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[Annie McCarthy]

Hello everyone, I'm new here. Great to find a place to share and discuss menopause issues!

I'm 49 and for the last year or so my periods have been getting lighter and closer together (23-25 days rather than the 'usual' 27-28). I haven't missed a period yet and I don't get any hot flashes or night sweats, but I seem to have developed dreadful insomnia in the 5-7 days leading up to the start of my period.

I go off to sleep well enough but find myself waking up 3-4 hours later and then can't get back to sleep. I can cope with this for a couple of nights, but when it's into night 4, 5, 6 etc I feel like I'm going insane the next day.

I'm normal weight, keep off the alcohol and caffeine, keep the bedroom cool, am quite fit and practice mindfulness meditation, which helps somewhat (so have tried all the self-help stuff in other words!).

I have a high pressure job and am finding it really difficult to cope on the day after a sleepless night. I've actually had to take a few sick days and people are starting to notice/comment on the drop in my performance at work.

This does seem to be an episodic thing, as when my period starts I go back to sleeping normally and feeling I can cope. It's just the turning into a mad werewolf for 7 days in every 25 that's getting me down!

Would HRT help do you think? Or perhaps sleeping tablets just for the nights when I'm in trouble?

I'm going to see my GP to discuss this but would really appreciate any advice/experiences you may have had.

Thanks!
Annie

[clare663]

Hi Annie66 and welcome!! Yes I had difficulties with my sleep during the peri and it wasnt brought on by hot flushes, just periods of insomnia. You may find that this will pass as you hormones flutuate. Im post meno for 5 years now and have times when I cant sleep. Goes on for 4-5 nights and then I sleep so deeply that I struggle to wake up!! If it is interferring with your life and affecting work etc, then maybe a short course of sleeping pills will help. At my doctors they do not likde to prescribe any more than 5 days as they say this is enough to get you out of the habit of waking. Good luck x

[Annie McCarthy]

Hi Clare663,

Thank you! Interesting to hear that you also had sleep difficulties as a separate symptom (not connected to flushes). I hadn't realised that but scanning through the forum, I now see I've got to learn about this process
Ideally, I'd just take 3-4 days of work as and when this happens, but alas I don't think there's any likelihood of my employer agreeing to that arrangement!
Guess I'll see what the doc has to say ...
A x

[Hurdity]

Hi Annie66

 

Sounds like you are at the classic stage just before peri-menopause - known as the late reproductive stage - when ovaries are still working, your periods are still regular but they are getting closer together. This is when hormonal changes begin to occur - although the peri-menopausal transition has not yet begun ( ie when cycles become erratic and irregular). If you are not having flushes or sweats then I'm not sure that HRT would help at this point - although others may come along to say that it might - as I only started HRT in late peri-menopause (early 50's) and have been on it ever since - and for me it worked like a dream.

I only suffered from insomnia due to night sweats and the period of overheating that preceded the development of these by some months (when I thought they were sweats!) but my periods had already stopped and started quite a bit by then.

You are just within the time (age) for being prescribed the Pill which will help to regulate the cycle but I've no idea what it does for sleep! There is one called Qlaira which contains estradiol - the same as our own oestrogen. It is mentioned here: http://www.menopausematters.co.uk/contra2.php (scroll down).

Which 7 days of the cycle are you affected?

Hurdity x

[Annie McCarthy]

Hi Hurdity,

Thanks for the link!

I'm affected in the 5-7 days leading up to the start of my period and the disturbed sleep stops the day bleeding starts. The rest of the time sleeping is fine and not related to feeling too hot. It appears to be an independent symptom for me.

Interesting, too, to note that my pattern seems to suggest I'm not quite at peri yet. I'd assumed that the shortening of the cycle was an indicator of entering that stage but, having spent the last couple of days browsing this site, I see that my knowledge of menopause is close to zero. It's shocking really how 'unspoken' all of this is in media/society at large. I've actually tried to bring it up with close female friends/colleagues my own age and they just don't want to discuss it. Weird!

A x

[clare663]

Annie66 I have said exactly the same thing. Only one of my 3 sisters discusses it with me and that is only because she had breast cancer which was oestrogen fed and had to have her ovaries out. She was given monthly medication to stop her producing oestrogen and had the op earlier this year but now she is experiencing the menopause. Everyone else treats it as a taboo subject but it effects almost all women in a negative way and we really should be given the knowledge to deal with it better. many of us have said that we thought we were going mad! I suffered with hot flushes from the age of 38 but never would I have thought it was the menopause, I had never heard of perimenopause!! Knowledge is power!!

[Ju Ju]

I started HRT very late the day at age 60. I had hot flushes, but not that severe. They were rarely the cause of my insomnia. I found it either difficult to get to sleep or wake up in the early hours of the morning. I had the odd good night of exhausted sleep, but with HRT it's the other way around. I get a reasonable nights sleep if not disturbed and the occasional night I hardly sleep. That and extreme exhaustion were the main reasons of going down the HRT route so late.

[Annie McCarthy]

@clare663 so true ... I always thought of myself as a reasonably well-informed person with a strong interest in "women's issues". But about menopause there's definitely some kind of taboo thing. And if you're having a hard time with it, it's definitely seems to be framed as your particular personal problem for not being able to 'cope'.  In my particular circumstances, what would work best would be for me to say to my employer, "look, I'm going to need to take 3-4 days a week off work every month, or have the flexibility to work at home on simple admin things during that period". Now, if I had small kids and/or elder care they would probably consider that kind of arrangement, but to say it's because of menopause?? No way! So I now have to consider medication in order to continue to appear like a 'normal' worker!! Something not right here ...

[Annie McCarthy]

@ ju ju Many thanks for the info. Good to hear that others also experience insomnia/disturbed sleep as a separate symptom, not especially related to hot flushes/night sweats. As you say, it's the exhaustion that builds up with chronic lack of decent sleep which is so debilitating. It'll be nteresting to hear what my doctor says about it all this afternoon. I've never actually met her before - I registered with this GP a year ago and haven't yet had cause to go there. Have no idea if she'll be knowledgeable and/or sympathetic ...

[Ju Ju]

My gynaecologist classified the exhaustion, that is not relieved by sleep, separate from the tiredness that results from insomnia. I had a lot of vague symptoms which I had just got on with, but hadn't associated with the menopause. HRT isn't magic. It doesn't solve everything, but it has given me back quality of life. I don't feel up to going back to work, but I can enjoy my retirement. CFS was being considered, which I took as 'we don't know what's wrong with you'!

[elsie001]

I'm 50 and my main peri symptoms were insomnia & very heavy periods.  Worst time of month was, like you, the 7 days leading up to a period.  Best time of month, sleep-wise, was 2-3 days into period.  My insomnia got worse and extended beyond those 7 days, possible due to stress at work.

I was eventually prescribed zopiclone 3.5mg tabs. These are great but you can only take them occasionally as they become less effective if taken too often.

On the advice of a gynea, I got a mirena coil fitted.  It has helped immensely with my insomnia...don't know how but it has!  My body must have been needing extra progesterone?

Please don't suffer if there's options out there for you - insomnia is truly horrible.  I don't need to take the tablets any more but have a few stashed away just in case!

[Annie McCarthy]

@ju ju Interesting to hear about the distinction your gynaecologist made between exhaustion and tiredness. I'm glad that HRT has given you some relief too. As you say, it may not solve everything but it does sound as though it's improved your quality of life and that has to be the most important thing. X

[Annie McCarthy]

@elsie001 Thanks for the info - very helpful! Good to know that my 7 day insomnia cycle is not some atypical thing I've developed ...

Doctor has given me a prescription for Zolpiden 5mg for occasional use with a follow up appointment in three months.

Very interesting to hear about how the mirena coil helped you with the sleep. Think I might prefer something like that rather than Z drugs, especially if this is going to be a long term problem.

Well, let's l see how I get on over the next 3 months or so!

[Hurdity]

Hi Hurdity,

Thanks for the link!

I'm affected in the 5-7 days leading up to the start of my period and the disturbed sleep stops the day bleeding starts. The rest of the time sleeping is fine and not related to feeling too hot. It appears to be an independent symptom for me.

Interesting, too, to note that my pattern seems to suggest I'm not quite at peri yet. I'd assumed that the shortening of the cycle was an indicator of entering that stage but, having spent the last couple of days browsing this site, I see that my knowledge of menopause is close to zero. It's shocking really how 'unspoken' all of this is in media/society at large. I've actually tried to bring it up with close female friends/colleagues my own age and they just don't want to discuss it. Weird!

A x

If it's pre-menstrual insomnia it sounds like a pms symptom for you - either due to the drop in oestrogen that occurs at this time, or due to sensitivity/intolerance to progesterone, or maybe the part of pmt - the classic progesterone withdrawal symptoms as it leaves your system when it is no longer needed. Maybe a bit of both?

I would have thought, as you a suggest a hormonal solution would be better if possible though, than a sleeping pill for a 5-7 day cyclical insomnia although I wouldn't have suggested a Mirena on its own unless you need it for contraception anyway? Progestogens have a sedative effect which is why some women report getting better sleep on the progesterone part of their HRT cycle for example.  However too much can have a depressive/fatigue-inducing effect on sensitive women too! It's not that your body needs it at this dose,

Anyway I hope the situation eases for you during this part of your cycle.

Hurdity x

[Annie McCarthy]

Many thanks Hurdity,

Yes, one thing I forgot to mention in my original post is that I have a family history of ovarian cancer: mother (diagnosis 68; survival 20 months) and maternal grandmother (diagnosis 82; survival 3 weeks). This came up in the meeting with my GP but she didn't say anything particular about it. Perhaps she's thinks it's preferable to delay hormonal treatment for a while ...

Anyway, I have about two weeks before I can expect the insomnia to kick in again. Then I'll give the sleeping pills a go and see how I get on :. In the meantime I can enjoy feeling like a (relatively) 'normal' person and carry on researching and reading up on all this.

There's so much information on this forum so thanks again to you and all the other contributors for your time and support. I'm sure all us newbies really appreciate it x