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Author Topic: Progesterone and Night Sweats  (Read 13688 times)

Stellajane

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Progesterone and Night Sweats
« on: March 04, 2016, 01:49:52 PM »

In recent months I've reduced my oestrogen to a very low dose which is proving absolutely fine in most respects. Being post meno, post 60 this is something I felt would be the way to go.

HOWEVER, having just started a course of progesterone (Utrogestan 100mg) I've been having major night sweats.  I'm absolutely boiling over during the night, and I certainly can't blame mild weather this week. I've experienced a bit of this in the past when I was on a higher dose of oestrogen and the higher strength Utrogestan but this seems to be much worse!

I did a bit of hunting around on the net this morning as I do recall reading that progesterone can interfere with oestrogen receptors. What I landed on was a forum where dozens and dozens of women (from 20s onwards, mostly in the USA) were reporting having severe night sweats every month for several days before their period started.

I've never heard of this before - has anyone else?

Unfortunately for them, none of their doctors seemed to be offering much in the way of help though one did say she had been given an oestrogen patch to wear for the week prior to her period starting.

Honestly, is there no end to the variety of problems these darned hormones can throw up? It just goes to show what a delicate balance there must be to get things just so.

For me personally I think its probably demonstrating that I really don't need very much progesterone.  Thoughts anyone??
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coldethyl

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Re: Progesterone and Night Sweats
« Reply #1 on: March 04, 2016, 01:52:53 PM »

I used to get sweats for a few days round my period starting and then for first few days of bleeds. Now I just get the bloomin things all the time though they are worse round ovulation and my period.
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Night_Owl

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Re: Progesterone and Night Sweats
« Reply #2 on: March 05, 2016, 11:17:30 AM »

Hi SJ -

Feel I'm stating the obvious here SJ: You may be experiencing worse night sweats on your reduced dose of estrogen as the progesterone is very efficiently (and annoyingly) cancelling out the small dose of estrogen (down to nearly zero?).  Hopefully the pay off will be hardly any withdrawal bleed - would that compensation be enough to endure the night sweats though?

As to whether you need a lower dose prog, not sure what to think as I'm on similar low dose, 25 patch, plus twice weekly Vagifem, however the Meno Clinic still recommend Utro 100mg x 12, v-route, 6 weekly - they are always erring on the side of caution. 

As we've said on here before, it does seem like a sledgehammer to crack to nut.  Sometimes I think about reducing to Utro 100mg x **10**, 6 weekly (as I still experience ghastly side effects) but then I bottle out and take 12.  Or taking every other night for 12 nights, to reduce the sweats.  Also a longer cycle would be preferable.  I'm going to raise this at my next appointment.  I'm always hoping for ways to cut down on progesterone use - quarterly or six monthly would be just about bearable.  No use at all would be the ideal.

I also prefer to be on lower dose now I'm nearly 54 and 9 years post meno:  More estrogen = having to take more progesterone and that's not where I want to be.  On this regime, no daytime flushes and the night sweats are mild during estrogen only - but pretty evil when on the Utro, sometimes soaking.  As discussed, I still dread taking it though.

When I was ultra-low, ie. HALF of 25 patch (12.5) the night sweats were worse than they are now on the progesterone phase - so the lower dose of estrogen, the worse the nights sweats on prog. 

Having said that, over the years, on high to low dose estrogen (at one time I was 100 patch) I've always had night sweats  - but just much more so during the progesterone phase and on withdrawal.  Maybe be due to the fluctuations rather than the specific dose of estrogen?  Who knows, it can be so confusing trying to work out how one's biochemistry works - especially when it's progressing further into meno.

As an aside, when I was younger I never experienced night sweats before a period - however I did from early 40s when I was peri - and didn't realise it.  I had dreadful night sweats, then a period, then everything would be fine.

Please do let us know how it goes re withdrawal.

J x
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Sunnydays

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Re: Progesterone and Night Sweats
« Reply #3 on: March 05, 2016, 12:04:18 PM »

Yes, I used to have night sweats prior to periods in the good old days before I was peri or post meno. I don't recall that I had them from when I first start d periods but I certainly had them for some years before hormones went berserk. They were not as extensive to the night sweats I got in the meno.
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Dancinggirl

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Re: Progesterone and Night Sweats
« Reply #4 on: March 05, 2016, 12:13:55 PM »

Stellajane - I experienced this on the Utro - especially when I was using 200mg. I remember you saying that you had tried using 100mg and still got a good bleed so maybe now you are using such a low dose of oestrogen you really could get away with 100mg for 12 days each month???
As you know, I did try 100mg on a conti basis with one pump of gel per day and I slept pretty well on this - when I increased to 200mg the sweating at might was quite bad.  I would wake drenched in sweat - it wasn't like the sweats I get when not on HRT as these tend to effect my head and legs more.   These sweats were like those one gets with a nasty virus!!! When I looked at Utro leaflet, it does give raised temperature as one of the side effects!!!! It is also known that around the time of our period/withdrawal bleed the body temperature will be raised - this fact was used in an advert for night-time sanitary towels some years ago.
I do wonder if the very low dose of oestrogen is not helping either???
I must also say that both my husband and I find we get very hot in bed at around 4am (but not for amorous reasons!) and I wonder if it also to do with sleep patterns generally - as we get older so many hormones are out of balance - I know I am not producing the hormones that stop the need to pee in the night so I get up at least twice a night - I'm sure other hormones go out of sync that effect our quality of sleep as well???. 

I do think there is so much to be discovered around the effects of all hormones - with us all living longer I do feel that maintaining good health will be about keeping all hormones in balance - not just oestrogen and progesterone. Dg xxx
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Dancinggirl

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Re: Progesterone and Night Sweats
« Reply #5 on: March 07, 2016, 10:15:42 AM »

Stellajane - I think you may be right about upping oestrogen through the progesterone phase - it would be really interesting to run this by a specialist gynae or endocrinologist who could support this as a good strategy.
Way back, when I was on BCPs, I was on a type that had 3 different phases giving different amounts of hormones through the month and it really suited me, so I think this supports your idea.
I know you were trying to reduce the amount of oestrogen you used generally in the hope you got a lighter withdrawal bleed? Maybe experiment with this a bit more - perhaps do slightly under one pump per day during the oestrogen phase and then just 1.5pumps per day during the Utro phase? I can't remember whether you are doing a longer cycle???? If you are reducing the amount of oestrogen generally then perhaps you could just use 100mg for 10-12 days each month which might result in a lighter bleed that would be less problematic? DG x
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Night_Owl

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Re: Progesterone and Night Sweats
« Reply #6 on: March 08, 2016, 03:17:31 PM »

Yes SJ the estrogen: progesterone ratio does seem to be so relevant.

Upping to 1.5 or 2 pumps only when you're on the Utro would seem to be a good experiment - you may still then have a lighter withdrawal bleed.  Especially so if you stay with the long cycle.

Wonder if one day they may manufacture Utro in 25 and 50 - or graduated tiered dose packs of 7, 10 and 12 capsules - when it's discovered that maybe not as much is needed for endometrial protection for those on low/ultra low estrogen.

Sometimes I think about sticking a pin in a Utro capsule to squeeze some out and reduce it down for use during the first
couple of nights - but then I get I think better of it!
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Dancinggirl

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Re: Progesterone and Night Sweats
« Reply #7 on: March 08, 2016, 11:11:53 PM »

In the USA, Prometrium, which is the American name for Utrogestan, comes as 50mg dose!!!
I simply don't know why we seem to be behind other countries when it comes to menopause treatment???
DG x
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andius

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Re: Progesterone and Night Sweats
« Reply #8 on: March 13, 2016, 05:26:16 PM »

Dancing Girl:

I am not aware that oral Prometrium comes in 50 mg dose in US.  I would like to know where to get some!!!!

Actually, compounding pharmacies in US can make generic progesterone in any dosage, but the bioavailability and the pharmacokinetics of the dosage formulation, i.e. vaginal gel, sublingual, capsules, troches will vary and there is no way to know for sure what you are getting as there are no trials on many people that can be used to infer the correct dosage needed for a given dose of estrogen. This necessitates getting multiple blood levels or scans.

Since last summer ( 9 mo) I have been using 50mg patch 2x/wk and 100mg prometrium daily all mo.  I still think it is too much prog for me.  I have tried a couple of 3 to 4 days off the prometrium for a break, and every time it takes about a week to get back to an even keel. I reduce my dose to 25mg patch for those 3-4 days with no prometrium and feel great during that time. Maybe I should take nothing estrogen wise at that time.?? I feel I could go to 25mg patch with lower prometrium dose or at least would like to try.

At nearly 60 and no periods for 6 years on or off continuous hrt (several 6 mo periods off), I feel I am clearly menopausal. I don't get the weight gain that I do with combo hrt, nor the depressed feelings with my current regimen. However, I do still have the burning nether regions although they are better than with no hrt.  If I use vagifem with this regimen to help the atrophy, it seems to get worse, so I either use it sparingly or not at all. Mostly that has always and still is the problem for me with menopause. Hot feelings/flashes always were minimal except at night though during the without hrt times.

Was following your comments re taking a break from HRT earlier in 2016.  What are you experiencing now and have you gone back on the local or systemic hrt or both and what dosages are you using?

This whole meno thing has been a drag for me for sure for the last decade. FYI>>>>never had any spotting, withdrawal bleed, etc. on or off any regimen of any type of continuous hrt since the day of my last menses in 2010.

Andius
« Last Edit: March 13, 2016, 05:30:29 PM by andius »
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dahliagirl

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Re: Progesterone and Night Sweats
« Reply #9 on: March 13, 2016, 05:38:08 PM »

I was on the pill for years and years.  It is high in progestogen.

I had night sweats from my mid-thirties (not sure when they started).  I went through loads of duvets trying to find the right one and never did.  It got significantly worse in the last 4 years, when I was getting other low oestrogen symptoms.  :-\

Then when I came off the pill at 49, it stopped completely.   I would have stopped taking it years ago if I had known.   ::)

Progesterone raises body temperature during a normal cycle (this is what you measure when you take your temperature to see if you are ovulating). I think it probably raises your basal temperature to the point where thermostat problems have an effect.  I did not have the problem on progestogen only pills, which is much less progestogen (but did have other problems with them).
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Keepgoing

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Re: Progesterone and Night Sweats
« Reply #10 on: March 13, 2016, 09:00:11 PM »

I'm going to try the extra pump of estrogel at night on utrogestan tabs as I'm boiling at night and having night sweats as bad as before the estrogel xx
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Dancinggirl

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Re: Progesterone and Night Sweats
« Reply #11 on: March 13, 2016, 10:23:10 PM »

andius - I found out about the 50mg Prometrium dose when my server decided to route my broadband via the USA so when I logged on to MM I was getting the USA version which showed the HRT types available in America. If you are based in the USA then your doctor should known this and in fact it should show up under TREATMENTS on the MM site - unless this has changed!!???
If you feel you would manage better on a lower dose of both hormones then you should discuss this with your doctor.
Regarding the burning: my VA and burning did get a lot better when I was on systemic HRT and when I stopped using the systemic I went back to using Vagifem every 3 days and so far the 'lady bits' have been OK.  I do use Multi Gyn Actigel every day though, as I find this keeps things healthy and more moisturised.  I also like to use a drop of Sylk just to sooth things. 
Since coming off systemic HRT my flushes have returned, though they aren't too bad during the day -  The worst thing is the headaches - I'm getting headaches lasting 2-3 days almost twice a week which is truly horrid.
I am thinking I will try the gel plus Utro again but go back to the sequential version - I had initially tried doing the long cycle and this had resulted in all the spotting/bleeding problems so I probably need to do the monthly cycle but use only one pump of gel per day (so very low dose) and 10-12 days of Utrogestan.
Stellajane has done a thread about feeling hot when on Utro so, as always, I think it is about getting the balance right.  DG x
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andius

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Re: Progesterone and Night Sweats
« Reply #12 on: March 14, 2016, 01:17:02 AM »



Well....I copied and pasted this from what I see for treatments on this site-MM.  The words show up but not the columns...so it is slightly rearranged but all text is the same as what I see.

As you can see...prometrium comes in 100, 200, and 300 mg capsules. Maybe you thought 50, 100 and 200???? I think the 300 is for fertility treatments.

Gosh...I really wish it was available in 50mg!!!!  I have never seen that anywhere.



Brand
Active Ingredients
Description
Strengths
Frequency of Dosing
 
ESTROGEN (ORAL)
CENESTIN   Synthetic conj. estrogens, A   Tablets   0.3mg, 0.45mg, 0.625mg, 0.9mg, 1.25mg   Once daily
ENJUVIA   Synthetic conj. estrogens, B   Tablets   0.3mg, 0.45mg, 0.625mg, 0.9mg, 1.25mg   Once daily
ESTRACE   Estradiol (micronized)   Tablets   0.5mg, 1mg, 2mg   Once daily
FEMTRACE   Estradiol   Tablets   0.9mg, 1.8mg   Once daily
MENEST   Esterified estrogens   Tablets   0.3mg, 0.625mg, 1.25mg, 2.5mg   Once daily
OGEN   Estropipate1   Tablets   0.625mg, 1.25mg, 2.5mg   Once daily
ORTHO-EST   Estropipate1   Tablets   0.625mg, 1.25mg   Once daily
PREMARIN   Conj. estrogens   Tablets   0.3mg, 0.45mg, 0.625mg, 0.9mg, 1.25mg, 2.5mg   Once daily
ESTROGEN (TRANSDERMAL)
ALORA   Estradiol   Patch (matrix)   0.025, 0.05, 0.075, 0.1mg/day   Twice weekly
CLIMARA   Estradiol   Patch (matrix)   0.025, 0.0375, 0.05, 0.06, 0.075, 0.1mg/day   Once weekly
DIVIGEL   Estradiol   Gel (topical)   0.25, 0.5, 1mg/packet   Once daily
ELESTRIN   Estradiol   Gel (topical)   0.87g/pump   Once daily
ESTRADERM   Estradiol   Patch (reservoir)   0.05, 0.1mg/day   Twice weekly
ESTRASORB   Estradiol   Emulsion (topical)   1.74g/pouch   2 pouches once daily
ESTROGEL   Estradiol   Gel (topical)   1.25g/pump   1 pump once daily
EVAMIST   Estradiol   Spray (topical)   1.53mg/spray   Initially 1 spray daily; may increase to 2–3 sprays if needed
MENOSTAR   Estradiol   Patch (matrix)   0.014mg/day   Once weekly
VIVELLE   Estradiol   Patch (matrix)   0.05, 0.1mg/day   Twice weekly
VIVELLE-DOT   Estradiol   Patch (matrix)   0.025, 0.0375, 0.05, 0.075, 0.1mg/day   Twice weekly
ESTROGEN (VAGINAL)
ESTRING   Estradiol   Ring   7.5micrograms/24hours   Once every 90 days
FEMRING   Estradiol   Ring   0.05mg/day, 0.1mg/day   Once every 3 months
PREMARIN   Conj. estrogens   Cream   0.625mg/g   As instructed
VAGIFEM   Estradiol   Vaginal tablets   10micrograms   Once daily for 2 weeks, then twice weekly
PROGESTOGEN (ORAL)
AYGESTIN   Norethindrone acetate   Tablets   5mg   Once daily
PROMETRIUM   Progesterone (micronized)   Capsules   100mg, 200mg, 300mg   Once daily
PROVERA   MPA   Tablets   2.5mg, 5mg, 10mg   Once daily
ESTROGEN + PROGESTOGEN (ORAL) SEQUENTIAL FOR PERIMENOPAUSE
PREFEST   Estradiol (3 tabs); then estradiol + norgestimate (3 tabs)   Tablets   1mg; then 1mg + 0.09mg   Once daily, sequentially
PREMPHASE   Conj. estrogens (14 tabs); then conj. estrogens + MPA (14 tabs)   Tablets   0.625mg; then 0.625mg + 5mg   Once daily, sequentially
ESTROGEN + PROGESTOGEN (ORAL) CONTINUOUS COMBINED FOR POSTMENOPAUSE
ACTIVELLA   Estradiol + norethindrone acetate   Tablets   0.5mg + 0.1mg; 1mg + 0.5mg   Once daily
ANGELIQ   Estradiol + drospirenone   Tablets   0.5mg + 0.25mg; 1mg + 0.5mg   Once daily
FEMHRT   Norethindrone acetate + ethinyl estradiol   Tablets   0.5mg + 2.5micrograms
1mg + 5micrograms   Once daily, continuously Note: Progestin listed first
PREMPRO   Conj. estrogens + MPA (28 tabs)   Tablets   0.3mg + 1.5mg, 0.45mg + 1.5mg,
0.625mg + 2.5mg, 0.625mg + 5mg   Once daily, continuously
ESTROGEN + PROGESTOGEN (TRANSDERMAL)
CLIMARA PRO   Estradiol + levonorgestrel   Patch (matrix)   0.045mg + 0.015mg/day   Once weekly
COMBIPATCH   Estradiol + norethindrone acetate   Patch (matrix)   0.05mg + 0.14mg/day
0.05mg + 0.25mg/day   Twice weekly
NOTES
This is not an inclusive list. Indications vary among products. For more information see the product listings in this section or contact the manufacturer.

For combination products, the estrogen component is listed first. Strengths listed are not necessarily the same as the dosage. Frequency of dosing is that used for HRT; other uses may have other frequencies. Some products are given cyclically.

1Formerly piperazine estrone sulfate. Tablet strengths given as mg sodium estrone sulfate. Matrix patch: Estradiol is embedded in the adhesive layer that is applied directly to the skin.

Reservoir patch: Estradiol is contained in a drug reservoir and its release is controlled by a copolymer membrane; contains more layers than matrix patch. MPA = medroxyprogesterone acetate.
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andius

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Re: Progesterone and Night Sweats
« Reply #13 on: March 14, 2016, 01:20:33 AM »


DG:

I am so glad the vagifem works for you!!! :)  I think the fillers it what causes the problems for me. I don't have a problem inside, just on the inside/outside border and urethral area is symptomatic when using systemic and adding vagifem makes the burning worse, especially when using the toilet.
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Hurdity

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Re: Progesterone and Night Sweats
« Reply #14 on: March 14, 2016, 08:58:31 AM »

Hi - I've come late to the thread owing to flu! yes I have noticed this effect - but not really on utrogestan, but when I take my now annual dose of norethisterone (as recommended by gynae GP) to strip any lining built up over the year. I take 5 mg per day for 12 days and half-way through the sweats start to build up again. The weird thing is progestogens can also help reduce hot flushes when given as a drug ie in pharmaceutical (not physiological) doses - as pointed out by Elisabeth Vliet and in the prescribable alternatives to HRT http://www.menopausematters.co.uk/prescribed.php - which just shows how little is known about how it all works! I can't think why anyone would choose to take high dose progestogens as a drug though, and it doesn't help replace oestrogen either!

Hurdity x
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