CYP1A2. Progesterone is broken down mainly by CYP3A4.
- CBD is broken down mainly by CYP2C19 and CYP3A4. The UK product information for Epidyolex, the licensed prescription CBD medicine, says CBD slows CYP2C19 and weakly slows CYP1A2. In a study in people, high-dose CBD did not slow or speed up CYP3A4.
- The overlap is small: CYP1A2 is a minor route for oestrogen, and the CYP1A2 effect was seen at prescription doses far above 10mg a day. That is why an effect on HRT is possible in theory but has never been shown.
The route your HRT takes matters too. Tablets are absorbed from the gut and pass through the liver before reaching the rest of the body. Patches, gel and spray go through the skin and largely skip that first pass, so HRT product information says they may be less affected by medicines that speed up liver enzymes. Our guide can CBD interact with medication? explains the enzymes in more detail, including why the “grapefruit warning” is only a prompt.
CBD with each type of HRT
“No known interaction” below means none is reported in the sources we checked, not that the combination has been tested.
| HRT type | How it works | What is known with CBD |
|---|---|---|
| Oestrogen or combined tablets | Swallowed; passes through the liver first | No known interaction. The most likely type to be affected in theory, because of the liver route |
| Patches, gel and spray | Through the skin into the blood | No known interaction. Less exposed to liver enzyme changes than tablets |
| Vaginal oestrogen (tablets, cream, ring) | Works locally; very little reaches the blood | No known interaction, and little reason to expect one |
| Mirena coil (levonorgestrel) | Releases progestogen mainly inside the womb | No known interaction. Blood levels of the hormone are low |
| Utrogestan (progesterone capsules) | Swallowed at bedtime; broken down by CYP3A4 | No known interaction. Both can cause drowsiness, so the effects may add up |
| Tibolone or testosterone | Tablet (tibolone) or skin gel (testosterone) | No studies with CBD. Ask your prescriber |
iIf you take other medicines as well as HRT, such as antidepressants, blood pressure tablets or a blood thinner, those are often the bigger question with CBD. Check each one with your pharmacist, and see CBD for older adults if you’re in your 50s or older.
Utrogestan and CBD: the drowsiness question
Utrogestan is taken at bedtime, and drowsiness and dizziness are listed among its possible effects. CBD can also make some people sleepy: in the Epidyolex trials, at doses many times higher than a food supplement, sleepiness was one of the most common side effects, and the product information warns that alcohol and other sedating medicines can add to it.
At 10mg a day the effect is likely to be much smaller, but it is worth being careful at first. Try CBD on a night when you don’t need to drive early the next day, go easy on alcohol (see CBD and alcohol), and tell your pharmacist if you feel groggy in the morning. Our guide to CBD side effects covers the others.
Is CBD a menopause treatment?
No. CBD is not a treatment for menopause or any of its symptoms, and food supplement CBD cannot claim to be. NICE’s menopause guideline (NG23, updated in November 2024) recommends HRT as the main treatment for hot flushes and night sweats, with cognitive behavioural therapy (CBT) as an option for some symptoms. No clinical trial has shown CBD helps menopause symptoms; our guide to CBD oil and menopause goes through the surveys and the trials still under way.
The NHS also points out that herbal remedies and supplements aren’t tested in the same way as medicines and may interact with them. If symptoms are hard to live with, the best next step is a GP or menopause clinic appointment, not a supplement. These guides may help you prepare:
What to ask your GP or pharmacist
A community pharmacist can usually answer this without an appointment. Take these with you:
- The name and type of your HRT (tablet, patch, gel, spray, coil, Utrogestan) and the dose.
- The CBD product, or a photo of its label, and how much CBD a day you plan to take.
- Every other medicine and supplement you take, including anything bought over the counter.
Then ask: “Is there any reason I shouldn’t take CBD with my HRT or my other medicines, and is there anything I should watch for?” Please don’t stop, skip or change your HRT to make room for CBD. Any change to HRT should be agreed with your prescriber.
When to get medical help
- Call 999 if you have chest pain, sudden breathlessness or cough up blood, as these can be signs of a blood clot in the lungs.
- Call 111 or ask for an urgent GP appointment if one leg becomes painful, swollen and warm (a possible blood clot), or if your skin or the whites of your eyes turn yellow.
- See your GP if you have unexpected or heavier bleeding on HRT, or if new side effects start after adding anything to your routine.
Next step
If your GP or pharmacist has said CBD is fine with your HRT, Sleep CBD Oil is Evopure’s evening oil for a wind-down routine: broad spectrum CBD (0% THC) with 70mg passionflower extract per half pipette in coconut MCT oil. 10mg of CBD is about 0.2ml of the 500mg oil. It is on the FSA public list (validated application RP438), vegan and made in the UK from US-grown hemp.
Add Sleep CBD Oil 500mg to bag or choose another strength
Prefer a fixed amount? Broad Spectrum CBD Capsules give one 10mg capsule with nothing to measure (the 25mg capsule is above the FSA’s 10mg advice). Add CBD Capsules 10mg to bag
For adults only. If you take HRT or any regular medicines, check with your GP or pharmacist first. We don’t recommend our products during pregnancy or breastfeeding. Subscribe and save 25% on your first order, then 20%. New to Evopure? Join our emails for 20% off a one-off first order. Free UK delivery over £40.
The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
Our Magnesium Glycinate Sleep Complex is a berry drink powder with 290mg of magnesium per serving; magnesium contributes to a reduction of tiredness and fatigue. It also contains herbal extracts, so check it with your pharmacist too. For timing, see when to take CBD oil, and for a fixed-dose option, our guide to the best CBD capsules UK.
Sources 9
- emc. Epidyolex 100 mg/ml oral solution: summary of product characteristics (sections 4.4, 4.5, 4.8 and 5.2; revised 8 June 2026).
- NHS. Oestrogen tablets, patches, gel and spray, including using oestrogen with other medicines.
- NHS. Taking Utrogestan with other medicines and herbal supplements and how and when to take Utrogestan.
- NHS. Types of hormone replacement therapy (HRT) and side effects of HRT.
- NHS. Deep vein thrombosis (DVT).
- NICE. Menopause: identification and management (NG23), updated November 2024.
- Food Standards Agency (gov.uk). Cannabidiol (CBD): consumer advice, including vulnerable groups.
- Food Standards Agency (gov.uk). Cannabidiol (CBD) guidance.
- Watkins PB et al. Cannabidiol and abnormal liver chemistries in healthy adults: results of a phase I clinical trial. Clin Pharmacol Ther, 2021.
This guide is general information, not medical advice. Evopure makes Sleep CBD Oil, Flow CBD Oil, Broad Spectrum CBD Capsules and the CBD Balm, Muscle and Joint Support.
